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Relaxin-2 mitigates the interaction between monocytes and endothelial cells by suppressing Egr-1 松弛素-2通过抑制Egr-1减轻单核细胞和内皮细胞之间的相互作用
IF 2.1 4区 医学 Q3 PHARMACOLOGY & PHARMACY Pub Date : 2025-04-07 DOI: 10.1111/fcp.70007
Jing Bai, Hui Zhou

Background

An overproduction of oxidized low-density lipoprotein (ox-LDL) can lead to vascular endothelial dysfunction. Relaxin-2, a novel peptide hormone, exhibits various biological functions within the cardiovascular system. However, the effects of Relaxin-2 in atherosclerosis (AS) are underreported.

Objectives

We aimed to investigate the regulatory role of Relaxin-2 in the endothelial function of human aortic endothelial cells (HAECs) upon ox-LDL stimulation.

Methods

HAECs were stimulated with ox-LDL (100 mg/l) and rhRelaxin-2 (25, 50 nM) for 24 h. Multiple techniques, including real-time PCR, Western blot analysis, ELISA, and Calcein AM staining, were applied.

Results

Treatment with human recombinant (rh) Relaxin-2 decreased lectin-like ox-LDL receptor 1 (LOX-1), a primary receptor for ox-LDL, in HAECs. rhRelaxin-2 also reduced the ox-LDL-induced expression of pro-inflammatory mediators such as interleukin 6 (IL-6), tumor necrosis factor-α (TNF-α), and monocyte chemoattractant protein-1 (MCP-1). Additionally, we observed increased expression of cyclooxygenase-2 (COX-2), prostaglandin E2 (PGE2), and high mobility group protein B1 (HMGB-1) in ox-LDL-challenged HAECs, which was diminished by rhRelaxin-2. Significantly, the heightened expression of intercellular cell adhesion molecule-1 (ICAM-1) and E-selectin in ox-LDL-stimulated HAECs was mitigated by rhRelaxin-2. Consequently, rhRelaxin-2 alleviated the attachment of THP-1 cells to HAECs in a dose-dependent manner. Mechanistically, we found that rhRelaxin-2 inhibited the expression of Egr-1, a central mediator of endothelial inflammation. Furthermore, overexpression of Egr-1 was found to negate the beneficial effects of rhRelaxin-2, suggesting that these effects are mediated by the suppression of Egr-1.

Conclusion

Our findings propose a novel therapeutic approach with rhRelaxin-2 for patients with atherosclerosis.

背景氧化低密度脂蛋白(ox-LDL)的过量产生可导致血管内皮功能障碍。松弛素-2是一种新型肽激素,在心血管系统中具有多种生物学功能。然而,松弛素-2在动脉粥样硬化(AS)中的作用被低估了。目的探讨松弛素-2在ox-LDL刺激下对人主动脉内皮细胞(HAECs)内皮功能的调节作用。方法用ox-LDL (100 mg/l)和rhRelaxin-2(25、50 nM)刺激HAECs 24h。使用多种技术,包括实时PCR, Western blot分析,ELISA和钙黄蛋白AM染色。结果人重组(rh)松弛素-2处理可降低haec中ox-LDL的主要受体凝集素样ox-LDL受体1 (LOX-1)。rhRelaxin-2还能降低ox- ldl诱导的促炎介质如白细胞介素6 (IL-6)、肿瘤坏死因子-α (TNF-α)和单核细胞趋化蛋白-1 (MCP-1)的表达。此外,我们观察到环氧化酶-2 (COX-2)、前列腺素E2 (PGE2)和高迁移率组蛋白B1 (HMGB-1)在ox- ldl挑战的haec中的表达增加,rhRelaxin-2降低了这种表达。值得注意的是,在ox- ldl刺激的haec中,细胞间细胞粘附分子-1 (ICAM-1)和e-选择素的表达升高被rhRelaxin-2缓解。因此,rhRelaxin-2以剂量依赖的方式减轻THP-1细胞对HAECs的附着。在机制上,我们发现rhRelaxin-2抑制Egr-1的表达,Egr-1是内皮炎症的中心介质。此外,研究发现Egr-1的过表达会抵消rhRelaxin-2的有益作用,这表明这些作用是通过抑制Egr-1介导的。结论本研究为动脉粥样硬化患者应用rhRelaxin-2提供了一种新的治疗方法。
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引用次数: 0
Second primary cancers and hormonal therapies for prostate cancer: A nested case–control study 第二原发性癌症和前列腺癌的激素治疗:一项嵌套病例对照研究
IF 2.1 4区 医学 Q3 PHARMACOLOGY & PHARMACY Pub Date : 2025-03-17 DOI: 10.1111/fcp.70004
Lucie-Marie Scailteux, Julien Bezin, Marion Gundelwein, Julien Edeline, Emmanuel Oger, Frédéric Balusson, Antoine Pariente

Introduction

(Pre-)clinical studies have not ruled out a potential risk of second primary cancer (SCP) under the effect of some new androgen receptor pathway inhibitors (ARPIs), especially enzalutamide (ENZ).

Methods

Using the French health reimbursement claims database (Système National des Données de Santé), we designed a case–control study nested in a 2013–2020 cohort of new users of androgen-deprivation therapy. The cases were patients with a first diagnosis of SPC, identified beyond 12 months following cohort entry and up to December 31st, 2021; up to 10 controls were matched per case, based on age and cohort entry date. The main analysis focused on patients who had not switched to a different ARPI. Applying a one-year lag time, we determined the most frequent and longest cumulative exposure patterns to abiraterone (ABI) or ENZ and estimated the odds ratios.

Results

The cohort comprised 147 092 patients, including 7928 cases and 78 554 controls eligible for analysis. The SPCs mainly involve the digestive organs, the urinary tract, or the lungs. Recent and short exposure to ENZ was associated with SPC: OR 1.7, 95% CI [1.2–2.4]. Recent one full year of exposure to ABI, as well as full-year plus part of the second year, was associated with SPC: OR 1.8 [1.2–2.7] and 2.3 [1.3–4.0], respectively.

Discussion/Conclusion

SPC cases were mainly observed among recently exposed patients, which could be linked to a detection bias. The insufficient number of patients exposed over many years means that no definitive conclusions can be drawn.

在一些新的雄激素受体途径抑制剂(arpi),特别是恩杂鲁胺(ENZ)的作用下,临床研究尚未排除第二原发性癌(SCP)的潜在风险。方法利用法国医疗报销报销数据库(systemme National des donnsamuise),在2013-2020年雄激素剥夺疗法新使用者队列中设计了一项病例对照研究。这些病例是首次诊断为SPC的患者,在队列进入后12个月内被发现,直到2021年12月31日;根据年龄和队列进入日期,每个病例最多匹配10个对照。主要分析集中在没有转换到不同ARPI的患者。应用一年的滞后时间,我们确定了阿比特龙(ABI)或ENZ最频繁和最长的累积暴露模式,并估计了优势比。结果该队列纳入147 092例患者,其中7928例患者和78 554例符合分析条件的对照组。SPCs主要累及消化器官、泌尿道或肺部。近期和短期暴露于ENZ与SPC相关:OR为1.7,95% CI[1.2-2.4]。最近一年的ABI暴露,以及全年加上第二年的部分时间,与SPC相关:OR分别为1.8[1.2-2.7]和2.3[1.3-4.0]。讨论/结论SPC病例主要发生在近期暴露的患者中,这可能与检测偏差有关。由于多年来接触的患者数量不足,因此无法得出明确的结论。
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引用次数: 0
Use and misuse of domperidone in patients living with Parkinson disease in France 多潘立酮在法国帕金森病患者中的使用和误用
IF 2.1 4区 医学 Q3 PHARMACOLOGY & PHARMACY Pub Date : 2025-03-10 DOI: 10.1111/fcp.70002
Edouard Januel, Jean Christophe Corvol, Philippe Remy, Wassilios G. Meissner, Claire Thiriez, Aymeric Lanore, Cecilia Bonnet, Jean-Philippe Azulay, Caroline Giordana, David Maltete, Solene Frismand, Christine Tranchant, Francois Sellal, Alain Jager, Matthieu Béreau, Giovanni Castelnovo, Anne Evelyne Vallet, Maryse Lapeyre-Mestre, Jean-Denis Turc, Olivier Rascol, Florence Tubach, DUMP study group

Context

After observing increased sudden death risk associated with domperidone use, the European Medicines Agency (EMA) imposed usage restrictions in 2014, limiting age (≤60 years), daily dose (≤30 mg/day), and duration (≤7 days). Nausea commonly occurs as an adverse effect of dopaminergic drugs in Parkinson's disease (PD) patients, with few alternative anti-emetic options. This study aimed to assess domperidone prescription patterns in French PD patients.

Methods

In this multicenter study, all consecutive PD patients from participating expert centers, hospitals, and private neurologists were included. We documented demographics, clinical data, comorbidities, domperidone use (indication, dose, and duration), and concurrent medications (related to PD or not). Domperidone misuse was assessed based on EMA guidelines.

Results

Between January and October 2021, 1579 patients from 16 centers (12 French PD expert centers, two general hospitals, and two private practice neurologists) were included. Among them, 109 (7%) received domperidone: 32 (29%) for nausea during apomorphine infusion, 71 (65%) for nausea during other dopaminergic therapies, and three (3%) for orthostatic hypotension. Domperidone misuse was found in 103 patients (95%): treatment duration >7 days (84%), age >60 years (79%), contraindicated drug interactions (6%), and contraindications due to cardiac comorbidity (5%). Only one patient exceeded the recommended dose (30 mg/day).

Conclusion

Domperidone is still prescribed in France for PD patients with dopaminergic-induced nausea, mostly disregarding EMA guidelines due to patient age (>60 years) and prolonged treatment (>7 days). Our study underscores the unmet need for managing gastrointestinal symptoms in PD, highlighting the inadequacy of EMA guidelines in this population.

在观察到与多潘立酮使用相关的猝死风险增加后,欧洲药品管理局(EMA)于2014年实施了使用限制,限制了年龄(≤60岁)、日剂量(≤30mg /天)和持续时间(≤7天)。在帕金森病(PD)患者中,恶心通常是多巴胺能药物的不良反应,很少有其他的止吐选择。本研究旨在评估法国PD患者的多潘立酮处方模式。方法在这项多中心研究中,包括所有来自专家中心、医院和私人神经科医生的连续PD患者。我们记录了人口统计学、临床数据、合并症、多潘立酮的使用(适应症、剂量和持续时间)以及同时使用的药物(与PD是否相关)。根据EMA指南评估了多潘立酮的滥用情况。结果2021年1月至10月,共纳入来自16个中心(12个法国PD专家中心、2个综合医院和2个私人执业神经科医生)的1579例患者。其中109例(7%)接受了多潘立酮治疗:32例(29%)因阿波吗啡输注期间恶心,71例(65%)因其他多巴胺能治疗期间恶心,3例(3%)因直立性低血压。103例(95%)患者发现多潘立酮滥用:治疗持续时间7天(84%),年龄60岁(79%),药物相互作用禁忌症(6%),心脏合并症禁忌症(5%)。只有一名患者超过了推荐剂量(30mg /天)。结论在法国,由于患者年龄(60岁)和治疗时间较长(7天),多潘立酮仍被用于PD患者多巴胺能引起的恶心,大多无视EMA指南。我们的研究强调了PD患者胃肠症状管理的未满足需求,强调了EMA指南在这一人群中的不足。
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引用次数: 0
Adrenaline enhances nociceptive and motor blockades by intrathecal carteolol and oxprenolol in rats 肾上腺素增强大鼠鞘内卡替洛尔和奥普萘洛尔造成的伤害性和运动性阻断
IF 2.1 4区 医学 Q3 PHARMACOLOGY & PHARMACY Pub Date : 2025-02-27 DOI: 10.1111/fcp.70003
Chong-Chi Chiu, Kuo-Sheng Liu, Chieh-Yu Liu, Ching-Hsia Hung, Yu-Wen Chen, Jhi-Joung Wang

Background

This study examined the effects of beta-blockers and the combination of carteolol/oxprenolol with epinephrine on spinal nociceptive and motor blockades and compared them with propranolol.

Methods

Nociceptive and motor blockades were assessed in rats after intrathecal injection of carteolol, oxprenolol, metoprolol, acebutolol, and sotalol. Carteolol and oxprenolol were used in combination with epinephrine for spinal nociceptive and motor blockades. Propranolol was used as a control.

Results

At the same dose of 0.6 μmol, carteolol and oxprenolol are more potent than propranolol, and the duration of action of carteolol and oxprenolol is longer than or the same as that of propranolol. At ED50 (50% effective dose), the potency rankings of drugs are carteolol > oxprenolol > propranolol (P > 0.01). At ED25, ED50, and ED75, the time to full recovery induced by carteolol was longer than that induced by oxprenolol or propranolol. When 1:40,000 epinephrine was added to beta-blocker (carteolol, oxprenolol, and propranolol) at ED50, spinal blockades and duration of action were increased compared to beta-blockers alone (P > 0.05).

Conclusion

Carteolol and oxprenolol are more effective than propranolol on spinal blockades, while other beta-blockers are relatively ineffective. Compared to propranolol, the duration of action of carteolol and oxprenolol is longer or the same. Epinephrine enhances spinal blockades of carteolol, oxprenolol, and propranolol, suggesting that alpha-adrenergic receptors may play an important role in enhancing the anti-nociceptive effects of beta-blockers.

本研究考察了-受体阻滞剂和卡替洛尔/奥普那洛尔联合肾上腺素对脊髓伤害性阻滞和运动阻滞的影响,并与心得安进行了比较。方法观察大鼠鞘内注射卡替洛尔、奥普萘洛尔、美托洛尔、乙酰布洛尔和索他洛尔后的伤害性和运动阻滞。卡替洛尔和奥普那洛尔联合肾上腺素用于脊髓伤害性和运动性阻滞。心得安作为对照。结果在相同剂量0.6 μmol时,卡替洛尔和奥普那洛尔的效价高于心得安,且卡替洛尔和奥普那洛尔的作用时间长于心得安或与心得安相同。在ED50(50%有效剂量)下,药物的效价排名依次为卡替洛尔;心得平比;心得安(P >;0.01)。在ED25、ED50和ED75时,卡替洛尔诱导的完全恢复时间比奥普萘洛尔和心得安诱导的时间长。当在ED50时将1:40万肾上腺素加入β受体阻滞剂(卡替洛尔、奥普萘洛尔和心得安)时,与单独使用β受体阻滞剂相比,脊髓阻滞和作用时间增加(P >;0.05)。结论卡替洛尔和奥普萘洛尔治疗脊髓阻滞较心得安有效,其他受体阻滞剂疗效较差。与心得安相比,卡替洛尔和奥普萘洛尔的作用时间更长或相同。肾上腺素增强卡替洛尔、奥普萘洛尔和心得安的脊髓阻滞,提示α -肾上腺素能受体可能在增强β受体阻滞剂的抗伤害作用中起重要作用。
{"title":"Adrenaline enhances nociceptive and motor blockades by intrathecal carteolol and oxprenolol in rats","authors":"Chong-Chi Chiu,&nbsp;Kuo-Sheng Liu,&nbsp;Chieh-Yu Liu,&nbsp;Ching-Hsia Hung,&nbsp;Yu-Wen Chen,&nbsp;Jhi-Joung Wang","doi":"10.1111/fcp.70003","DOIUrl":"https://doi.org/10.1111/fcp.70003","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This study examined the effects of beta-blockers and the combination of carteolol/oxprenolol with epinephrine on spinal nociceptive and motor blockades and compared them with propranolol.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Nociceptive and motor blockades were assessed in rats after intrathecal injection of carteolol, oxprenolol, metoprolol, acebutolol, and sotalol. Carteolol and oxprenolol were used in combination with epinephrine for spinal nociceptive and motor blockades. Propranolol was used as a control.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>At the same dose of 0.6 μmol, carteolol and oxprenolol are more potent than propranolol, and the duration of action of carteolol and oxprenolol is longer than or the same as that of propranolol. At ED<sub>50</sub> (50% effective dose), the potency rankings of drugs are carteolol &gt; oxprenolol &gt; propranolol (<i>P</i> &gt; 0.01). At ED<sub>25</sub>, ED<sub>50</sub>, and ED<sub>75</sub>, the time to full recovery induced by carteolol was longer than that induced by oxprenolol or propranolol. When 1:40,000 epinephrine was added to beta-blocker (carteolol, oxprenolol, and propranolol) at ED<sub>50</sub>, spinal blockades and duration of action were increased compared to beta-blockers alone (<i>P</i> &gt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Carteolol and oxprenolol are more effective than propranolol on spinal blockades, while other beta-blockers are relatively ineffective. Compared to propranolol, the duration of action of carteolol and oxprenolol is longer or the same. Epinephrine enhances spinal blockades of carteolol, oxprenolol, and propranolol, suggesting that alpha-adrenergic receptors may play an important role in enhancing the anti-nociceptive effects of beta-blockers.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12657,"journal":{"name":"Fundamental & Clinical Pharmacology","volume":"39 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143513849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Severe fluoropyrimidine toxicity in older adults with cancer with DPYD wild type 老年DPYD野生型癌症患者的严重氟嘧啶毒性
IF 2.1 4区 医学 Q3 PHARMACOLOGY & PHARMACY Pub Date : 2025-02-19 DOI: 10.1111/fcp.70000
Edwin Brokaar, Jonathan Knikman, Loes Visser, Frederiek van den Bos, Linda Henricks, Carin Lunenburg, Femke de Man, Hans Gelderblom, Jan Schellens, Ron Mathijssen, Henk-Jan Guchelaar, Johanneke Portielje, Annemieke Cats, Wout Postmus, Nienke de Glas

Background

Despite the implementation of DPYD genotype-guided dosing, approximately 1 in 3 patients receiving fluoropyrimidine-containing chemotherapy continues to experience severe toxicity. While clinical studies have demonstrated a favorable tolerance among highly selected fit older adults, real-world studies have shown an increased risk of toxicity.

Objective

To identify predictors of severe toxicity or treatment deintensification in older DPYD wild-type adults receiving fluoropyrimidine-containing chemotherapy.

Method

Patients wild type for four tested DPYD variants, aged ≥65 years, who participated in a prospective clinical trial investigating genotype-guided individualized fluoropyrimidine dosing, were eligible for the study. The association between tumor-, treatment-, and patient-related characteristics and the occurrence of severe toxicity (grade ≥3, CTCAE v5.0) was analyzed in univariate and multivariate logistic regression analyses. The same analyses were performed for a composite endpoint of severe toxicity or treatment deintensification (including dose reduction, cycle delay, or discontinuation).

Results

A total of 311 patients were included. Median age was 71.2 years and 58.8% were male. Grade ≥3 toxicity occurred in 23.2% of patients. In multivariate analysis, none of the characteristics studied were significantly associated with the occurrence of grade ≥3 toxicity. The composite endpoint occurred in 41.2% of patients and was associated with the use of full dose monotherapy in multivariate analysis.

Conclusion

Despite DPYD genotype-based dosing, grade ≥3 toxicity and treatment deintensification frequently occur in older patients treated with fluoropyrimidine chemotherapy. No patient-related variables were found to be associated with grade ≥3 toxicity, but treatment with dose-reduced monotherapy resulted in fewer treatment deintensification or severe toxicity events.

尽管实施了DPYD基因型指导给药,但大约三分之一接受含氟嘧啶化疗的患者继续经历严重的毒性。虽然临床研究表明,在精心挑选的适合的老年人中,耐受性良好,但现实世界的研究表明,毒性风险增加。目的探讨老年DPYD野生型成人接受含氟嘧啶化疗后出现严重毒性或治疗去强化的预测因素。方法:参加一项前瞻性临床试验研究基因型引导个体化氟嘧啶给药的四种DPYD变异野生型患者,年龄≥65岁,符合研究条件。采用单因素和多因素logistic回归分析分析肿瘤、治疗和患者相关特征与严重毒性(分级≥3级,CTCAE v5.0)发生之间的关系。对严重毒性或治疗去强化(包括剂量减少、周期延迟或停药)的复合终点进行了相同的分析。结果共纳入311例患者。中位年龄为71.2岁,58.8%为男性。23.2%的患者发生≥3级毒性。在多变量分析中,没有研究的特征与≥3级毒性的发生显著相关。在多变量分析中,41.2%的患者出现复合终点,并与使用全剂量单药治疗相关。结论尽管基于DPYD基因型给药,但在接受氟嘧啶化疗的老年患者中,仍经常发生≥3级毒性和治疗去强化。没有发现与≥3级毒性相关的患者相关变量,但采用减剂量单药治疗可减少治疗去强化或严重毒性事件。
{"title":"Severe fluoropyrimidine toxicity in older adults with cancer with DPYD wild type","authors":"Edwin Brokaar,&nbsp;Jonathan Knikman,&nbsp;Loes Visser,&nbsp;Frederiek van den Bos,&nbsp;Linda Henricks,&nbsp;Carin Lunenburg,&nbsp;Femke de Man,&nbsp;Hans Gelderblom,&nbsp;Jan Schellens,&nbsp;Ron Mathijssen,&nbsp;Henk-Jan Guchelaar,&nbsp;Johanneke Portielje,&nbsp;Annemieke Cats,&nbsp;Wout Postmus,&nbsp;Nienke de Glas","doi":"10.1111/fcp.70000","DOIUrl":"https://doi.org/10.1111/fcp.70000","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Despite the implementation of <i>DPYD</i> genotype-guided dosing, approximately 1 in 3 patients receiving fluoropyrimidine-containing chemotherapy continues to experience severe toxicity. While clinical studies have demonstrated a favorable tolerance among highly selected fit older adults, real-world studies have shown an increased risk of toxicity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To identify predictors of severe toxicity or treatment deintensification in older <i>DPYD</i> wild-type adults receiving fluoropyrimidine-containing chemotherapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Patients wild type for four tested <i>DPYD</i> variants, aged ≥65 years, who participated in a prospective clinical trial investigating genotype-guided individualized fluoropyrimidine dosing, were eligible for the study. The association between tumor-, treatment-, and patient-related characteristics and the occurrence of severe toxicity (grade ≥3, CTCAE v5.0) was analyzed in univariate and multivariate logistic regression analyses. The same analyses were performed for a composite endpoint of severe toxicity or treatment deintensification (including dose reduction, cycle delay, or discontinuation).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 311 patients were included. Median age was 71.2 years and 58.8% were male. Grade ≥3 toxicity occurred in 23.2% of patients. In multivariate analysis, none of the characteristics studied were significantly associated with the occurrence of grade ≥3 toxicity. The composite endpoint occurred in 41.2% of patients and was associated with the use of full dose monotherapy in multivariate analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Despite <i>DPYD</i> genotype-based dosing, grade ≥3 toxicity and treatment deintensification frequently occur in older patients treated with fluoropyrimidine chemotherapy. No patient-related variables were found to be associated with grade ≥3 toxicity, but treatment with dose-reduced monotherapy resulted in fewer treatment deintensification or severe toxicity events.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12657,"journal":{"name":"Fundamental & Clinical Pharmacology","volume":"39 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/fcp.70000","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143438949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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
Population pharmacokinetics of sivelestat in Chinese patients with severe pneumonia 中国重症肺炎患者西司他的人群药代动力学
IF 2.1 4区 医学 Q3 PHARMACOLOGY & PHARMACY Pub Date : 2025-02-09 DOI: 10.1111/fcp.70001
Xiaolin Zhang, Huiliang Hu, Ziran Li, Peng Zhang, Lei Pan, Lei Wang, Jingqin Mao, Feng Li, Lijun Zhang

Background

Sivelestat sodium, an inhibitor of neutrophil elastase, was broadly used in the treatment of severe pneumonia. However, the pharmacokinetic (PK) characteristics of sivelestat in patients with severe pneumonia were still unknown.

Objectives

To understand the PK characteristics of sivelestat for optimizing the dose in Chinese patients with severe pneumonia.

Methods

In this study, we enrolled 15 participants who received sivelestat 300–500 mg every 24 h with an infusion duration of 5 to 14 days. Blood samples of 48 were collected and separated for plasma drug concentration detection by an ultra-high-performance liquid chromatography/tandem mass spectrometry. A population pharmacokinetic (PPK) analysis of sivelestat was performed using a monolix2024R1 software. A Monte Carlo simulation was conducted to assess various dosing schedules and varying covariate levels within the desired therapeutic drug-monitoring concentration range (Cmin,ss 8–12 mg/L).

Results

The patients had a mean age of 65 years (range, 35–87), with 2 females and 13 males. These data were best described by a one-compartment model with proportional residual error. The apparent distribution volume and apparent clearance (CL) of sivelestat were 20.88 L and 1.79 L/h, respectively. The clearance of sivelestat is influenced by the covariate total bilirubin (TBIL), prompting a recommendation for a reduced dose in patients with elevated TBIL levels.

Conclusion

In conclusion, our findings suggest that the CL/F in patients with severe pneumonia is similar to that in healthy individuals. TBIL can affect CL/F of sivelestat; therefore, TBIL-based dosing regimens provide a practical strategy for achieving sivelestat therapy.

西维司他钠是一种中性粒细胞弹性酶抑制剂,被广泛用于治疗重症肺炎。然而,西维司他在重症肺炎患者中的药代动力学(PK)特征尚不清楚。目的了解西司他的药代动力学特征,为我国重症肺炎患者优化用药剂量提供依据。在这项研究中,我们招募了15名参与者,他们每24小时接受西司他300 - 500mg的输注,输注时间为5 - 14天。采用超高效液相色谱/串联质谱法对48例患者进行血药浓度检测。采用monolix2024R1软件对西司他进行群体药代动力学(PPK)分析。通过蒙特卡罗模拟来评估各种给药方案和所需治疗药物监测浓度范围(Cmin,ss 8 - 12mg /L)内不同的协变量水平。结果患者平均年龄65岁(35 ~ 87岁),其中女性2例,男性13例。这些数据最好的描述是一个具有比例残差的单室模型。西司他的表观分布体积和表观清除率分别为20.88 L和1.79 L/h。西司他的清除率受协变量总胆红素(TBIL)的影响,提示建议在TBIL水平升高的患者减少剂量。结论重症肺炎患者的CL/F与健康人群相似。TBIL可影响西维司他的CL/F;因此,基于tbil的给药方案为实现西司他治疗提供了一种实用的策略。
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引用次数: 0
Real-world interpatient variability in the pharmacokinetics of levetiracetam 真实世界中左乙拉西坦药代动力学的患者间变异性
IF 2.1 4区 医学 Q3 PHARMACOLOGY & PHARMACY Pub Date : 2025-02-05 DOI: 10.1111/fcp.13059
Alina Chykharivska, Leonid Kagan, Mary Wagner, Luigi Brunetti

Background

Levetiracetam (LEV) is an antiepileptic drug (AED) used to treat a variety of seizures in adult and pediatric populations. It is an ideal AED due to its favorable pharmacokinetic (PK) and pharmacodynamic profile and lack of interactions with other AEDs.

Methods

This retrospective cohort study was designed to identify covariates that affect LEV clearance and volume of distribution and to generate a population PK model. Adults with a seizure history receiving LEV during hospital admission with a minimum of one serum LEV concentration available were included in the study. Population PK modeling and covariate testing was performed with MONOLIX Suite 2020R1 (Lixoft, France).

Results

A total of 162 serum concentrations were collected from 143 patients. Age, sex, body weight descriptors, serum creatinine, creatinine clearance (CrCL), serum albumin, liver enzymes, and total bilirubin were evaluated. Body surface area (BSA) was a significant covariate for the apparent volume of distribution (V/F). The exclusion of BSA as a covariate of V/F increased the objective function value (OFV) 5.6. CrCL was a significant covariate of apparent plasma clearance (CL/F). The exclusion of CrCL increased the OFV by 18.16 and significantly increased the root square error (RSE) % of the between-subject variabilities of the parameters.

Conclusion

LEV clearance is an effective predictor of serum concentration. CrCL was a significant covariate influencing LEV clearance, and BSA was found to influence the volume of distribution. Further studies are needed to determine the effect of body weight descriptors on LEV clearance and, ultimately, outcomes.

背景左乙拉西坦(LEV)是一种抗癫痫药物(AED),用于治疗成人和儿童人群的各种癫痫发作。由于其良好的药代动力学(PK)和药效学特征以及与其他AED缺乏相互作用,它是一种理想的AED。方法本回顾性队列研究旨在确定影响LEV清除率和分布体积的协变量,并建立种群PK模型。在住院期间有癫痫发作史且至少有一种血清LEV浓度可用的成人纳入研究。使用MONOLIX Suite 2020R1 (Lixoft, France)进行种群PK建模和协变量检验。结果143例患者共采集162项血清浓度。评估年龄、性别、体重描述符、血清肌酐、肌酐清除率(CrCL)、血清白蛋白、肝酶和总胆红素。体表面积(BSA)是表观分布体积(V/F)的显著协变量。排除BSA作为V/F的协变量增加了目标函数值(OFV) 5.6。CrCL是表观血浆清除率(CL/F)的显著协变量。排除CrCL后,OFV增加了18.16%,参数的受试者间变异的根方误差(RSE) %显著增加。结论LEV清除率是血药浓度的有效预测因子。CrCL是影响LEV清除率的显著协变量,BSA影响分布体积。需要进一步的研究来确定体重描述符对LEV清除率和最终结果的影响。
{"title":"Real-world interpatient variability in the pharmacokinetics of levetiracetam","authors":"Alina Chykharivska,&nbsp;Leonid Kagan,&nbsp;Mary Wagner,&nbsp;Luigi Brunetti","doi":"10.1111/fcp.13059","DOIUrl":"https://doi.org/10.1111/fcp.13059","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Levetiracetam (LEV) is an antiepileptic drug (AED) used to treat a variety of seizures in adult and pediatric populations. It is an ideal AED due to its favorable pharmacokinetic (PK) and pharmacodynamic profile and lack of interactions with other AEDs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective cohort study was designed to identify covariates that affect LEV clearance and volume of distribution and to generate a population PK model. Adults with a seizure history receiving LEV during hospital admission with a minimum of one serum LEV concentration available were included in the study. Population PK modeling and covariate testing was performed with MONOLIX Suite 2020R1 (Lixoft, France).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 162 serum concentrations were collected from 143 patients. Age, sex, body weight descriptors, serum creatinine, creatinine clearance (CrCL), serum albumin, liver enzymes, and total bilirubin were evaluated. Body surface area (BSA) was a significant covariate for the apparent volume of distribution (V/F). The exclusion of BSA as a covariate of V/F increased the objective function value (OFV) 5.6. CrCL was a significant covariate of apparent plasma clearance (CL/F). The exclusion of CrCL increased the OFV by 18.16 and significantly increased the root square error (RSE) % of the between-subject variabilities of the parameters.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>LEV clearance is an effective predictor of serum concentration. CrCL was a significant covariate influencing LEV clearance, and BSA was found to influence the volume of distribution. Further studies are needed to determine the effect of body weight descriptors on LEV clearance and, ultimately, outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12657,"journal":{"name":"Fundamental & Clinical Pharmacology","volume":"39 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/fcp.13059","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143248512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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
Detection of ketamine in the oral fluid of drivers in northeastern France during the years 2020–2023 2020-2023年法国东北部司机口服液中氯胺酮的检测
IF 2.1 4区 医学 Q3 PHARMACOLOGY & PHARMACY Pub Date : 2025-02-05 DOI: 10.1111/fcp.13060
Laïyna Lilo Aouichi, Elise Pape, Jean-Yves Jouzeau, Valérie Gibaja, Eyrian Aubin-Beale, Allan Kolodziej, Catherine Feliu, Elodie Marchand, Nicolas Gambier, Julien Scala-Bertola

Background and Objectives

Ketamine is a psychoactive substance used for its stimulant and hallucinogenic properties. As the use of ketamine may lead to impaired driving, we aimed to assess the occurrence of ketamine in the driving population tested positive for narcotics in roadside checks using oral fluid analysis. Oral fluid concentrations of ketamine and norketamine were examined to determine the percentage of drivers susceptible to ketamine impairment.

Methods

A retrospective descriptive study was conducted over a 32-month period in 2020–2023 on drivers who tested positive to the DrugWipe®5S saliva test in our region of northeastern France. Mass spectrometry was used to confirm the DrugWipe®5S result and to determine oral fluid concentrations of ketamine and norketamine.

Results

During the entire study period, 3364 drivers were tested positive at the roadside using the DrugWipe®5S rapid test. After mass spectrometry, 3043 drivers were finally confirmed as true positives. Ketamine was detected in 88 drivers who were 80.7% male, 95.4% polydrug users and were 27.5 ± 7.1 years old, representing 2.6% of the total driver population. Ketamine concentrations were 821 ± 2264 and 7.8 ± 12.3 ng/mL in the presence and absence of norketamine, respectively. Finally, 26.1% of the ketamine-positive drivers had a ketamine oral fluid concentration potentially associated with impaired driving.

Conclusion

Ketamine and norketamine should be added to the list of drugs to be tested in oral fluid for driving under the influence of drugs. Besides blood or urine, oral fluid could be an interesting alternative biological matrix for addiction medicine.

背景和目的氯胺酮是一种精神活性物质,因其兴奋和致幻特性而被使用。由于使用氯胺酮可能导致驾驶受损,我们的目的是评估在路边检查中检测出毒品阳性的驾驶人群中氯胺酮的发生率。检测了氯胺酮和去氯胺酮的口服液浓度,以确定易受氯胺酮损害的驾驶员的百分比。方法在2020-2023年的32个月期间,对法国东北部地区DrugWipe®5S唾液检测阳性的驾驶员进行回顾性描述性研究。质谱法用于确认DrugWipe®5S检测结果,并测定口服液中氯胺酮和去甲氯胺酮的浓度。结果在整个研究期间,3364名驾驶员在路边使用DrugWipe®5S快速检测呈阳性。经质谱分析,3043名司机最终被确认为真阳性。88名司机检出氯胺酮,其中男性占80.7%,多药使用者占95.4%,年龄为27.5±7.1岁,占司机总人数的2.6%。氯胺酮浓度分别为821±2264和7.8±12.3 ng/mL。最后,26.1%的氯胺酮阳性司机有可能与驾驶障碍相关的氯胺酮口服液浓度。结论应将氯胺酮和诺氯胺酮列入药物作用下驾驶口服液的检测药物清单。除了血液或尿液,口服液可能是一种有趣的替代成瘾药物的生物基质。
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引用次数: 0
RETRACTION: Mineralocorticoid receptor antagonist-mediated cognitive improvement in a mouse model of Alzheimer's type: possible involvement of BDNF-H2S-Nrf2 signaling 引用本文:陈丽丽,石仁,佘霞,顾春春,张丽丽,李仁仁,“矿物皮质激素受体拮抗剂介导的阿尔茨海默氏型小鼠认知改善:BDNF-H2S-Nrf2信号通路的可能参与,”基础与临床药理学,34,no。6 (2020): 697-707, 10.1111/fcp.12576。
IF 2.1 4区 医学 Q3 PHARMACOLOGY & PHARMACY Pub Date : 2025-01-23 DOI: 10.1111/fcp.13051
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引用次数: 0
Repurposing bosentan as an anticancer agent: EGFR/ERK/c-Jun modulation inhibits NSCLC tumor growth 重新利用波生坦作为抗癌药物:EGFR/ERK/c-Jun调节抑制NSCLC肿瘤生长
IF 2.1 4区 医学 Q3 PHARMACOLOGY & PHARMACY Pub Date : 2025-01-12 DOI: 10.1111/fcp.13052
Marwa M. Khalaf, Marina N. Malak, Tariq G. Alsahli, Musaad Althobaiti, Mohamed A. Hamzawy, Maha M. Abdel-Fattah

Drug repurposing of well-established drugs to be targeted against lung cancer has been a promising strategy. Bosentan is an endothelin 1 (ET-1) blocker widely used in pulmonary hypertension. The current experiment intends to inspect the anticancer and antiangiogenic mechanism of bosentan targeting epidermal growth factor receptor (EGFR) /extra-cellular Signal Regulated Kinase (ERK) /c-Jun/vascular endothelial growth factor (VEGF) carcinogenic pathway. BALB/c mice were randomized into four groups, the first received the vehicle, the second received 100 mg/kg oral bosentan alone, the third has non-small cell lung cancer (NSCLC) induced by two doses of 1.5 g/kg urethane i.p. and finally the fourth has NSCLC received bosentan. To determine the anti-proliferative impact of bosentan, cytokeratin 19 fragments (CYFRA 21-1) level was assessed, and Ki-67 positive cells were counted by immunohistochemical (IHC). Molecular expression of EGFR via IHC, relative expression of p-ERK1/2 and p-c-Jun via western blotting and caspase 3, Bcl-2 Associated X-protein (BAX)/B-cell lymphoma 2 (Bcl-2) ratio and VEGF via ELISA were quantified. Bosentan showed pronounced improvement in lung index and histopathological examinations. Bosentan exerted a noticeable arrest of lung cancer growth indicated by the attenuation of CYFRA 21-1 and Ki-67 positive cell counts besides the boost of BAX/Bcl-2 ratio and caspase 3. Bosentan induced a remarkable decline of EGFR, T-ERK1/2/p-ERK1/2, T-c-Jun/p-c-Jun, and VEGF. Bosentan induced cytotoxic and anti-angiogenic impact through regulation of EGFR/ERK/c-Jun/VEGF axis suggesting its potential therapeutic impact against lung cancer.

将成熟药物重新用于肺癌靶向治疗是一种前景广阔的策略。波生坦是一种内皮素1(ET-1)阻断剂,广泛用于肺动脉高压。本实验旨在研究波生坦靶向表皮生长因子受体(EGFR)/细胞外信号调节激酶(ERK)/c-Jun/血管内皮生长因子(VEGF)致癌通路的抗癌和抗血管生成机制。将 BALB/c 小鼠随机分为四组,第一组接受载体,第二组单独口服 100 毫克/千克波生坦,第三组接受两剂 1.5 克/千克尿烷诱导的非小细胞肺癌(NSCLC),最后第四组接受波生坦。为确定波生坦的抗增殖作用,评估了细胞角蛋白19片段(CYFRA 21-1)的水平,并通过免疫组化(IHC)计数了Ki-67阳性细胞。通过 IHC 测定表皮生长因子受体(EGFR)的分子表达,通过 Western 印迹测定 p-ERK1/2 和 p-c-Jun 的相对表达,通过 ELISA 测定 Caspase 3、Bcl-2 相关 X 蛋白(BAX)/B 细胞淋巴瘤 2(Bcl-2)比值和血管内皮生长因子(VEGF)。波生坦明显改善了肺指数和组织病理学检查。除了提高 BAX/Bcl-2 比率和 caspase 3 外,波生坦还能减少 CYFRA 21-1 和 Ki-67 阳性细胞数,从而明显抑制肺癌的生长。波生坦诱导表皮生长因子受体、T-ERK1/2/p-ERK1/2、T-c-Jun/p-c-Jun 和血管内皮生长因子显著下降。波生坦通过调节表皮生长因子受体/ERK/c-Jun/VEGF轴诱导细胞毒性和抗血管生成影响,这表明它对肺癌具有潜在的治疗作用。
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引用次数: 0
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Fundamental & Clinical Pharmacology
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