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Impacts of genetic polymorphisms and cancer cachexia on naldemedine pharmacokinetics and bowel movements in patients receiving opioid analgesics 基因多态性和癌症恶病质对接受阿片类镇痛药的患者中纳尔地定药代动力学和肠蠕动的影响。
IF 2.9 4区 医学 Q2 Medicine Pub Date : 2024-01-08 DOI: 10.1111/fcp.12976
Emi Nakatsugawa, Takafumi Naito, Kaito Shibata, Ryo Kitajima, Junichi Kawakami

Background/Objectives

Clinical responses to naldemedine vary between individuals with advanced cancer. This is a prospective, single-center, observational study aimed to evaluate the influence of genetic polymorphisms and cachexia status on plasma naldemedine and clinical responses.

Methods

Forty-eight patients being treated with naldemedine for opioid-induced constipation under treatment of cancer pain were enrolled. Plasma naldemedine concentrations were determined on the fourth day or later after administration of naldemedine, and the associations with genotypes, cachexia status, and clinical responses were assessed.

Results

Cancer patients exhibited a large variation in the plasma naldemedine concentrations, and it was correlated with serum total protein level. Patients who were homozygous CYP3A5*3 had a higher plasma concentration of naldemedine than those with the *1 allele. ABCB1 genotypes tested in this study were not associated with plasma naldemedine. A negative correlation was observed between the plasma naldemedine concentration and 4β-hydroxycholesterol level. The plasma naldemedine concentration was lower in patients with refractory cachexia than in those with precachexia and cachexia. While serum levels of interleukin-6 (IL-6) and acute-phase proteins were higher in patients with refractory cachexia, they were not associated with plasma naldemedine. A higher plasma concentration of naldemedine, CYP3A5*3/*3, and an earlier naldemedine administration after starting opioid analgesics were related to improvement of bowel movements.

Conclusion

Plasma naldemedine increased under deficient activity of CYP3A5 in cancer patients. Cachectic patients with a higher serum IL-6 had a lower plasma naldemedine. Plasma naldemedine, related to CYP3A5 genotype, and the initiation timing of naldemedine were associated with improved bowel movements.

背景/目的:晚期癌症患者对纳尔灭定的临床反应因人而异。这是一项前瞻性、单中心、观察性研究,旨在评估基因多态性和恶病质状态对血浆纳尔地定和临床反应的影响:方法:研究纳入了48名正在接受纳尔地定治疗的患者,这些患者在治疗癌痛的过程中因阿片类药物引起便秘。结果:癌症患者的基因型、恶病质状态和临床反应有很大差异:结果:癌症患者血浆中纳尔灭定的浓度变化很大,且与血清总蛋白水平相关。CYP3A5*3等位基因患者的血浆中纳尔灭定浓度高于*1等位基因患者。本研究中检测的 ABCB1 基因型与血浆中纳尔灭定的浓度无关。血浆中纳尔灭定的浓度与 4β- 羟基胆固醇的水平呈负相关。难治性恶病质患者的血浆纳尔德美汀浓度低于先兆性恶病质和恶病质患者。虽然难治性恶病质患者血清中的白细胞介素-6(IL-6)和急性期蛋白水平较高,但它们与血浆中的萘美汀无关。结论:血浆中纳尔灭定、CYP3A5*3/*3的浓度较高,以及在开始使用阿片类镇痛药后较早服用纳尔灭定与肠蠕动的改善有关:结论:在癌症患者CYP3A5活性不足的情况下,血浆中纳尔灭定的含量会增加。血清IL-6较高的癌症患者血浆中纳尔灭定的含量较低。与CYP3A5基因型有关的血浆纳尔地美定和纳尔地美定的开始使用时间与肠蠕动的改善有关。
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引用次数: 0
The comparison of the antidiabetic effects of exenatide, empagliflozin, quercetin, and combination of the drugs in type 2 diabetic rats 比较艾塞那肽、恩格列净、槲皮素以及这几种药物的复方制剂对 2 型糖尿病大鼠的抗糖尿病作用。
IF 2.9 4区 医学 Q2 Medicine Pub Date : 2023-12-27 DOI: 10.1111/fcp.12975
Yasemin Korkmaz, Burak Dik

Background

Type 2 diabetes, a metabolic disease that involves extended treatment, is rapidly increasing in humans and animals worldwide.

Objectives

This study aimed to compare monotherapy and combined therapy of exenatide, empagliflozin, and quercetin in 67 Wistar Albino male rats.

Methods

The animals were divided into the following seven groups: healthy control, diabetes control, diabetes + sham, diabetes + exenatide (10 μg/kg), diabetes + empagliflozin (50 mg/kg), diabetes + quercetin (50 mg/kg), and diabetes + combination treatment. The treatments were continued for 8 weeks.

Results

At the end of the experiment, glucose and HbA1c levels decreased with all monotherapy treatments and the combination treatments, while insulin levels increased with exenatide and combined treatments. Adiponectin levels increased with empagliflozin, quercetin, and combined treatments, while leptin levels decreased only with combined treatments. All monotherapies caused an increase in total antioxidant levels. Exenatide and quercetin treatments reduced low-density lipoprotein (LDL) levels; therewithal, exenatide and combined treatments increased high-density lipoprotein (HDL) levels. Triglyceride levels decreased in all treatment groups. The homeostatic model assessment for insulin resistance (HOMA-IR) level decreased with the combined treatment; on the contrary, the homeostatic model assessment for β-cell activity (HOMA-β) level increased with empagliflozin, exenatide, and combined treatments.

Conclusion

In conclusion, the antidiabetic effects of exenatide were more pronounced than empagliflozin and quercetin, however, the combined treatment had better antidiabetic and antihyperlipidemic effects than monotherapies. Quercetin could be a supportive or food supplement antidiabetic agent. The exenatide treatment can be recommended for monotherapy in type 2 patients, and the combination of empagliflozin, exenatide, and quercetin may be effective in diabetic patients who need combined therapy.

背景:2型糖尿病是一种需要长期治疗的代谢性疾病,在全球人类和动物中的发病率迅速上升:本研究旨在比较艾塞那肽、恩格列净和槲皮素对67只Wistar Albino雄性大鼠的单药治疗和联合治疗:动物分为以下七组:健康对照组、糖尿病对照组、糖尿病+假治疗组、糖尿病+艾塞那肽(10 μg/kg)组、糖尿病+恩格列净(50 mg/kg)组、糖尿病+槲皮素(50 mg/kg)组、糖尿病+联合治疗组。治疗持续8周:实验结束时,所有单一疗法和联合疗法的血糖和 HbA1c 水平都有所下降,而艾塞那肽和联合疗法的胰岛素水平有所上升。安帕格列净、槲皮素和联合疗法可提高脂联素水平,而只有联合疗法可降低瘦素水平。所有单一疗法都能提高总抗氧化剂水平。艾塞那肽和槲皮素疗法降低了低密度脂蛋白(LDL)水平;与此同时,艾塞那肽和联合疗法提高了高密度脂蛋白(HDL)水平。所有治疗组的甘油三酯水平均有所下降。胰岛素抵抗的稳态模型评估(HOMA-IR)水平随着联合治疗而降低;相反,β细胞活性的稳态模型评估(HOMA-β)水平随着恩格列净、艾塞那肽和联合治疗而升高:总之,艾塞那肽的抗糖尿病效果比恩格列净和槲皮素更明显,但联合治疗的抗糖尿病和降血脂效果比单一疗法更好。槲皮素可作为一种辅助或食物补充抗糖尿病药物。对于 2 型糖尿病患者,可推荐使用艾塞那肽单药治疗,而对于需要联合治疗的糖尿病患者,联合使用恩格列净、艾塞那肽和槲皮素可能会有效。
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引用次数: 0
Antimalarial activities of benzothiazole analogs: A systematic review 苯并噻唑类似物的抗疟活性:系统综述。
IF 2.9 4区 医学 Q2 Medicine Pub Date : 2023-12-26 DOI: 10.1111/fcp.12974
Linh Tran, Vo Linh Tu, Mohammad Najm Dadam, Jeza Muhamad Abdul Aziz, Tran Le Dinh Duy, Hajer Hatim Hassan Ahmed, Patrick Amanning Kwaah, Hoang Nghia Quoc, Truong Van Dat, Satoshi Mizuta, Kenji Hirayama, Nguyen Tien Huy

Background

Benzothiazole derivatives have been reported to possess a wide range of biological activities, including antimalarial activity. This systematic review aims to summarize and evaluate the antimalarial activities of benzothiazole analogs.

Methods

We conducted an electronic search using nine databases in October 2017 and subsequently updated in September 2022. We included all original in vitro and in vivo studies that documented the antimalarial activities of compounds containing benzothiazole analogs with no restriction. The risk of bias of each included study was assessed by ToxRTool.

Results

Twenty-eight articles were included in our study, which are in vitro, in vivo, or both. Of these, 232 substances were identified to have potent antiplasmodial activity against various strains of the malaria parasite. Benzothiazole analogs show different antimalarial mechanisms, including inhibition of Plasmodium falciparum enzymes in in vitro studies and inhibition of blood parasites in in vivo studies.

Conclusions

Benzothiazole derivatives are promising substances for treating malaria. The structure–activity relationship studies suggest that the substitution pattern of the benzothiazole scaffold plays a crucial role in determining the antimalarial activity of the analog.

背景:据报道,苯并噻唑衍生物具有广泛的生物活性,包括抗疟活性。本系统综述旨在总结和评估苯并噻唑类似物的抗疟活性:我们于 2017 年 10 月使用九个数据库进行了电子检索,随后于 2022 年 9 月进行了更新。我们不受限制地纳入了所有记录了含有苯并噻唑类似物的化合物抗疟活性的体外和体内原始研究。我们使用 ToxRTool 对每项纳入研究的偏倚风险进行了评估:我们的研究共纳入了 28 篇文章,这些文章或为体外研究,或为体内研究,或两者兼而有之。其中有 232 种物质被鉴定出对各种疟原虫菌株具有强效抗疟活性。苯并噻唑类似物显示出不同的抗疟机制,包括在体外研究中抑制恶性疟原虫酶,在体内研究中抑制血液中的寄生虫:结论:苯并噻唑衍生物是治疗疟疾的有效物质。结构-活性关系研究表明,苯并噻唑支架的取代模式在决定类似物的抗疟活性方面起着至关重要的作用。
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引用次数: 0
Lacosamide use during breastfeeding: A case report and a literature review 哺乳期使用拉科酰胺:病例报告和文献综述。
IF 2.9 4区 医学 Q2 Medicine Pub Date : 2023-12-06 DOI: 10.1111/fcp.12971
Morgan Cercos, Ines Seqat, Anthony Facile, Thierry Vial, Marine Auffret

Lacosamide, a voltage-gated sodium channel inhibitor, is an anti-seizure medication (ASM) from the age of 4. We report on the case of a woman treated with lacosamide for pharmacoresistant epilepsy who breastfed her infant for more than 6 months after birth. The infant's blood concentrations of lacosamide were 2.4 mg/L on Day 1 and less than 1 mg/L on Day 10 (reference values are 1–10 mg/L). No adverse drug reactions (ADRs) were reported for the infant. Eight cases of breastfeeding by mothers receiving lacosamide are described in the literature. These data confirm that a significant amount of lacosamide seems to pass into breast milk, with a relative infant dose (RID) above 20% in two cases but a low RID (1.8%) in another case. Nevertheless, blood tests, performed in two breastfed infants, revealed low concentrations of lacosamide. No ADRs were reported in eight of the breastfed infants; however, one infant, whose mother was also treated with levetiracetam, presented poor feeding and sleepiness at Day 15 of life. Given the well-known benefits of breastfeeding for both mothers and their infants, as well as the above reassuring data, breastfeeding of healthy full-term infants could be possible for mothers on lacosamide monotherapy. Nonetheless, relatives should be warned that data concerning the safety of lacosamide during breastfeeding are scarce and that long-term neurodevelopment outcomes in breastfed children are unknown. Clinical monitoring of breastfed infants for drowsiness, adequate weight gain, or cutaneous rash is recommended. Additionally, the infants' serum levels should be measured in case of an unexplained adverse reaction.

拉科酰胺是一种电压门控钠离子通道抑制剂,是一种从 4 岁起就开始使用的抗癫痫药物(ASM)。我们报告了这样一例病例:一名妇女在使用拉科酰胺治疗药物耐药性癫痫后,在婴儿出生后对其进行了 6 个多月的母乳喂养。婴儿第 1 天的拉科酰胺血药浓度为 2.4 毫克/升,第 10 天低于 1 毫克/升(参考值为 1-10 毫克/升)。该婴儿未出现药物不良反应(ADR)。文献中描述了八例接受拉科沙胺治疗的母亲进行母乳喂养的病例。这些数据证实,大量拉科酰胺似乎会进入母乳,其中两例的相对婴儿剂量(RID)超过 20%,但另一例的相对婴儿剂量(RID)较低(1.8%)。不过,对两名母乳喂养的婴儿进行的血液检测显示,拉科酰胺的浓度较低。八名母乳喂养的婴儿均未出现不良反应;但有一名婴儿(其母亲也服用了左乙拉西坦)在出生后第 15 天出现喂养不畅和嗜睡的症状。鉴于母乳喂养对母婴的益处众所周知,以及上述令人欣慰的数据,接受拉氯沙胺单药治疗的母亲可以对健康的足月婴儿进行母乳喂养。然而,需要提醒亲属的是,有关拉科酰胺在母乳喂养期间的安全性的数据很少,而且母乳喂养婴儿的长期神经发育结果尚不清楚。建议对母乳喂养的婴儿进行临床监测,看其是否嗜睡、体重是否有足够的增长或是否出现皮疹。此外,如果出现不明原因的不良反应,应测量婴儿的血清水平。
{"title":"Lacosamide use during breastfeeding: A case report and a literature review","authors":"Morgan Cercos,&nbsp;Ines Seqat,&nbsp;Anthony Facile,&nbsp;Thierry Vial,&nbsp;Marine Auffret","doi":"10.1111/fcp.12971","DOIUrl":"10.1111/fcp.12971","url":null,"abstract":"<p>Lacosamide, a voltage-gated sodium channel inhibitor, is an anti-seizure medication (ASM) from the age of 4. We report on the case of a woman treated with lacosamide for pharmacoresistant epilepsy who breastfed her infant for more than 6 months after birth. The infant's blood concentrations of lacosamide were 2.4 mg/L on Day 1 and less than 1 mg/L on Day 10 (reference values are 1–10 mg/L). No adverse drug reactions (ADRs) were reported for the infant. Eight cases of breastfeeding by mothers receiving lacosamide are described in the literature. These data confirm that a significant amount of lacosamide seems to pass into breast milk, with a relative infant dose (RID) above 20% in two cases but a low RID (1.8%) in another case. Nevertheless, blood tests, performed in two breastfed infants, revealed low concentrations of lacosamide. No ADRs were reported in eight of the breastfed infants; however, one infant, whose mother was also treated with levetiracetam, presented poor feeding and sleepiness at Day 15 of life. Given the well-known benefits of breastfeeding for both mothers and their infants, as well as the above reassuring data, breastfeeding of healthy full-term infants could be possible for mothers on lacosamide monotherapy. Nonetheless, relatives should be warned that data concerning the safety of lacosamide during breastfeeding are scarce and that long-term neurodevelopment outcomes in breastfed children are unknown. Clinical monitoring of breastfed infants for drowsiness, adequate weight gain, or cutaneous rash is recommended. Additionally, the infants' serum levels should be measured in case of an unexplained adverse reaction.</p>","PeriodicalId":12657,"journal":{"name":"Fundamental & Clinical Pharmacology","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2023-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138487292","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
Effect of Bacille-Calmette-Guerin vaccine against rotenone-induced Parkinson's disease: Role of neuroinflammation and neurotransmitters 卡介苗对鱼藤酮诱导的帕金森病的作用:神经炎症和神经递质的作用。
IF 2.9 4区 医学 Q2 Medicine Pub Date : 2023-12-02 DOI: 10.1111/fcp.12968
Narhari Gangaram Yedke, Divya Soni, Puneet Kumar

Background

Parkinson's disease (PD) is an extrapyramidal movement disorder associated with a hypokinetic condition generated by impairment in dopaminergic neuronal viability in the nigrostriatal region of the brain. Current medications can only provide symptomatic management; to date, no permanent cure is available. To compensate for this lacuna, researchers are gaining interest in antigen-based therapy, and Bacille-Calmette-Guerin (BCG) is one of the vaccines with a high safety margin that acts by stimulating immunoreactive T-cells in the CNS and reducing expression of pro-inflammatory cytokines including interleukin (IL)-1β and tumor necrotic factor (TNF-α) to produce neuroprotection. A previous study reported that BCG exerts a neuroprotective effect against several neurodegenerative disorders, such as Alzheimer's disease.

Objective

The objective of this study is to explore the neuroprotective effect of the BCG vaccine against the rotenone model of PD.

Methods

Rotenone (1.5 mg/kg, s.c) for 28 days, and BCG vaccine (2 × 107 cfu, i.p) single dose was injected to rats, and behavioral assessments were performed on the 21st and 28th day. On the 29th day, rats were sacrificed, and brains were isolated for biochemical and neurochemical estimation.

Results

BCG vaccine significantly restored rotenone-induced motor deficits (open field test, narrow beam walk, and rotarod), biochemical levels (GSH, SOD, catalase, MDA, and nitrite), neurotransmitters (dopamine, 5-hydroxy tryptamine, norepinephrine, 3,4-dihydroxyphenylacetic acid, hemovanillic acid, and 5-hydroxy indoleacetic acid), and levels of inflammatory cytokines (IL-1β and TNF-α) in the striatum. It also prevents histopathological changes by reducing eosinophilic lesions in the striatum.

Conclusion

From the results, we conclude that BCG vaccine showed neuroprotection through antioxidant and anti-inflammatory effect. Thus, in the future, it can be used as a neuroprotective agent for other neurological disorders, including PD.

背景:帕金森病(PD)是一种锥体外系运动障碍,与大脑黑质纹状体区域多巴胺能神经元活力受损引起的运动障碍相关。目前的药物只能提供症状管理;到目前为止,还没有永久性的治疗方法。为了弥补这一空白,研究人员对基于抗原的治疗越来越感兴趣,卡介苗(BCG)是一种具有高安全性的疫苗,通过刺激中枢神经系统中的免疫反应性t细胞,减少包括白细胞介素(IL)-1β和肿瘤坏死因子(TNF-α)在内的促炎细胞因子的表达来产生神经保护作用。先前的一项研究报告称,卡介苗对几种神经退行性疾病(如阿尔茨海默病)具有神经保护作用。目的:探讨卡介苗对鱼藤酮模型帕金森病的神经保护作用。方法:大鼠连续注射鱼藤酮(1.5 mg/kg, s.c)和卡介苗(2 × 107 cfu, i.p)单剂量,分别于第21、28天进行行为学评价。第29天处死大鼠,分离脑进行生化和神经化学评价。结果:卡介苗可显著恢复鱼藤酮诱导的运动障碍(开场试验、窄梁行走和轮虫行走)、纹状体生化水平(GSH、SOD、过氧化氢酶、MDA和亚硝酸盐)、神经递质(多巴胺、5-羟基色胺、去甲肾上腺素、3,4-二羟基苯乙酸、血香草酸和5-羟基吲哚乙酸)和炎症因子(IL-1β和TNF-α)水平。它还通过减少纹状体中的嗜酸性损伤来防止组织病理学变化。结论:卡介苗通过抗氧化和抗炎作用发挥神经保护作用。因此,在未来,它可以作为一种神经保护剂用于其他神经系统疾病,包括PD。
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引用次数: 0
Prospective pilot study evaluating a vitamin D3 loading dose in critically ill children with vitamin D deficiency 评估维生素D缺乏症重症儿童维生素D3负荷剂量的前瞻性试点研究。
IF 2.9 4区 医学 Q2 Medicine Pub Date : 2023-11-27 DOI: 10.1111/fcp.12973
Elizabeth W. Covington, Shaneese L. Jasper-Trotter, Robert D. Arnold, Raj Amin, Susan Egbert, Allison Chung

Background

Vitamin D deficiency is a common finding in critically ill children. However, the optimal supplementation strategy in this patient population is unknown. The objective of this study was to evaluate the effects of high-dose (10 000 IU/kg, max. 400 000 IU) vitamin D supplementation on 25-hydroxyvitamin D3 (25[OH]D3) levels in pediatric intensive care unit (PICU) patients with baseline vitamin D deficiency.

Methods

This was a prospective, institutional review board-approved pilot research study performed at the University of South Alabama Women's and Children's Hospital in Mobile, AL. The study sample consisted of patients less than 18 years old admitted to the PICU with baseline 25-hydroxyvitamin D (25[OH]D) level less than 30 ng/ml. Included patients received a one-time dose of vitamin D3 orally or via gastric tube (10 000 IU/kg, max. 400 000 IU).

Results

A total of 17 patients were screened with 11 included in the study. Blood analysis revealed a significant increase in 25(OH)D3 level from baseline to 12-h post dose (21.6 [4.5] ng/ml vs. 46.7 [15.5] ng/ml, P < 0.001). At the 12-h post-dose time point, 10/11 patients (91%) had 25(OH)D3 levels that were greater than 30 ng/ml. No adverse effects were observed.

Conclusion

Vitamin D3 supplementation at a dose of 10 000 IU/kg (max. 400 000 IU) significantly increased 25(OH)D3 levels in critically ill pediatric patients.

背景:维生素D缺乏症在危重儿童中很常见。然而,该患者群体的最佳补充策略尚不清楚。本研究的目的是评估高剂量(10 000 IU/kg,最大剂量)的影响。40万IU)补充维生素D对儿童重症监护病房(PICU)基线维生素D缺乏症患者25-羟基维生素D3 (25[OH]D3)水平的影响方法:这是一项前瞻性的、机构审查委员会批准的试点研究,在阿拉巴马州莫比尔的南阿拉巴马大学妇女和儿童医院进行。研究样本包括入院PICU的年龄小于18岁的患者,基线25-羟基维生素D (25[OH]D)水平低于30 ng/ml。纳入的患者接受一次剂量的维生素D3口服或通过胃管(10 000 IU/kg,最大。40万iu)。结果:共筛选17例患者,其中11例纳入研究。血液分析显示,从基线到给药后12小时,25(OH)D3水平显著增加(21.6 [4.5]ng/ml vs. 46.7 [15.5] ng/ml, P。40万IU)可显著提高危重儿科患者25(OH)D3水平。
{"title":"Prospective pilot study evaluating a vitamin D3 loading dose in critically ill children with vitamin D deficiency","authors":"Elizabeth W. Covington,&nbsp;Shaneese L. Jasper-Trotter,&nbsp;Robert D. Arnold,&nbsp;Raj Amin,&nbsp;Susan Egbert,&nbsp;Allison Chung","doi":"10.1111/fcp.12973","DOIUrl":"10.1111/fcp.12973","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Vitamin D deficiency is a common finding in critically ill children. However, the optimal supplementation strategy in this patient population is unknown. The objective of this study was to evaluate the effects of high-dose (10 000 IU/kg, max. 400 000 IU) vitamin D supplementation on 25-hydroxyvitamin D3 (25[OH]D3) levels in pediatric intensive care unit (PICU) patients with baseline vitamin D deficiency.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a prospective, institutional review board-approved pilot research study performed at the University of South Alabama Women's and Children's Hospital in Mobile, AL. The study sample consisted of patients less than 18 years old admitted to the PICU with baseline 25-hydroxyvitamin D (25[OH]D) level less than 30 ng/ml. Included patients received a one-time dose of vitamin D3 orally or via gastric tube (10 000 IU/kg, max. 400 000 IU).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 17 patients were screened with 11 included in the study. Blood analysis revealed a significant increase in 25(OH)D3 level from baseline to 12-h post dose (21.6 [4.5] ng/ml vs. 46.7 [15.5] ng/ml, <i>P</i> &lt; 0.001). At the 12-h post-dose time point, 10/11 patients (91%) had 25(OH)D3 levels that were greater than 30 ng/ml. No adverse effects were observed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Vitamin D3 supplementation at a dose of 10 000 IU/kg (max. 400 000 IU) significantly increased 25(OH)D3 levels in critically ill pediatric patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12657,"journal":{"name":"Fundamental & Clinical Pharmacology","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2023-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138444459","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
Association between immune-related adverse events and prognosis in patients treated with immune checkpoint inhibitors in melanoma: A surrogacy analysis 免疫检查点抑制剂治疗黑色素瘤患者免疫相关不良事件与预后之间的关联:一项替代分析。
IF 2.9 4区 医学 Q2 Medicine Pub Date : 2023-11-27 DOI: 10.1111/fcp.12966
Romain Euvrard, Marie Robert, Sabine Mainbourg, Stéphane Dalle, Jean-Christophe Lega

Background

Immune checkpoint inhibitors (ICI) represent a breakthrough in oncology in terms of prognosis and safety. They now constitute a cornerstone in the management of metastatic melanoma. However, a new kind of adverse event called immune-related adverse events (irAE) has emerged. These irAE could be conceptually considered as an indicator of the antitumoral immune response, but the association between irAE and prognosis is still a matter of debate.

Objective

The purpose of this study was to investigate the association between the overall survival (OS) and the prevalence of irAE in melanoma.

Methods

MEDLINE/PubMed, WebofScience, ClinicalTrials, and WHOTrials databases were searched to identify phase 3 randomized controlled trials (RCT) assessing ICI in melanoma and published up to April 2021. A weighted regression was performed to estimate this association according to standard method of surrogacy analysis.

Results

A total of 14 RCT including 7646 patients (median age: 59.3 years) with melanoma were included. All types of ICI were represented (ipilimumab, tremelimumab, pembrolizumab, nivolumab, atezolizumab, as well as ipilimumab and nivolumab combination). irAE were frequent but rarely fatal. The combination of ICI caused more irAE than anti-PD1 (or PDL1) and anti-CTLA4 monotherapies. No relationship was found between the occurrence of irAE and OS (beta coefficient 0.078, R2 3%, p = 0.52), nor between cutaneous irAE and OS (beta coefficient 0.080, R2 6%, p = 0.33).

Conclusion

Although limited by the heterogeneity of ICI included in the regression and the low number of included RCT, the present study suggests an absence of association between irAE and prognosis in melanoma.

背景:免疫检查点抑制剂(ICI)在肿瘤预后和安全性方面取得了突破性进展。它们现在构成了转移性黑色素瘤治疗的基石。然而,一种新的不良事件被称为免疫相关不良事件(irAE)已经出现。这些irAE可以在概念上被认为是抗肿瘤免疫反应的一个指标,但irAE与预后之间的关系仍然是一个有争议的问题。目的:本研究的目的是探讨黑色素瘤患者总生存期(OS)与irAE患病率之间的关系。方法:检索MEDLINE/PubMed、WebofScience、ClinicalTrials和WHOTrials数据库,以确定评估黑素瘤ICI的3期随机对照试验(RCT),并发表至2021年4月。根据代孕分析的标准方法进行加权回归来估计这种关联。结果:共纳入14项随机对照试验,包括7646例黑色素瘤患者(中位年龄:59.3岁)。代表了所有类型的ICI (ipilimumab, tremelimumab, pembrolizumab, nivolumab, atezolizumab,以及ipilimumab和nivolumab联合)。伊拉克战争频繁发生,但很少致命。ICI联合治疗比抗pd1(或PDL1)和抗ctla4单药治疗引起更多的irAE。irAE的发生与OS无相关性(β系数0.078,R2 3%, p = 0.52),皮肤irAE与OS无相关性(β系数0.080,R2 6%, p = 0.33)。结论:尽管受回归中ICI异质性和纳入的RCT数量较少的限制,本研究提示irAE与黑色素瘤预后之间不存在关联。
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引用次数: 0
Chlorogenic acid co-administration alleviates cisplatin-induced peripheral neuropathy in rats 绿原酸联合给药可减轻顺铂所致大鼠周围神经病变。
IF 2.9 4区 医学 Q2 Medicine Pub Date : 2023-11-23 DOI: 10.1111/fcp.12970
Çiğdem Çengelli Ünel, Ezgi Eroğlu, Orhan Özatik, Kevser Erol

Background

Chemotherapy-induced peripheral neuropathy (CIPN) is still an unresolved problem in cisplatin (CIS) use.

Objectives

This study investigates possible anti-neuropathic effect of chlorogenic acid (CGA) against CIS-induced CIPN in rats while also investigating the contribution of nitric oxide (NO) to this phenomenon.

Methods

Initially, CGA (250–1000 μM) was tested by MTT assay on primary DRG neurons. Subsequently, CIPN was induced in Sprague–Dawley rats by 3 mg/kg intraperitoneal injections of CIS once/week for 5 weeks. CGA (100 mg/kg) was co-administered with CIS, both alone and in combination with l-arginine (LARG) or l-nitro-arginine-methyl-ester (LNAME), to elucidate the contribution of nitrergic system to anti-neuropathic effects. Mechanical allodynia, thermal hyperalgesia, and cold plate tests were performed to test CIPN. Rotarod, footprint analysis, and activitymeter were used to evaluate motor coordination and performance. Tumor necrosis factor alpha (TNF-α) was measured as a marker of inflammation. Histological evaluations of DRG and sciatic nerves (SNs) were performed utilizing toluidine blue staining. Two-way analysis of variance and Kruskal–Wallis following Tukey's test were used as statistical analysis.

Results

Higher concentration of CGA (1000 μM) exhibited protective effect against in vitro neurotoxicity. Neither LARG nor LNAME exerted significant change in this effect. Co-administration of CGA alleviated histological abnormalities and neuropathic effects induced by CIS. Ameliorative effect of CGA was not changed in mechanical allodynia but attenuated in cold allodynia, and motor activity/coordination tests by LARG and LNAME. Neuropathic effects of CIS remained unchanged with LARG and LNAME in behavioral experiments.

Conclusion

The study identified CGA as candidate agent in mitigating CIPN. NO seems to play a modulatory role in this effect.

背景:化疗引起的周围神经病变(CIPN)仍然是顺铂(CIS)使用中未解决的问题。目的:本研究探讨绿原酸(CGA)对cis诱导大鼠CIPN可能的抗神经病变作用,同时探讨一氧化氮(NO)在这一现象中的作用。方法:采用MTT法检测CGA (250 ~ 1000 μM)对原代DRG神经元的影响。随后,Sprague-Dawley大鼠腹腔注射CIS 3 mg/kg,每周1次,连续5周诱导CIPN。CGA (100 mg/kg)与CIS联合给药,包括单独给药和与l-精氨酸(LARG)或l-硝基精氨酸甲酯(LNAME)联合给药,以阐明氮能系统在抗神经病变作用中的作用。采用机械异常性痛、热痛觉过敏和冷板试验来检测CIPN。使用旋转杆、足迹分析和活动计来评估运动协调和表现。检测肿瘤坏死因子α (TNF-α)作为炎症指标。采用甲苯胺蓝染色对DRG和坐骨神经(SNs)进行组织学评价。统计分析采用双向方差分析和Tukey检验后的Kruskal-Wallis检验。结果:较高浓度(1000 μM)的CGA对体外神经毒性具有保护作用。LARG和LNAME在这方面都没有产生显著的变化。同时给药CGA可减轻CIS引起的组织学异常和神经病变。CGA的改善作用在机械异常性痛中没有改变,但在冷异常性痛和LARG和LNAME的运动活动/协调试验中减弱。在行为实验中,CIS对LARG和LNAME的神经病变作用保持不变。结论:本研究确定CGA为缓解CIPN的候选药物。NO似乎在这一作用中起调节作用。
{"title":"Chlorogenic acid co-administration alleviates cisplatin-induced peripheral neuropathy in rats","authors":"Çiğdem Çengelli Ünel,&nbsp;Ezgi Eroğlu,&nbsp;Orhan Özatik,&nbsp;Kevser Erol","doi":"10.1111/fcp.12970","DOIUrl":"10.1111/fcp.12970","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Chemotherapy-induced peripheral neuropathy (CIPN) is still an unresolved problem in cisplatin (CIS) use.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study investigates possible anti-neuropathic effect of chlorogenic acid (CGA) against CIS-induced CIPN in rats while also investigating the contribution of nitric oxide (NO) to this phenomenon.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Initially, CGA (250–1000 μM) was tested by MTT assay on primary DRG neurons. Subsequently, CIPN was induced in Sprague–Dawley rats by 3 mg/kg intraperitoneal injections of CIS once/week for 5 weeks. CGA (100 mg/kg) was co-administered with CIS, both alone and in combination with <span>l</span>-arginine (LARG) or <span>l</span>-nitro-arginine-methyl-ester (LNAME), to elucidate the contribution of nitrergic system to anti-neuropathic effects. Mechanical allodynia, thermal hyperalgesia, and cold plate tests were performed to test CIPN. Rotarod, footprint analysis, and activitymeter were used to evaluate motor coordination and performance. Tumor necrosis factor alpha (TNF-α) was measured as a marker of inflammation. Histological evaluations of DRG and sciatic nerves (SNs) were performed utilizing toluidine blue staining. Two-way analysis of variance and Kruskal–Wallis following Tukey's test were used as statistical analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Higher concentration of CGA (1000 μM) exhibited protective effect against in vitro neurotoxicity. Neither LARG nor LNAME exerted significant change in this effect. Co-administration of CGA alleviated histological abnormalities and neuropathic effects induced by CIS. Ameliorative effect of CGA was not changed in mechanical allodynia but attenuated in cold allodynia, and motor activity/coordination tests by LARG and LNAME. Neuropathic effects of CIS remained unchanged with LARG and LNAME in behavioral experiments.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The study identified CGA as candidate agent in mitigating CIPN. NO seems to play a modulatory role in this effect.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12657,"journal":{"name":"Fundamental & Clinical Pharmacology","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2023-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138298877","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
Myrtenal exhibits cardioprotective effects by attenuating the pathological progression associated with myocardial infarction 桃金娘醛通过减缓与心肌梗死相关的病理进展表现出心脏保护作用。
IF 2.9 4区 医学 Q2 Medicine Pub Date : 2023-11-21 DOI: 10.1111/fcp.12965
N Abhirami, Mahesh Chandran, Athira Ramadasan, Dhanalekshmi Bhasura, Janeesh Plakkal Ayyappan

Background

Myocardial infarction poses major risks to human health because of their incredibly high rates of morbidity and mortality. Infarctions are more likely to develop as a result of dysregulation of cell death. Myrtenal can be considered for their bioactive beneficial activity in the context of cardiovascular pathologies and, particularly, in the protection toward oxidative stress followed by ischemic injury.

Objective

This study aimed to put limelight on the antioxidant, anti-apoptotic, and antibacterial properties of Myrtenal.

Methods

An in vitro model of oxidative stress-induced injury was entrenched in H9c2 cells using hydrogen peroxide, and the effects of Myrtenal were investigated. The MTT, cellular enzyme level, staining, and flow cytometry analysis were used to examine protective, antioxidant, and anti-apoptotic effects. The gene expressions were detected by qPCR. Antibacterial effect and biofilm formation were also done.

Result

The findings revealed that Myrtenal alone had negligible cytotoxic effects and that Myrtenal protects H9c2 against H2O2-induced cell death at micromolar concentrations. Myrtenal pre-treatment inhibited the generation of reactive oxygen species (ROS) as well as remarkably decreased the fluorescence intensity of ROS. Additionally, Myrtenal considerably increased the synthesis of antioxidant enzymes while dramatically decreasing the production of MDA and LDH. qPCR demonstrated the downregulation of Cas-9, TNF-α, NF-κB, P53, BAX, iNOS, and IL-6 expression while an upregulation of Bcl-2 expression in Myrtenal pre-treated groups. Myrtenal also holds the magnificent property of inhibiting bacterial growth.

Conclusion

Myrtenal ameliorates H2O2-induced cardiomyocyte injury and protects cardiomyocyte by inhibiting oxidative stress, inflammation, and apoptosis and may be a promise drug for the treatment of heart diseases.

背景:心肌梗死因其极高的发病率和死亡率而对人类健康构成重大威胁。梗死更有可能是细胞死亡失调的结果。桃金娘醛可以被认为是在心血管疾病的背景下具有生物活性的有益活性,特别是在对缺血损伤后的氧化应激的保护。目的:研究桃金娘烯醛的抗氧化、抗凋亡和抗菌作用。方法:采用双氧水建立体外氧化应激诱导的H9c2细胞损伤模型,观察桃金桃醛的作用。MTT、细胞酶水平、染色和流式细胞术分析检测其保护、抗氧化和抗凋亡作用。采用qPCR检测基因表达。并对其抑菌效果和生物膜的形成进行了研究。结果:桃金娘烯醛单独作用的细胞毒作用可以忽略不计,桃金娘烯醛在微摩尔浓度下可以保护H9c2免受H2 O2诱导的细胞死亡。桃金娘醛预处理抑制活性氧(ROS)的生成,并显著降低ROS的荧光强度。此外,桃金娘烯醛显著增加抗氧化酶的合成,同时显著降低MDA和LDH的产生。qPCR结果显示,桃金酸钠预处理组的cas9、TNF-α、NF-κB、P53、BAX、iNOS、IL-6表达下调,Bcl-2表达上调。桃金娘酸还具有抑制细菌生长的优良特性。结论:桃金娘烯醛可通过抑制氧化应激、炎症和细胞凋亡,改善h2o2诱导的心肌细胞损伤,保护心肌细胞,可能是治疗心脏病的有希望的药物。
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引用次数: 0
In vitro stability study of 10 beta-lactam antibiotics in human plasma samples 10种β -内酰胺类抗生素在人血浆样品中的体外稳定性研究。
IF 2.9 4区 医学 Q2 Medicine Pub Date : 2023-11-20 DOI: 10.1111/fcp.12969
Matthieu Brenkman, Tom Cartau, Elise Pape, Allan Kolodziej, Alexandre Charmillon, Emmanuel Novy, Jean-Yves Jouzeau, Nicolas Gambier, Julien Scala-Bertola

Background and Objectives

Beta-lactam antibiotics are reported for some of them to be subject to a rapid degradation in infusion solutions and in human blood samples. However, the current data of stability available in blood samples are limited to a few number of beta-lactam antibiotics, and the methodology of the corresponding studies may be discussed. The objective of the present study is to evaluate the stability of 10 beta-lactam antibiotics in human plasma samples.

Methods

Stability of amoxicillin, cefazolin, cefepime, cefotaxime, cefoxitin, ceftazidime, ceftriaxone, imipenem, meropenem, and piperacillin was evaluated at low and high concentrations at 20°C, 4°C, −20°C, and −80°C for 1, 7, 60, and 90 days, respectively.

Results

Amoxicillin, cefepime, meropenem, and piperacillin were the least stable antibiotics. The maximum durations allowing the stability for all the evaluated beta-lactams at both tested concentrations were estimated at 3 h, 23 h, 10 days, and 35 days at 20°C, 4°C, −20°C, and −80°C, respectively.

Conclusion

We recommend to transport antibiotic plasma samples in ice at 4°C and even at −20°C if these samples come from external hospitals. Ideally, plasma samples should be stored at −80°C if possible; if not, the analysis of the samples should be performed as soon as possible in the limit of 10 days after a storage at −20°C.

背景和目的:据报道,有些β -内酰胺类抗生素在输注溶液和人类血液样本中会迅速降解。然而,目前血液样本中可用的稳定性数据仅限于少数β -内酰胺类抗生素,相应研究的方法可能会被讨论。本研究的目的是评价10种β -内酰胺类抗生素在人血浆样品中的稳定性。方法:测定阿莫西林、头孢唑林、头孢吡肟、头孢噻肟、头孢西丁、头孢他啶、头孢曲松、亚胺培南、美罗培南、哌拉西林在20℃、4℃、-20℃、-80℃低、高浓度条件下的稳定性,分别为1、7、60、90 d。结果:阿莫西林、头孢吡肟、美罗培南和哌拉西林是最不稳定的抗生素。在20°C、4°C、-20°C和-80°C条件下,所有评估的β -内酰胺在两种测试浓度下的最大稳定性持续时间分别为3小时、23小时、10天和35天。结论:我们建议抗生素血浆样本在4°C的冰中运输,如果这些样本来自外部医院,甚至在-20°C。理想情况下,如果可能,血浆样品应储存在-80°C;如果没有,应在-20°C保存后的10天内尽快对样品进行分析。
{"title":"In vitro stability study of 10 beta-lactam antibiotics in human plasma samples","authors":"Matthieu Brenkman,&nbsp;Tom Cartau,&nbsp;Elise Pape,&nbsp;Allan Kolodziej,&nbsp;Alexandre Charmillon,&nbsp;Emmanuel Novy,&nbsp;Jean-Yves Jouzeau,&nbsp;Nicolas Gambier,&nbsp;Julien Scala-Bertola","doi":"10.1111/fcp.12969","DOIUrl":"10.1111/fcp.12969","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Objectives</h3>\u0000 \u0000 <p>Beta-lactam antibiotics are reported for some of them to be subject to a rapid degradation in infusion solutions and in human blood samples. However, the current data of stability available in blood samples are limited to a few number of beta-lactam antibiotics, and the methodology of the corresponding studies may be discussed. The objective of the present study is to evaluate the stability of 10 beta-lactam antibiotics in human plasma samples.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Stability of amoxicillin, cefazolin, cefepime, cefotaxime, cefoxitin, ceftazidime, ceftriaxone, imipenem, meropenem, and piperacillin was evaluated at low and high concentrations at 20°C, 4°C, −20°C, and −80°C for 1, 7, 60, and 90 days, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Amoxicillin, cefepime, meropenem, and piperacillin were the least stable antibiotics. The maximum durations allowing the stability for all the evaluated beta-lactams at both tested concentrations were estimated at 3 h, 23 h, 10 days, and 35 days at 20°C, 4°C, −20°C, and −80°C, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>We recommend to transport antibiotic plasma samples in ice at 4°C and even at −20°C if these samples come from external hospitals. Ideally, plasma samples should be stored at −80°C if possible; if not, the analysis of the samples should be performed as soon as possible in the limit of 10 days after a storage at −20°C.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12657,"journal":{"name":"Fundamental & Clinical Pharmacology","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2023-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138176060","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
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Fundamental & Clinical Pharmacology
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