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Rapamycin and Starvation Mitigate Indomethacin-Induced Intestinal Damage through Preservation of Lysosomal Vacuolar ATPase Integrity. 雷帕霉素和饥饿通过保护溶酶体空泡ATP酶的完整性减轻吲哚美辛诱发的肠道损伤
IF 3.1 3区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2024-06-21 DOI: 10.1124/jpet.123.001981
Makoto Shirakawa, Shunichi Yokoe, Takatoshi Nakagawa, Kazumasa Moriwaki, Toshihisa Takeuchi, Michio Asahi

Nonsteroidal anti-inflammatory drugs (NSAIDs) possess anti-inflammatory, antipyretic, and analgesic properties and are among the most commonly used drugs. Although the cause of NSAID-induced gastric ulcers is well understood, the mechanism behind small intestinal ulcers remains elusive. In this study, we examined the mechanism through which indomethacin (IM), a prominent NSAID, induces small intestinal ulcers, both in vitro and in vivo. In IEC6 cells, a small intestinal epithelial cell line, IM treatment elevated levels of LC3-II and p62. These expression levels remained unaltered after treatment with chloroquine or bafilomycin, which are vacuolar ATPase (V-ATPase) inhibitors. IM treatment reduced the activity of cathepsin B, a lysosomal protein hydrolytic enzyme, and increased the lysosomal pH. There was a notable increase in subcellular colocalization of LC3 with Lamp2, a lysosome marker, post IM treatment. The increased lysosomal pH and decreased cathepsin B activity were reversed by pretreatment with rapamycin (Rapa) or glucose starvation, both of which stabilize V-ATPase assembly. To validate the in vitro findings in vivo, we established an IM-induced small intestine ulcer mouse model. In this model, we observed multiple ulcerations and heightened inflammation following IM administration. However, pretreatment with Rapa or fasting, which stabilize V-ATPase assembly, mitigated the IM-induced small intestinal ulcers in mice. Coimmunoprecipitation studies demonstrated that IM binds to V-ATPase in vitro and in vivo. These findings suggest that IM induces small intestinal injury through lysosomal dysfunction, likely due to the disassembly of lysosomal V-ATPase caused by direct binding. Moreover, Rapa or starvation can prevent this injury by stabilizing the assembly. SIGNIFICANCE STATEMENT: This study elucidates the largely unknown mechanisms behind small intestinal ulceration induced by indomethacin and reveals the involvement of lysosomal dysfunction via vacuolar ATPase disassembly. The significance lies in identifying potential preventative interventions, such as rapamycin treatment or glucose starvation, offering pivotal insights that extend beyond nonsteroidal anti-inflammatory drugs-induced ulcers to broader gastrointestinal pathologies and treatments, thereby providing a foundation for novel therapeutic strategies aimed at a wide array of gastrointestinal disorders.

非甾体抗炎药(NSAIDs)具有消炎、解热和镇痛作用,是最常用的药物之一。虽然非甾体抗炎药诱发胃溃疡的原因已广为人知,但小肠溃疡的发病机制却仍然扑朔迷离。在这项研究中,我们研究了吲哚美辛(IM)这种著名的非甾体抗炎药在体外和体内诱发小肠溃疡的机制。 在小肠上皮细胞系 IEC6 细胞中,IM 处理会升高 LC3-Ⅱ 和 p62 的水平。这些表达水平在使用氯喹或巴佛洛霉素(空泡 ATP 酶(V-ATP 酶)抑制剂)处理后保持不变。IM 处理降低了溶酶体蛋白水解酶 cathepsin B 的活性,并增加了溶酶体的 pH 值。IM处理后,LC3与溶酶体标记物Lamp2的亚细胞共定位明显增加。使用雷帕霉素(Rapa)或葡萄糖饥饿预处理可逆转溶酶体 pH 值的升高和 cathepsin B 活性的降低,这两种方法都能稳定 V-ATPase 的装配。为了在体内验证体外研究结果,我们建立了 IM 诱导的小肠溃疡小鼠模型。在该模型中,我们观察到在服用 IM 后出现多处溃疡和炎症加剧。然而,使用能稳定 V-ATP 酶组装的拉帕或禁食进行预处理,可减轻 IM 诱导的小鼠小肠溃疡。共免疫沉淀研究表明,IM 在体外和体内都与 V-ATP 酶结合。这些发现表明,IM 通过溶酶体功能障碍诱导小肠损伤,这可能是由于直接结合导致溶酶体 V-ATP 酶解体。此外,Rapa 或饥饿可通过稳定装配来防止这种损伤。意义声明 本研究阐明了吲哚美辛诱发小肠溃疡背后的未知机制,并揭示了溶酶体功能障碍通过 V-ATP 酶解体的参与。其意义在于确定了潜在的预防性干预措施,如雷帕霉素治疗或葡萄糖饥饿,提供了从非甾体抗炎药诱导的溃疡扩展到更广泛的胃肠道病理和治疗的关键见解,从而为针对各种胃肠道疾病的新型治疗策略奠定了基础。
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引用次数: 0
The Evolving Challenge of New Psychoactive Substances: Understanding the Risks and Behavioral Effects of Novel Analogs of Dissociative Anesthetics. 新型精神活性物质不断演变的挑战:了解解离麻醉剂新型类似物的风险和行为效应。
IF 3.1 3区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2024-06-21 DOI: 10.1124/jpet.124.002109
Marco Pistis
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引用次数: 0
Small Peptide-Based Nanodelivery Systems for Cancer Therapy and Diagnosis. 用于癌症治疗和诊断的小肽基纳米递送系统。
IF 3.1 3区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2024-06-21 DOI: 10.1124/jpet.123.001845
Imocha Rajkumar Singh, Nidhi Aggarwal, Swapnil Srivastava, Jiban Jyoti Panda, Jibanananda Mishra

Developing nano-biomaterials with tunable topology, size, and surface characteristics has shown tremendously favorable benefits in various biologic and clinical applications. Among various nano-biomaterials, peptide-based drug delivery systems offer multiple merits over other synthetic systems due to their enhanced bio- and cytocompatibility and desirable biochemical and biophysical properties. Currently, around 100 peptide-based drugs are clinically available for numerous therapeutic purposes. In conjugation with chemotherapeutic moieties, peptides demonstrate a remarkable ability to reduce nonspecific drug effects by improving drug targetability at cancer sites. This review encompasses a wide-ranging role played by different peptide-based nanostructures in cancer theranostics. Section 1 introduces the rising concern about cancer as a disease and further describes peptide-based nanomaterials as biomedical agents to tackle the ailment. The subsequent section explores the mechanistic pathways behind the self-assembly of peptides to form hierarchically distinct assemblies. The crux of our review lies in an exhaustive exploration of the applications of various types of peptide-based nanostructures in cancer therapy and diagnosis. SIGNIFICANCE STATEMENT: Peptide-based drug delivery systems possess superior biocompatibility, biochemical, and biophysical properties compared to other synthetic alternatives. The development of these nano-biomaterials with customizable topology, size, and surface characteristics have shown promising outcomes in biomedical contexts. Peptides in conjunction with chemotherapeutic agents exhibit the ability to enhance drug targetability at cancer sites, reducing nonspecific drug effects. This comprehensive review emphasizes the pivotal role of diverse peptide-based nanostructures as cancer theranostics, elucidating their potential in revolutionizing cancer therapy and diagnosis.

开发具有可调拓扑、尺寸和表面特性的纳米生物材料在各种生物学和临床应用中显示出巨大的优势。在各种纳米生物材料中,基于肽的药物传递系统由于其增强的生物和细胞相容性以及理想的生化和生物物理特性而比其他合成系统具有多种优点。目前,临床上约有100种肽类药物可用于多种治疗目的。在与化疗部分结合时,多肽通过提高癌症部位的药物靶向性来减少非特异性药物效应。本文综述了不同肽基纳米结构在癌症治疗中的广泛作用。第1节介绍了对癌症作为一种疾病的日益关注,并进一步描述了基于肽的纳米材料作为生物医学制剂来治疗这种疾病。随后的部分探讨了多肽自组装背后的机制途径,以形成层次上不同的组装。我们回顾的关键在于对各种类型的肽基纳米结构在癌症治疗和诊断中的应用进行详尽的探索。与其他合成替代品相比,基于肽的药物传递系统具有优越的生物相容性,生化和生物物理特性。这些具有可定制拓扑结构、尺寸和表面特征的纳米生物材料的开发在生物医学领域显示出了很好的成果。多肽与化疗药物结合在一起,可以增强药物在癌症部位的靶向性,减少非特异性药物效应。这篇综合综述强调了多种基于肽的纳米结构在癌症治疗中的关键作用,阐明了它们在癌症治疗和诊断中的革命性潜力。
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引用次数: 0
Phencyclidine-Like Abuse Liability and Psychosis-Like Neurocognitive Effects of Novel Arylcyclohexylamine Drugs of Abuse in Rodents. 新型芳基环己胺滥用药物在啮齿动物中的吩环苷滥用责任和类似精神病的神经认知效应。
IF 3.1 3区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2024-06-21 DOI: 10.1124/jpet.123.001942
Hannah E Shaw, Dylan R Patel, Brenda M Gannon, Lauren R Fitzgerald, Theresa M Carbonaro, Chad R Johnson, William E Fantegrossi

Abuse of novel arylcyclohexylamines (ACX) poses risks for toxicities, including adverse neurocognitive effects. In vivo effects of ring-substituted analogs of phencyclidine (PCP), eticyclidine (PCE), and ketamine are understudied. Adult male National Institutes of Health Swiss mice were used to assess locomotor effects of PCP and its 3-OH, 3-MeO, 3-Cl, and 4-MeO analogs, PCE and its 3-OH and 3-MeO analogs, and ketamine and its deschloro and 2F-deschloro analogs, in comparison with those of methamphetamine (METH), 3,4-methylenedioxymethamphetamine (MDMA), and two benzofuran analogs of MDMA. PCP-like interoceptive effects for all of these ACXs were determined using a food-reinforced drug discrimination procedure in adult male Sprague Dawley rats. A novel operant assay of rule-governed behavior incorporating aspects of attentional set-shifting was used to profile psychosis-like neurocognitive effects of PCP and 3-Cl-PCP in rats, in comparison with cocaine and morphine. PCP-like ACXs were more effective locomotor stimulants than the amphetamines, PCE-like ACXs were as effective as the amphetamines, and ketamine-like ACXs were less effective than the amphetamines. Addition of -Cl, -OH, or -OMe at the 3-position on the aromatic ring did not impact locomotor effectiveness, but addition of -OMe at the 4-position reduced locomotor effectiveness. Lethal effects were induced by drugs with -OH at the 3-position or -OMe at the 3- or 4-position. All novel ACXs substituted at least partially for PCP, and PCP and 3-Cl-PCP elicited dose-dependent psychosis-like neurocognitive deficits in the rule-governed behavior task not observed with cocaine or morphine. Novel ACXs exhibit substantial abuse liability and toxicities not necessarily observed with their parent drugs. SIGNIFICANCE STATEMENT: Novel arylcyclohexylamine analogs of PCP, PCE, and ketamine are appearing on the illicit market, and abuse of these drugs poses risks for toxicities, including adverse neurocognitive effects. These studies demonstrate that the novel ACXs exhibit PCP-like abuse liability in the drug discrimination assay, elicit varied locomotor stimulant and lethal effects in mice, and induce psychosis-like neurocognitive effects in rats.

滥用新型芳基环己胺 (ACX) 会带来毒性风险,包括对神经认知的不良影响。对苯环利定(PCP)、乙酰胞苷(PCE)和氯胺酮的环取代类似物的体内效应研究不足。研究人员利用成年雄性 NIH 瑞士小鼠评估了五氯苯酚及其 3-OH、3-MeO、3-Cl 和 4-MeO 类似物;五氯苯甲醚及其 3-OH 和 3-MeO 类似物;氯胺酮及其去氯和 2F- 去氯类似物的运动效应,并将其与甲基苯丙胺 (METH)、3,4-亚甲二氧基甲基苯丙胺 (MDMA) 和 MDMA 的两种苯并呋喃类似物的运动效应进行了比较。在成年雄性 Sprague Dawley 大鼠身上使用食物强迫药物辨别程序测定了所有这些 ACX 的类似 PCP 的感知间效应。与可卡因和吗啡相比,五氯苯酚和 3-Cl-PCP 对大鼠神经认知的影响更类似于精神病。五氯苯酚类 ACX 比苯丙胺类兴奋剂更有效,五氯苯乙醚类 ACX 与苯丙胺类兴奋剂同样有效,而氯胺酮类 ACX 的效果则不如苯丙胺类兴奋剂。在芳香环的 3 位添加 -Cl、-OH 或 -OMe 不会影响运动效力,但在 4 位添加 -OMe 会降低运动效力。3 位上有 -OH 或 3 或 4 位上有 -OMe 的药物会诱发致死效应。五氯苯酚和 3-Cl-PCP 在规则行为任务中会引起剂量依赖性精神病样神经认知障碍,而可卡因或吗啡则不会出现这种情况。新型 ACX 具有很大的滥用可能性和毒性,这在其母体药物中不一定能观察到。意义声明 非法市场上出现了五氯苯酚、五氯乙酸和氯胺酮的新型芳基环己胺类似物,滥用这些药物会带来毒性风险,包括对神经认知的不良影响。这些研究表明,新型 ACX 在药物鉴别试验中表现出类似五氯苯酚的滥用倾向,在小鼠体内引起不同的运动兴奋剂和致死效应,并在大鼠体内诱发类似精神病的神经认知效应。
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引用次数: 0
Blood Pressure Lowering in Patients with Left Ventricular Hypertrophy - Navigating between Scylla and Charybdis. 左心室肥大患者的降压治疗--在 Scylla 和 Charybdis 之间游刃有余。
IF 3.1 3区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2024-06-21 DOI: 10.1124/jpet.123.002093
Renate Schoenenberger-Berzins, Franz H Messerli
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引用次数: 0
Tauroursodeoxycholic Acid Reverses Dextran Sulfate Sodium-Induced Colitis in Mice via Modulation of Intestinal Barrier Dysfunction and Microbiome Dysregulation. 牛磺脱氧胆酸通过调节肠屏障功能障碍和微生物组失调逆转DSS诱导的小鼠结肠炎
IF 3.1 3区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2024-06-21 DOI: 10.1124/jpet.123.002020
Longbiao Luo, Yi Zhao, Guangji Zhang, Sijing Dong, YinYue Xu, Hehe Shi, Menggai Zhang, Xue Liu, Sicen Wang, Hua Luo, Wanghui Jing

Ulcerative colitis (UC) is an immune-mediated inflammatory disease that can lead to persistent damage and even cancer without any intervention. Conventional treatments can alleviate UC symptoms but are costly and cause various side effects. Tauroursodeoxycholic acid (TUDCA), a secondary bile acid derivative, possesses anti-inflammatory and cytoprotective properties for various diseases, but its potential therapeutic benefits in UC have not been fully explored. Mice were subjected to colitis induction using 3% dextran sulfate sodium (DSS). The therapeutic effect of TUDCA was evaluated by body weight loss, disease activity index (DAI), colon length, and spleen weight ratio. Tissue pathology was assessed using H&E staining, while the levels of pro-inflammatory and anti-inflammatory cytokines in colonic tissue were quantified via ELISA. Tight junction proteins were detected by immunoblotting and intestinal permeability was assessed using fluorescein isothiocyanate (FITC)-dextran. Moreover, the gut microbiota was profiled using high-throughput sequencing of the 16S rDNA gene. TUDCA alleviated the colitis in mice, involving reduced DAI, attenuated colon and spleen enlargement, ameliorated histopathological lesions, and normalized levels of pro-inflammatory and anti-inflammatory cytokines. Furthermore, TUDCA treatment inhibited the downregulation of intestinal barrier proteins, including zonula occludens-1 and occludin, thus reducing intestinal permeability. The analysis of gut microbiota suggested that TUDCA modulated the dysbiosis in mice with colitis, especially for the remarkable rise in Akkermansia TUDCA exerted a therapeutic efficacy in DSS-induced colitis by reducing intestinal inflammation, protecting intestinal barrier integrity, and restoring gut microbiota balance. SIGNIFICANCE STATEMENT: This study demonstrates the potential therapeutic benefits of Tauroursodeoxycholic acid (TUDCA) in ulcerative colitis. TUDCA effectively alleviated colitis symptoms in mice, including reducing inflammation, restoring intestinal barrier integrity and the dysbiosis of gut microbiota. This work highlights the promising role of TUDCA as a potentially alternative treatment, offering new insights into managing this debilitating condition.

背景:溃疡性结肠炎(UC)是一种免疫介导的炎症性疾病,如果不采取任何干预措施,可导致持续性损害,甚至癌变。传统治疗方法可以缓解 UC 症状,但费用昂贵,甚至会产生各种副作用。牛磺脱氧胆酸(TUDCA)是一种次级胆汁酸衍生物,对多种疾病具有抗炎和细胞保护作用,但其对 UC 的潜在治疗作用尚未得到充分探索。研究方法使用 3% 右旋糖酐硫酸钠(DSS)诱导小鼠患结肠炎。通过体重下降、疾病活动指数(DAI)、结肠长度和脾脏重量比来评估 TUDCA 的治疗效果。组织病理学采用 H&E 染色法进行评估,结肠组织中的促炎和抗炎细胞因子水平则通过酶联免疫吸附试验(ELISA)进行量化。通过免疫印迹法检测了紧密连接蛋白,并使用异硫氰酸荧光素(FITC)-葡聚糖评估了肠道通透性。此外,还利用 16S rDNA 基因的高通量测序分析了肠道微生物群。研究结果TUDCA能缓解小鼠结肠炎,包括降低DAI、减轻结肠和脾脏肿大、改善组织病理学病变、使促炎和抗炎细胞因子水平正常化。此外,TUDCA 还能抑制肠道屏障蛋白(包括 ZO-1 和闭塞素)的下调,从而降低肠道通透性。对肠道微生物群的分析表明,TUDCA 可调节结肠炎小鼠体内的菌群失调,尤其是 Akkermansia 的显著增加:TUDCA通过减轻肠道炎症、保护肠道屏障完整性和恢复肠道微生物群平衡,对DSS诱导的结肠炎具有疗效。意义声明 本研究证明了牛磺脱氧胆酸(TUDCA)对溃疡性结肠炎(UC)的潜在治疗效果。TUDCA 能有效缓解小鼠的结肠炎症状,包括减轻炎症、恢复肠道屏障完整性和肠道微生物群失调。这项工作凸显了 TUDCA 作为一种潜在替代疗法的前景,为控制这种使人衰弱的疾病提供了新的见解。
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引用次数: 0
Special Section on Nanotherapeutics in Cancer Research-Editorial. 癌症研究中的纳米疗法》特刊编辑部。
IF 3.1 3区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2024-06-21 DOI: 10.1124/jpet.124.002257
Rheal A Towner, Marya Ahmed
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引用次数: 0
Myocardial SERCA2 Protects Against Cardiac Damage and Dysfunction Caused by Inhaled Bromine. 心肌 SERCA2 可防止吸入溴引起的心脏损伤和功能障碍。
IF 3.1 3区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2024-06-21 DOI: 10.1124/jpet.123.002084
Juan Xavier Masjoan Juncos, Fahad Nadeem, Shazia Shakil, Malik El-Husari, Iram Zafar, William E Louch, Ganesh V Halade, Ahmed Zaky, Aftab Ahmad, Shama Ahmad

Myocardial sarcoendoplasmic reticulum calcium ATPase 2 (SERCA2) activity is critical for heart function. We have demonstrated that inhaled halogen (chlorine or bromine) gases inactivate SERCA2, impair calcium homeostasis, increase proteolysis, and damage the myocardium ultimately leading to cardiac dysfunction. To further elucidate the mechanistic role of SERCA2 in halogen-induced myocardial damage, we used bromine-exposed cardiac-specific SERCA2 knockout (KO) mice [tamoxifen-administered SERCA2 (flox/flox) Tg (αMHC-MerCreMer) mice] and compared them to the oil-administered controls. We performed echocardiography and hemodynamic analysis to investigate cardiac function 24 hours after bromine (600 ppm for 30 minutes) exposure and measured cardiac injury markers in plasma and proteolytic activity in cardiac tissue and performed electron microscopy of the left ventricle (LV). Cardiac-specific SERCA2 knockout mice demonstrated enhanced toxicity to bromine. Bromine exposure increased ultrastructural damage, perturbed LV shape geometry, and demonstrated acutely increased phosphorylation of phospholamban in the KO mice. Bromine-exposed KO mice revealed significantly enhanced mean arterial pressure and sphericity index and decreased LV end diastolic diameter and LV end systolic pressure when compared with the bromine-exposed control FF mice. Strain analysis showed loss of synchronicity, evidenced by an irregular endocardial shape in systole and irregular vector orientation of contractile motion across different segments of the LV in KO mice, both at baseline and after bromine exposure. These studies underscore the critical role of myocardial SERCA2 in preserving cardiac ultrastructure and function during toxic halogen gas exposures. SIGNIFICANCE STATEMENT: Due to their increased industrial production and transportation, halogens such as chlorine and bromine pose an enhanced risk of exposure to the public. Our studies have demonstrated that inhalation of these halogens leads to the inactivation of cardiopulmonary SERCA2 and results in calcium overload. Using cardiac-specific SERCA2 KO mice, these studies further validated the role of SERCA2 in bromine-induced myocardial injury. These studies highlight the increased susceptibility of individuals with pathological loss of cardiac SERCA2 to the effects of bromine.

心肌肌浆网钙离子 ATP 酶 2(SERCA2)的活性对心脏功能至关重要。我们已经证明,吸入的卤素(氯或溴)气体会使 SERCA2 失活,损害钙稳态,增加蛋白分解,损伤心肌,最终导致心脏功能障碍。为了进一步阐明 SERCA2 在卤素诱导的心肌损伤中的机理作用,我们利用暴露于溴气的心脏特异性 SERCA2 基因敲除(KO)小鼠(他莫昔芬给药 SERCA(flox/flox) Tg(aMHC-MerCreMer) 小鼠),并将它们与给油对照组(FF)进行比较。溴(600 ppm,30 分钟)暴露 24 小时后,我们进行了超声心动图和血流动力学分析以研究心脏功能,并测量了血浆中的心脏损伤标记物和心脏组织中的蛋白水解活性,还对左心室(LV)进行了电子显微镜检查。心脏特异性 SERCA2 基因敲除小鼠对溴的毒性增强。溴暴露增加了超微结构损伤,扰乱了左心室的几何形状,并显示出 KO 小鼠体内磷脂兰班的磷酸化急性增加。与暴露于溴的对照 FF 小鼠相比,暴露于溴的 KO 小鼠的平均动脉压(MAP)和球形指数明显升高,左心室舒张末期直径 LVEDD 和左心室收缩末期压力(LVESP)下降。应变分析表明,KO 小鼠在收缩期心内膜形状不规则,收缩运动在左心室不同区段的矢量方向不规则,这表明小鼠在基线期和溴暴露后都丧失了同步性。这些研究强调了心肌 SERCA2 在有毒卤素气体暴露期间保护心脏超微结构和功能的关键作用。意义声明 由于工业生产和运输的增加,氯和溴等卤素给公众带来了更大的暴露风险。我们的研究表明,吸入这些卤素会导致心肺 SERCA2 失活,造成钙超载。通过使用心脏特异性 SERCA2 基因敲除小鼠,这些研究进一步验证了 SERCA2 在溴诱导的心肌损伤中的作用。这些研究突出表明,心脏 SERCA2 病理缺失的个体更容易受到溴的影响。
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引用次数: 0
Achieving a Systolic Blood Pressure Below 130 mmHg Reduces the Incidence of Cardiovascular Events in Hypertensive Patients with Echocardiographic Left Ventricular Hypertrophy. 收缩压低于 130 mmHg 可降低超声心动图左心室肥厚型高血压患者的心血管事件发生率
IF 3.1 3区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2024-06-21 DOI: 10.1124/jpet.123.001952
Maria Lembo, Valentina Trimarco, Raffaele Izzo, Maria Virginia Manzi, Francesco Rozza, Paola Gallo, Carmine Morisco, Luca Bardi, Giovanni Esposito, Imma Forzano, Gaetano Santulli, Bruno Trimarco

Background: Recent reports have evidenced an increased mortality rate in hypertensive patients with electrocardiographic left ventricular hypertrophy (ECG-LVH) achieving systolic blood pressure (SBP) <130 mmHg. However, to the best of our knowledge, the actual effects of blood pressure reduction to the ≤130/80 mmHg target on the incidence of cardiovascular (CV) events have never been determined in hypertensive patients with a diagnosis of left ventricular hypertrophy based on echocardiographic criteria (Echo-LVH). Methods: To fill this long-standing knowledge gap, we harnessed a population of 9511 hypertensive patients, followed-up for 33.6 [interquartile range 7.9-72.7] months. The population was divided into six groups according to the average SBP achieved during the follow-up (≤130, 130-139, and ≥140 mmHg) and absence/presence of Echo-LVH. The primary endpoint was a composite of fatal or nonfatal myocardial infarction and stroke, sudden cardiac death, heart failure requiring hospitalization, revascularization, and carotid stenting. Secondary endpoints included atrial fibrillation and transient ischemic attack. Results: During the follow-up, achieved SBP and diastolic blood pressure (DBP) were comparable between patients with and without Echo-LVH. Strikingly, the rates of primary and secondary endpoints were significantly higher in patients with Echo-LVH and SBP >130 mmHg, reaching the highest values in the Echo-LVH group with SBP ≥140 mmHg. By separate Cox multivariable regressions, after adjusting for potential confounders, both primary and secondary endpoints were significantly associated with SBP ≥140 mmHg and Echo-LVH. Instead, DBP reduction ≤80 mmHg was associated with a significant increased rate of secondary events. Conclusions: In hypertensive patients with Echo-LVH, achieving an average in-treatment SBP target ≤130 mmHg has a beneficial prognostic impact on incidence of CV events. SIGNIFICANCE STATEMENT: Contrary to recent findings, achieving in-treatment SBP ≤130 mmHg lowers the incidence of CV events in hypertensive patients with Echo-LVH. However, reducing DBP ≤80 mmHg is linked to increased CV complications. Cox multivariable regression models, considering potential confounders, reveal that the rate of hard and soft CV events is significantly associated with Echo-LVH and SBP ≥140 mmHg. Our data indicate that therapeutic strategies for Echo-LVH patients should target SBP ≤130 mmHg while avoiding lowering DBP ≤80 mmHg.

背景:最近的报告表明,心电图左心室肥厚(ECG-LVH)达到收缩压(SBP)的高血压患者死亡率增加 方法:为了填补这一长期知识空白,我们对 9511 名高血压患者进行了为期 33.6 [IQR 7.9-72.7] 个月的随访:为了填补这一长期存在的知识空白,我们对 9511 名高血压患者进行了为期 33.6 [IQR 7.9-72.7] 个月的随访。根据随访期间达到的平均 SBP({小于或等于}130、130-139 和 {大于或等于}140mmHg)以及无/有回声-LVH 将患者分为六组。主要终点是致命性或非致命性心肌梗死和中风、心脏性猝死、需要住院治疗的心力衰竭、血管重建和颈动脉支架植入术的复合终点。次要终点包括心房颤动和短暂性脑缺血发作。研究结果在随访期间,Echo-LVH 患者和未接受 Echo-LVH 治疗的患者达到的 SBP 和舒张压(DBP)相当。引人注目的是,回声-LVH 和 SBP>130mmHg 患者的主要和次要终点发生率明显更高,SBP{大于或等于}140mmHg 的回声-LVH 组发生率最高。在调整了潜在的混杂因素后,通过单独的 Cox 多变量回归,主要终点和次要终点均与 SBP{ 大于或等于}140mmHg 和 Echo-LVH 显著相关。相反,DBP 下降{小于或等于}80mmHg 与继发性事件发生率的显著增加有关。结论:对于患有 Echo-LVH 的高血压患者,实现治疗中平均 SBP 目标值{小于或等于}130mmHg 对心血管事件的发生率具有有利的预后影响。意义声明 与最近的报道相反,实现治疗期间 SBP≤130mmHg 可降低回声-LVH 高血压患者的心血管事件发生率。降低 DBP≤80mmHg 反而与较高的冠心病并发症发生率相关。通过 Cox 多变量回归模型,调整潜在的混杂因素,硬性和软性 CV 事件的发生率与 Echo-LVH 和 SBP≥140mmHg 显著相关。我们的数据表明,回声-LVH 患者的治疗策略应以降低 SBP≤130mmHg 为目标,同时注意不要降低 DBP≤80mmHg。
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引用次数: 0
Immunogenic Treatment of Metastatic Breast Cancer Using Targeted Carbon Nanotube Mediated Photothermal Therapy in Combination with Anti-Programmed Cell Death Protein-1. 利用靶向碳纳米管介导的光热疗法与抗-PD-1联合治疗转移性乳腺癌的免疫疗法。
IF 3.1 3区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2024-06-21 DOI: 10.1124/jpet.123.001796
Gabriela N F Faria, Clement G Karch, Sampurna Chakraborty, Tingting Gu, Alexis Woodward, Adam Aissanou, Sathish Lageshetty, Ricardo Prada Silvy, Daniel Resasco, Jorge Andres Ballon, Roger G Harrison

The high prevalence of breast cancer is a global health concern, compounded by the lack of safe or effective treatments for its advanced stages. These facts urge the development of novel treatment strategies. Annexin A5 (ANXA5) is a natural human protein that binds with high specificity to phosphatidylserine, a phospholipid tightly maintained in the inner leaflet of the cell membrane on most healthy cells but externalized in tumor cells and the tumor vasculature. Here, we have developed a targeted photosensitizer for photothermal therapy (PTT) of solid tumors through the functionalization of single-walled carbon nanotubes (SWCNTs) to ANXA5-the SWCNT-ANXA5 conjugate. The ablation of tumors through the SWCNT-ANXA5-mediated PTT synergizes with checkpoint inhibition, creating a systemic anticancer immune response. In vitro ablation of cells incubated with the conjugate promoted cell death in a dose-dependent and targeted manner. This treatment strategy was tested in vivo with the orthotopic EMT6 breast tumor model in female balb/cJ mice. Enhanced therapeutic effects were achieved by using intratumoral injection of the conjugate and treating tumors at a lower PTT temperature (45°C). Intratumoral injection prevented the accumulation of the SWCNTs in major clearance organs. When combined with checkpoint inhibition of anti-programmed cell death protein-1, SWCNT-ANXA5-mediated PTT increased survival and 80% of the mice survived for 100 days. Evidence of immune system activation by flow cytometry of splenic cells strengthens the hypothesis of an abscopal effect as a mechanism of prolonged survival. SIGNIFICANCE STATEMENT: This study demonstrated a relatively high survival rate (80% at 100 days) of mice with aggressive breast cancer when treated with photothermal therapy using the SWCNT-ANXA5 conjugate injected intratumorally and combined with immune stimulation using the anti-programmed cell death protein-1 checkpoint inhibitor. Photothermal therapy was accomplished by maintaining the tumor temperature at a relatively low level of 45°C and avoiding accumulation of the nanotubes in the clearance organs by using intratumoral administration.

乳腺癌的高发病率是一个全球性的健康问题,但目前还没有安全有效的晚期治疗方法。这些事实促使人们开发新的治疗策略。磷脂酰丝氨酸是一种磷脂,大多数健康细胞的细胞膜内叶都有这种磷脂,但在肿瘤细胞和肿瘤血管中却外化了。在这里,我们通过将单壁碳纳米管(SWCNT)与 ANXA5 功能化,开发出一种用于实体瘤光热疗法(PTT)的靶向光敏剂--SWCNT-ANXA5 共轭物。通过 SWCNT-ANXA5 介导的 PTT 消融肿瘤与检查点抑制协同作用,产生全身性抗癌免疫反应。体外消融与共轭物培养的细胞,以剂量依赖性和靶向性的方式促进细胞死亡。这种治疗策略在雌性 balb/cJ 小鼠的 EMT6 乳腺肿瘤模型中进行了体内试验。通过瘤内注射共轭物和在较低的 PTT 温度(45 摄氏度)下治疗肿瘤,增强了治疗效果。瘤内注射可防止 SWCNTs 在主要清除器官中积聚。当与抗PD-1的检查点抑制相结合时,SWCNT-ANXA5介导的PTT提高了存活率,80%的小鼠存活了100天。脾脏细胞流式细胞术显示的免疫系统活化证据加强了缺氧效应作为延长存活期机制的假设。意义声明 本研究表明,使用瘤内注射的 SWCNT-ANXA5 结合物进行光热疗法,并结合使用抗 PD-1 检查点抑制剂进行免疫刺激,侵袭性乳腺癌小鼠的存活率相对较高(100 天内存活率为 80%)。光热疗法是通过将肿瘤温度保持在相对较低的 45oC 水平,并通过瘤内给药避免纳米管在清除器官中积聚来实现的。
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Journal of Pharmacology and Experimental Therapeutics
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