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AlphaFold-based AI docking reveals AMPK/SIRT1-TFEB pathway modulation by traditional Chinese medicine in metabolic-associated fatty liver disease 基于alphafold的AI对接揭示中药对代谢相关脂肪肝AMPK/SIRT1-TFEB通路的调节
IF 9.1 2区 医学 Q1 PHARMACOLOGY & PHARMACY Pub Date : 2025-02-01 DOI: 10.1016/j.phrs.2025.107617
Lulu Zhang , Yi Zheng , Mingyan Shao , Aiping Chen , Meiyi Liu , Wenlong Sun , Tianxing Li , Yini Fang , Yang Dong , Shipeng Zhao , Hui Luo , Juan Feng , Qi Wang , Lingru Li , Yanfei Zheng
Metabolic-associated fatty liver disease (MAFLD) is a chronic, progressive disorder characterized by hepatic steatosis and excessive lipid accumulation. Its high global adult prevalence (approximately 50.7 %) is a significant concern worldwide. However, FDA-approved therapeutic drugs remains lacking. Qigui Jiangzhi Formula (QGJZF) shows promise in treating MAFLD by effectively decreasing lipid levels and improving hepatic steatosis, however its mechanisms remain unclear. This study investigated QGJZF’s effects in high-fat diet-induced zebrafish and golden hamsters, and in palmitate (PA) and oleic acid (OA) - induced HepG2 cells, using the SymMap database to identify potential targets and pathways of QGJZF in MAFLD and AlphaFold algorithms to predict protein structures. In vivo, QGJZF significantly alleviated hepatic lipid deposition. Intriguingly, QGJZF decreased lipid droplets and its levels are negative correlated with the numbers of autolysosomes, indicating that QGJZF’s mechanism of ameliorating liver lipid deposition may be related to the regulation of autophagy. QGJZF upregulated the expressions of phosphorylated -Adenosine 5‘-monophosphate (AMP) - activated protein kinase (p-AMPK), Sirtuin deacetylase 1 (SIRT1) and Transcription factor EB (TFEB), accompanied by the changes in autophagy-related proteins. In vitro, QGJZF inhibited the lipid deposition in PA/OA-stimulated HepG2 cells, and its effect was blocked by an autophagy inhibitor Baf-A1, which was mediated through upregulation of TFEB and its mediated autophagy-lysosomal pathway. Moreover, cotreatment with AMPK inhibitor Compound C, the regulation of QGJZF on TFEB, SIRT1, autophagy-related protein levels, and lipid deposition were reversed. Network pharmacology identified the PRKAA2 (AMPK) and SIRT1 as key hub targets. Futher analysis of their structures using AlphaFold3 algorithms, yielded high-ranking scores of 0.97 and 0.93, respectively. Liquid chromatography-mass spectrometry combined with molecular docking expounded its five compounds in QGJZF binding to AMPK protein. These findings suggest that QGJZF as a therapeutic agent in augmenting autophagy-facilitated lipid clearance for the management of MAFLD via AMPK/SIRT1-TFEB axis.
代谢性脂肪性肝病(MAFLD)是一种慢性进行性疾病,以肝脏脂肪变性和过度脂质积累为特征。然而,其全球成人患病率很高(约50.7%),fda批准的治疗药物仍然缺乏。七归降脂方通过有效降低脂质水平和改善肝脏脂肪变性,有望治疗mald,但其机制尚不清楚。本研究研究了QGJZF在高脂肪饮食诱导的斑马鱼和金仓鼠以及棕榈酸(PA)和油酸(OA)诱导的HepG2细胞中的作用,利用SymMap数据库识别QGJZF在MAFLD和AlphaFold算法中潜在的靶点和通路,以预测蛋白质结构。在体内,清热健脾方明显减轻肝脏脂质沉积。令人感兴趣的是,清热参能减少脂滴,且其水平与自噬酶体数量呈负相关,说明清热参能改善肝脏脂滴沉积的机制可能与调节自噬有关。QGJZF上调磷酸化-腺苷5′-单磷酸(AMP)活化蛋白激酶(p-AMPK)、Sirtuin去乙酰化酶1 (SIRT1)和转录因子EB (TFEB)的表达,并伴有自噬相关蛋白的改变。在体外实验中,清热参汤能抑制大鼠脑内脂质沉积,其作用被Baf-A1阻断,其作用机制是通过上调TFEB及其介导的自噬-溶酶体途径实现的。此外,与AMPK抑制剂化合物C共处理,QGJZF对TFEB、SIRT1、自噬相关蛋白水平和脂质沉积的调节被逆转。网络药理学鉴定PRKAA2 (AMPK)和SIRT1为关键枢纽靶点。使用AlphaFold3算法对它们的结构进行进一步分析,分别获得了0.97和0.93的高分。液相色谱-质谱结合分子对接,阐述了QGJZF与AMPK蛋白结合的5个化合物。这些发现表明,QGJZF作为一种治疗剂,可以通过AMPK/SIRT1-TFEB轴增强自噬促进脂质清除,从而管理MAFLD。
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引用次数: 0
Ginseng polysaccharides circumvent acquired resistance to anti-PD-1 immunotherapy in patients with non-small cell lung cancer 人参多糖可避免非小细胞肺癌患者对抗pd -1免疫治疗的获得性耐药。
IF 9.1 2区 医学 Q1 PHARMACOLOGY & PHARMACY Pub Date : 2025-02-01 DOI: 10.1016/j.phrs.2025.107611
Jumin Huang , Ziming Wang , Feng Li , Huiting Wang, Yang Xiang, Runze Li, Chun Xie, Yuwei Wang, Zhihong Jiang, Yabing Cao, Wenhua Liang, Elaine Lai-Han Leung
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引用次数: 0
Sailing south from regulations to strategies: Macau as a promising gateway for the export of proprietary Chinese medicines to ASEAN countries 从法规到策略南行:澳门作为中成药出口东盟国家的理想门户。
IF 9.1 2区 医学 Q1 PHARMACOLOGY & PHARMACY Pub Date : 2025-02-01 DOI: 10.1016/j.phrs.2025.107600
Dong-mei Xue, Dan-ni Wang, Jia Yuan, Lan Yao, Ying Bian
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引用次数: 0
Exploring the benefits and prescribing informations of combining East Asian herbal medicine with conventional medicine in the treatment of rheumatoid arthritis: A systematic review and multifaceted analysis of 415 randomized controlled trials
IF 9.1 2区 医学 Q1 PHARMACOLOGY & PHARMACY Pub Date : 2025-02-01 DOI: 10.1016/j.phrs.2025.107616
Hee-Geun Jo , Jihye Seo , Eunhye Baek , Donghun Lee
<div><h3>Background</h3><div>Notwithstanding progress in conventional medicine (CM), the management of rheumatoid arthritis (RA) continues to be problematic due to factors such as limited patient response to treatment and restricted medication access. This study aimed to evaluate the extent to which East Asian herbal medicine with CM combination therapy (EACM) provides additional benefits in effectiveness and safety.</div></div><div><h3>Methods</h3><div>We conducted a comprehensive search across 11 databases in English, Chinese, Korean, and Japanese for randomized controlled trials. The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, using the American College of Rheumatology (ACR) 20/50/70 Response Criteria and the incidence of adverse events (AEI) as primary outcomes. This meta-analysis was performed using a random-effects model. The quality of each study was assessed according to the RoB 2. Of the 1036 full-text articles screened, 415 were included in the review.</div></div><div><h3>Results</h3><div>This review included data from 37,839 participants. EACM was associated with higher ACR responses: ACR 20 (RR: 1.2332; 95 % CI: 1.1852–1.2831, p < 0.0001), ACR 50 (RR: 1.3782; 95 % CI: 1.2936–1.4684, p < 0.0001), and ACR 70 (RR: 1.7084; 95 % CI: 1.5555–1.8762, p < 0.0001), as well as a favorable AEI (OR: 0.3977; 95 % CI: 0.3476–0.4551, p < 0.0001), indicating both better efficacy and safety compared to CM alone. These patterns were consistent across eight secondary outcomes measuring pain, inflammation, and disease activity in RA. Subgroup analyses showed that EACM's effects were independent of the control CM type. Through a comprehensive analysis of a polyherbal prescription dataset, we identified 18 key herbs and 16 significant combination rules, further supported by relevant preclinical evidence. These herbs and synergistic herbal combinations were anticipated to be the most pharmacologically influential in contributing to the meta-analysis outcomes, as substantiated by analytical metrics including network topology and intricate association pattern evaluations.</div></div><div><h3>Conclusions</h3><div>The findings suggest that EACM may serve as a valuable complementary strategy for RA patients insufficiently managed by CM alone. In particular, given that the ACR index integrates multiple aspects of RA patients, the results are expected to provide valuable complementary decision support for the management of RA patients who do not respond well to CM therapy, both for medical and economic reasons. Additionally, the key herbs derived through the multifaceted analysis, which actively reflect clinicians' implicit preferences for prescribing EACMs, may serve as important hypotheses for further research and clinical application. However, additional qualitative and quantitative improvements in research are needed for more definitive conclusions. Further analysis of the herbal prescriptions p
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引用次数: 0
Therapeutics of bitter plants from Northeast region of India and their pharmacological and phytochemical perspectives
IF 9.1 2区 医学 Q1 PHARMACOLOGY & PHARMACY Pub Date : 2025-02-01 DOI: 10.1016/j.phrs.2025.107626
Bhaskar Das , Bharat Gopalrao Somkuwar , Sushil Kumar Chaudhary , Evanylla Kharlyngdoh , Careen Liza Pakyntein , Kishor Basor , Jitendra Kumar Shukla , Pardeep Kumar Bhardwaj , Pulok Kumar Mukherjee
Natural resources have been used for food and medicine since the beginning of human civilization, and they have always been a low-cost, easily accessible source for individuals. Northeast region of India (NER) represents a significant portion of India's flora and fauna. Marginality, fragility, inaccessibility, ethnicity, and cultural diversity thrived in the region, resulting in the richest reservoir of genetic variation of bioresources. Several bitter plants are used by the locals as both food and medicine to treat a variety of diseases. These medicinal plants are an excellent source of chemically diverse biologically active phytometabolites. There have been few efforts to raise awareness about health benefits of bitter plant resources abound in this region that may provides opportunities for their sustainable utilization. Understanding the structural features of plant derived bitterants in relationship with specific bitter receptor will provide research prospects to identify biomolecules with health benefits. In this context the present review is intended to deliver phyto-pharmacological aspects of bitter plant resources of NER together with detailed understanding of possible association between plant derived phytometabolites as bitter agonists with extraoral bitter receptors.
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引用次数: 0
Protein kinase inhibitors as targeted therapy for glioblastoma: a meta-analysis of randomized controlled clinical trials 蛋白激酶抑制剂作为胶质母细胞瘤的靶向治疗:随机对照临床试验的荟萃分析。
IF 9.1 2区 医学 Q1 PHARMACOLOGY & PHARMACY Pub Date : 2025-02-01 DOI: 10.1016/j.phrs.2024.107528
José Pinto-Fraga , Celia García-Chico , Simone Lista , Pedro Miguel Lacal , Giuseppe Carpenzano , Maurizio Salvati , Alejandro Santos-Lozano , Grazia Graziani , Claudia Ceci
Glioblastoma (GBM) is the most common and lethal primary brain tumor. The standard treatment for newly diagnosed GBM includes surgical resection, when feasible, followed by radiotherapy and temozolomide-based chemotherapy. Upon disease progression, the anti-vascular endothelial growth factor-A (VEGF-A) monoclonal antibody bevacizumab, can be considered.
Given the limited efficacy of pharmacological treatments, particularly for the recurrent disease, several molecularly targeted interventions have been explored, such as small-molecule protein kinase inhibitors (PKIs), inhibiting tyrosine kinase growth factor receptors and downstream signaling pathways involved in GBM angiogenesis and infiltrative behavior.
This meta-analysis, based on searches in PubMed and Web Of Science, evaluated 12 randomized controlled trials (RCTs) examining PKIs in patients with newly diagnosed or recurrent GBM. Pooled analysis of shared clinical outcomes - progression-free survival (PFS) and overall survival (OS) - revealed a lack of significant improvements with the use of PKIs. In newly diagnosed GBM, no significant differences were observed in median [-1.02 months, 95 % confidence interval (CI), −2.37–0.32, p = 0.14] and pooled [hazard ratio (HR) = 1.13, 95 % CI, 0.95–1.35, p = 0.17) OS, or in median (0.34 months, 95 % CI, −0.9–1.58, p = 0.60) and pooled (HR = 0.98, 95 % CI, 0.76–1.27, p = 0.89) PFS, when comparing PKI addition to standard chemo-radiotherapy versus chemo-radiotherapy alone. In recurrent GBM, three different analyses were conducted: PKI versus other treatments, PKI combined with other treatments versus those treatments alone, PKI versus PKI combined with other treatments. Also, across these analyses, no significant clinical benefits were found. For instance, when comparing PKI treatment with other treatments, median OS and PFS showed no significant difference (-0.78 months, 95 % CI, −2.12–0.55, p = 0.25; −0.23 months, 95 % CI, −0.79–0.34, p = 0.43, respectively), and similar non-significant results were observed in the pooled analyses (OS: HR = 0.89, 95 % CI, 0.59–1.32, p = 0.55; PFS: HR = 0.83, 95 % CI, 0.63–1.11, p = 0.21).
Despite these overall negative findings, some data indicate improved clinical outcomes in a subset of GBM patients treated with certain PKIs (i.e., regorafenib) and encourage further research to identify PKIs with better blood-brain barrier penetration and lower risk for resistance development.
胶质母细胞瘤(GBM)是最常见和最致命的原发性脑肿瘤。新诊断的GBM的标准治疗包括手术切除,如果可行,然后是放疗和替莫唑胺为基础的化疗。当疾病进展时,可以考虑使用抗血管内皮生长因子- a (VEGF-A)单克隆抗体贝伐单抗。鉴于药物治疗的有效性有限,特别是对于复发性疾病,一些分子靶向干预已经被探索,如小分子蛋白激酶抑制剂(PKIs),抑制酪氨酸激酶生长因子受体和下游信号通路参与GBM血管生成和浸润行为。这项荟萃分析基于PubMed和Web Of Science的搜索,评估了12项随机对照试验(rct),这些试验检查了新诊断或复发的GBM患者的PKIs。共享临床结果-无进展生存期(PFS)和总生存期(OS)的汇总分析显示,使用PKIs缺乏显著的改善。在新诊断的GBM中,当比较PKI联合标准化疗与单独化疗时,中位[-1.02个月,95%可信区间(CI), -2.37-0.32, p=0.14]和合并[风险比(HR)=1.13, 95% CI, 0.95-1.35, p=0.17] OS或中位(0.34个月,95% CI, -0.9-1.58, p=0.60)和合并(HR=0.98, 95% CI, 0.76-1.27, p=0.89) PFS无显著差异。在复发性GBM中,进行了三种不同的分析:PKI与其他治疗,PKI联合其他治疗与单独治疗,PKI与PKI联合其他治疗。此外,在这些分析中,没有发现显著的临床益处。例如,当比较PKI治疗与其他治疗时,中位OS和PFS没有显着差异(-0.78个月,95% CI, -2.12-0.55, p=0.25;-0.23个月,95% CI, -0.79-0.34, p=0.43),并且在合并分析中观察到类似的无显著性结果(OS: HR=0.89, 95% CI, 0.59-1.32, p=0.55;PFS: HR=0.83, 95% CI, 0.63-1.11, p=0.21)。尽管这些总体阴性结果,但一些数据表明,某些PKIs(即瑞非尼)治疗的一部分GBM患者的临床结果有所改善,并鼓励进一步研究确定PKIs具有更好的血脑屏障穿透性和更低的耐药风险。
{"title":"Protein kinase inhibitors as targeted therapy for glioblastoma: a meta-analysis of randomized controlled clinical trials","authors":"José Pinto-Fraga ,&nbsp;Celia García-Chico ,&nbsp;Simone Lista ,&nbsp;Pedro Miguel Lacal ,&nbsp;Giuseppe Carpenzano ,&nbsp;Maurizio Salvati ,&nbsp;Alejandro Santos-Lozano ,&nbsp;Grazia Graziani ,&nbsp;Claudia Ceci","doi":"10.1016/j.phrs.2024.107528","DOIUrl":"10.1016/j.phrs.2024.107528","url":null,"abstract":"<div><div>Glioblastoma (GBM) is the most common and lethal primary brain tumor. The standard treatment for newly diagnosed GBM includes surgical resection, when feasible, followed by radiotherapy and temozolomide-based chemotherapy. Upon disease progression, the anti-vascular endothelial growth factor-A (VEGF-A) monoclonal antibody bevacizumab, can be considered.</div><div>Given the limited efficacy of pharmacological treatments, particularly for the recurrent disease, several molecularly targeted interventions have been explored, such as small-molecule protein kinase inhibitors (PKIs), inhibiting tyrosine kinase growth factor receptors and downstream signaling pathways involved in GBM angiogenesis and infiltrative behavior.</div><div>This meta-analysis, based on searches in PubMed and Web Of Science, evaluated 12 randomized controlled trials (RCTs) examining PKIs in patients with newly diagnosed or recurrent GBM. Pooled analysis of shared clinical outcomes - progression-free survival (PFS) and overall survival (OS) - revealed a lack of significant improvements with the use of PKIs. In newly diagnosed GBM, no significant differences were observed in median [-1.02 months, 95 % confidence interval (CI), −2.37–0.32, <em>p = 0.14</em>] and pooled [hazard ratio (HR) = 1.13, 95 % CI, 0.95–1.35, <em>p = 0.17</em>) OS, or in median (0.34 months, 95 % CI, −0.9–1.58, <em>p = 0.60</em>) and pooled (HR = 0.98, 95 % CI, 0.76–1.27, <em>p = 0.89</em>) PFS, when comparing PKI addition to standard chemo-radiotherapy <em>versus</em> chemo-radiotherapy alone. In recurrent GBM, three different analyses were conducted: PKI <em>versus</em> other treatments, PKI combined with other treatments <em>versus</em> those treatments alone, PKI <em>versus</em> PKI combined with other treatments. Also, across these analyses, no significant clinical benefits were found. For instance, when comparing PKI treatment with other treatments, median OS and PFS showed no significant difference (-0.78 months, 95 % CI, −2.12–0.55, <em>p = 0.25;</em> −0.23 months, 95 % CI, −0.79–0.34, <em>p = 0.43,</em> respectively), and similar non-significant results were observed in the pooled analyses (OS: HR = 0.89, 95 % CI, 0.59–1.32, <em>p = 0.55</em>; PFS: HR = 0.83, 95 % CI, 0.63–1.11, <em>p = 0.21</em>).</div><div>Despite these overall negative findings, some data indicate improved clinical outcomes in a subset of GBM patients treated with certain PKIs (i.e., regorafenib) and encourage further research to identify PKIs with better blood-brain barrier penetration and lower risk for resistance development.</div></div>","PeriodicalId":19918,"journal":{"name":"Pharmacological research","volume":"212 ","pages":"Article 107528"},"PeriodicalIF":9.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142786403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
New insights into anti-depression effects of bioactive phytochemicals 生物活性植物化学物质抗抑郁作用的新见解。
IF 9.1 2区 医学 Q1 PHARMACOLOGY & PHARMACY Pub Date : 2025-02-01 DOI: 10.1016/j.phrs.2024.107566
Ruohan Zhao , Jingwen Wang , Sookja Kim Chung , Baojun Xu
Depression is one of the most common psychological disorders, and due to its high prevalence and mortality rates, it imposes a significant disease burden. Contemporary treatments for depression involve various synthetic drugs, which have limitations such as side effects, single targets, and slow onset of action. Unlike synthetic medications, phytochemicals offer the benefits of a multi-target and multi-pathway mode of treatment for depression. In this literature review, we describe the pharmacological actions, experimental models, and clinical trials of the antidepressant effects of various phytochemicals. Additionally, we summarize the potential mechanisms by which these phytochemicals prevent depression, including regulating neurotransmitters and their receptors, the HPA axis, inflammatory responses, managing oxidative stress, neuroplasticity, and the gut microbiome. Phytochemicals exert therapeutic effects through multiple pathways and targets, making traditional Chinese medicine (TCM) a promising adjunctive antidepressant for the prevention, alleviation, and treatment of depression. Therefore, this review aims to provide robust evidence for subsequent research into developing phytochemical resources as effective antidepressant agents.
抑郁症是最常见的心理障碍之一,由于其高患病率和死亡率,它造成了重大的疾病负担。当代治疗抑郁症的方法包括各种合成药物,这些药物有副作用、单一靶点和起效缓慢等局限性。与合成药物不同,植物化学物质提供了多靶点和多途径治疗抑郁症的好处。在这篇文献综述中,我们描述了各种植物化学物质的抗抑郁作用的药理作用,实验模型和临床试验。此外,我们总结了这些植物化学物质预防抑郁症的潜在机制,包括调节神经递质及其受体、HPA轴、炎症反应、管理氧化应激、神经可塑性和肠道微生物群。植物化学物质通过多种途径和靶点发挥治疗作用,使中药成为预防、缓解和治疗抑郁症的一种很有前景的辅助抗抑郁药。因此,本综述旨在为后续研究开发植物化学资源作为有效的抗抑郁药物提供有力的证据。
{"title":"New insights into anti-depression effects of bioactive phytochemicals","authors":"Ruohan Zhao ,&nbsp;Jingwen Wang ,&nbsp;Sookja Kim Chung ,&nbsp;Baojun Xu","doi":"10.1016/j.phrs.2024.107566","DOIUrl":"10.1016/j.phrs.2024.107566","url":null,"abstract":"<div><div>Depression is one of the most common psychological disorders, and due to its high prevalence and mortality rates, it imposes a significant disease burden. Contemporary treatments for depression involve various synthetic drugs, which have limitations such as side effects, single targets, and slow onset of action. Unlike synthetic medications, phytochemicals offer the benefits of a multi-target and multi-pathway mode of treatment for depression. In this literature review, we describe the pharmacological actions, experimental models, and clinical trials of the antidepressant effects of various phytochemicals. Additionally, we summarize the potential mechanisms by which these phytochemicals prevent depression, including regulating neurotransmitters and their receptors, the HPA axis, inflammatory responses, managing oxidative stress, neuroplasticity, and the gut microbiome. Phytochemicals exert therapeutic effects through multiple pathways and targets, making traditional Chinese medicine (TCM) a promising adjunctive antidepressant for the prevention, alleviation, and treatment of depression. Therefore, this review aims to provide robust evidence for subsequent research into developing phytochemical resources as effective antidepressant agents.</div></div>","PeriodicalId":19918,"journal":{"name":"Pharmacological research","volume":"212 ","pages":"Article 107566"},"PeriodicalIF":9.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142922480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Deciphering consciousness: The role of corticothalamocortical interactions in general anesthesia 解读意识:皮质-丘脑-皮质相互作用在全身麻醉中的作用。
IF 9.1 2区 医学 Q1 PHARMACOLOGY & PHARMACY Pub Date : 2025-02-01 DOI: 10.1016/j.phrs.2025.107593
Yuxi Zhou , Shiqian Huang , Tianhao Zhang , Daling Deng , Li Huang , Xiangdong Chen
General anesthesia is administered to millions of individuals each year, however, the precise mechanism by which it induces unconsciousness remains unclear. While some theories suggest that anesthesia shares similarities with natural sleep, targeting sleep-promoting areas and inhibiting arousal nuclei, recent research indicates a more complex process. Emerging evidence highlights the critical role of corticothalamocortical circuits, which are involved in higher cognitive functions, in controlling arousal states and modulating transitions between different conscious states during anesthesia. The administration of general anesthetics disrupts connectivity within these circuits, resulting in a reversible state of unconsciousness. This review elucidates how anesthetics impair corticothalamocortical interactions, thereby affecting the flow of information across various cortical layers and disrupting higher-order cognitive functions while preserving basic sensory processing. Additionally, the role of the prefrontal cortex in regulating arousal through both top-down and bottom-up pathways was examined. These findings highlight the intricate interplay between the cortical and subcortical networks in maintaining and restoring consciousness under anesthesia, offering potential therapeutic targets for enhancing anesthesia management.
每年有数以百万计的人接受全身麻醉,然而,全身麻醉诱发无意识的确切机制尚不清楚。虽然一些理论认为麻醉与自然睡眠有相似之处,针对促进睡眠的区域并抑制唤醒核,但最近的研究表明一个更复杂的过程。新出现的证据强调了皮质丘脑皮质回路的关键作用,它涉及到高级认知功能,在麻醉过程中控制唤醒状态和调节不同意识状态之间的转换。全身麻醉会破坏这些神经回路的连接,导致可逆的无意识状态。这篇综述阐明了麻醉药如何损害皮质-丘脑-皮质的相互作用,从而影响不同皮质层之间的信息流动,在保留基本感觉处理的同时破坏高阶认知功能。此外,前额叶皮层通过自上而下和自下而上的途径调节唤醒的作用也得到了检验。这些发现强调了皮层和皮层下网络在麻醉下维持和恢复意识中的复杂相互作用,为加强麻醉管理提供了潜在的治疗靶点。
{"title":"Deciphering consciousness: The role of corticothalamocortical interactions in general anesthesia","authors":"Yuxi Zhou ,&nbsp;Shiqian Huang ,&nbsp;Tianhao Zhang ,&nbsp;Daling Deng ,&nbsp;Li Huang ,&nbsp;Xiangdong Chen","doi":"10.1016/j.phrs.2025.107593","DOIUrl":"10.1016/j.phrs.2025.107593","url":null,"abstract":"<div><div>General anesthesia is administered to millions of individuals each year, however, the precise mechanism by which it induces unconsciousness remains unclear. While some theories suggest that anesthesia shares similarities with natural sleep, targeting sleep-promoting areas and inhibiting arousal nuclei, recent research indicates a more complex process. Emerging evidence highlights the critical role of corticothalamocortical circuits, which are involved in higher cognitive functions, in controlling arousal states and modulating transitions between different conscious states during anesthesia. The administration of general anesthetics disrupts connectivity within these circuits, resulting in a reversible state of unconsciousness. This review elucidates how anesthetics impair corticothalamocortical interactions, thereby affecting the flow of information across various cortical layers and disrupting higher-order cognitive functions while preserving basic sensory processing. Additionally, the role of the prefrontal cortex in regulating arousal through both top-down and bottom-up pathways was examined. These findings highlight the intricate interplay between the cortical and subcortical networks in maintaining and restoring consciousness under anesthesia, offering potential therapeutic targets for enhancing anesthesia management.</div></div>","PeriodicalId":19918,"journal":{"name":"Pharmacological research","volume":"212 ","pages":"Article 107593"},"PeriodicalIF":9.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142952901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Neoadjuvant chemoimmunotherapy for locally advanced squamous cell carcinoma of the head and neck: Systematic review and meta-analysis 新辅助化疗免疫治疗局部晚期头颈部鳞状细胞癌:系统回顾和荟萃分析。
IF 9.1 2区 医学 Q1 PHARMACOLOGY & PHARMACY Pub Date : 2025-02-01 DOI: 10.1016/j.phrs.2025.107598
Xiayi Zhu, Jie Qiu, Ya Zhang, Chunni Lin, Xiaohui Wang, Xiwei Shi, Siya Yang, Qiaoyan Wu, Li Cong

Background

Neoadjuvant chemoimmunotherapy emerged as a promising treatment for locally advanced squamous cell carcinoma of the head and neck (LA-SCCHN). However, a comparison of clinical outcomes with neoadjuvant chemotherapy was lacking.

Objective

To provide evidence supporting clinical decision-making for neoadjuvant chemoimmunotherapy in LA-SCCHN treatment.

Methods

Literature was retrieved from PubMed, Web of Science, Embase, and the Cochrane Library for studies on the efficacy and safety of neoadjuvant chemoimmunotherapy and chemotherapy in LA-SCCHN published before August 10, 2024. The study was registered in the PROSPERO (CRD42024573816).

Results

A total of 28 clinical trials with 2021 patients were included. The neoadjuvant chemoimmunotherapy group had significantly higher pathologic complete response (pCR) (33 % vs. 18 %, P = 0.04) and partial response (PR) (65 % vs. 38 %, P < 0.01). No significant differences were found in overall survival (OS) (hazard ratio: 0.85, 95 % CI: 0.77–0.93) and progression-free survival (PFS) (hazard ratio: 0.72, 95 % CI: 0.61–0.86). Regarding safety outcomes, in the single-arm trials, grade 3–4 treatment-related adverse events (TRAEs) occurred in 14 % of the chemoimmunotherapy group and 13 % of the chemotherapy group, with grade 5 TRAEs at 0 % and 4 %, respectively, showing no significant difference (P = 0.80; P = 0.08). In both RCTs and non-RCT, chemoimmunotherapy had a higher Risk Ratio (RR) for grade 3–4 TRAEs (RR: 1.42, 95 % CI: 0.87–2.31).

Conclusion

Neoadjuvant chemoimmunotherapy has shown promising efficacy and safety for LA-SCCHN, but further randomized trials are needed to confirm long-term survival benefits.
背景:新辅助化学免疫治疗是治疗局部晚期头颈部鳞状细胞癌(LA-SCCHN)的一种很有希望的治疗方法。然而,缺乏与新辅助化疗的临床结果的比较。目的:为LA-SCCHN新辅助化疗的临床决策提供依据。方法:检索PubMed、Web of Science、Embase和Cochrane图书馆,检索2024年8月10日前发表的关于LA-SCCHN新辅助化疗、免疫治疗和化疗的疗效和安全性的文献。该研究已在PROSPERO注册(CRD42024573816)。结果:共纳入28项临床试验,2021例患者。新辅助化疗组病理完全缓解(pCR) (33% vs. 18%, P = 0.04)和部分缓解(PR) (65% vs. 38%, P < 0.01)明显高于化疗组。总生存期(OS)(风险比:0.85,95% CI: 0.77-0.93)和无进展生存期(PFS)(风险比:0.72,95% CI: 0.61-0.86)无显著差异。关于安全性结局,在单臂试验中,化疗免疫治疗组和化疗组发生3 - 4级治疗相关不良事件(TRAEs)的比例分别为14%和13%,其中5级TRAEs分别为0%和4%,差异无统计学意义(P = 0.80;P = 0.08)。在随机对照试验和非随机对照试验中,化疗免疫治疗对3 - 4级TRAEs的风险比(RR)更高(RR: 1.42, 95% CI: 0.87-2.31)。结论:新辅助化疗免疫治疗对LA-SCCHN具有良好的疗效和安全性,但需要进一步的随机试验来证实长期生存益处。
{"title":"Neoadjuvant chemoimmunotherapy for locally advanced squamous cell carcinoma of the head and neck: Systematic review and meta-analysis","authors":"Xiayi Zhu,&nbsp;Jie Qiu,&nbsp;Ya Zhang,&nbsp;Chunni Lin,&nbsp;Xiaohui Wang,&nbsp;Xiwei Shi,&nbsp;Siya Yang,&nbsp;Qiaoyan Wu,&nbsp;Li Cong","doi":"10.1016/j.phrs.2025.107598","DOIUrl":"10.1016/j.phrs.2025.107598","url":null,"abstract":"<div><h3>Background</h3><div>Neoadjuvant chemoimmunotherapy emerged as a promising treatment for locally advanced squamous cell carcinoma of the head and neck (LA-SCCHN). However, a comparison of clinical outcomes with neoadjuvant chemotherapy was lacking.</div></div><div><h3>Objective</h3><div>To provide evidence supporting clinical decision-making for neoadjuvant chemoimmunotherapy in LA-SCCHN treatment.</div></div><div><h3>Methods</h3><div>Literature was retrieved from PubMed, Web of Science, Embase, and the Cochrane Library for studies on the efficacy and safety of neoadjuvant chemoimmunotherapy and chemotherapy in LA-SCCHN published before August 10, 2024. The study was registered in the PROSPERO (CRD42024573816).</div></div><div><h3>Results</h3><div>A total of 28 clinical trials with 2021 patients were included. The neoadjuvant chemoimmunotherapy group had significantly higher pathologic complete response (pCR) (33 % vs. 18 %, <em>P</em> = 0.04) and partial response (PR) (65 % vs. 38 %, <em>P</em> &lt; 0.01). No significant differences were found in overall survival (OS) (hazard ratio: 0.85, 95 % CI: 0.77–0.93) and progression-free survival (PFS) (hazard ratio: 0.72, 95 % CI: 0.61–0.86). Regarding safety outcomes, in the single-arm trials, grade 3–4 treatment-related adverse events (TRAEs) occurred in 14 % of the chemoimmunotherapy group and 13 % of the chemotherapy group, with grade 5 TRAEs at 0 % and 4 %, respectively, showing no significant difference (<em>P</em> = 0.80; <em>P</em> = 0.08). In both RCTs and non-RCT, chemoimmunotherapy had a higher Risk Ratio (RR) for grade 3–4 TRAEs (RR: 1.42, 95 % CI: 0.87–2.31).</div></div><div><h3>Conclusion</h3><div>Neoadjuvant chemoimmunotherapy has shown promising efficacy and safety for LA-SCCHN, but further randomized trials are needed to confirm long-term survival benefits.</div></div>","PeriodicalId":19918,"journal":{"name":"Pharmacological research","volume":"212 ","pages":"Article 107598"},"PeriodicalIF":9.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142979402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Wogonin effects on the efflux transporters BCRP and MRP2, explain its effectiveness in ulcerative colitis: Implications for metabolic and transport interactions Wogonin对外排转运体BCRP和MRP2的影响解释了其在溃疡性结肠炎中的有效性:对代谢和转运相互作用的影响。
IF 9.1 2区 医学 Q1 PHARMACOLOGY & PHARMACY Pub Date : 2025-02-01 DOI: 10.1016/j.phrs.2024.107570
Yuanyuan Liu , Zerong Zhang , Xiaoyan Li , Qinghong Hu , Zhangyu Jiang , Jia Lv , Jiayi Xue , Dongyu Wang , Jianxiong Cao , Lingyu Li , Xiaowen Ou , Lijun Zhu , Zhongqiu Liu , Tao Su
Wogonin is a flavonoid with efficacy in ulcerative colitis (UC), while the mechanism of its action remains to be fully elucidated. Previous research has indicated that the triple recycling significantly enhances the bioavailability of flavonoids. The efflux transporters, breast cancer resistance protein (BCRP) and multidrug resistance-associated protein 2 (MRP2) are critical regulatory molecules within the enterohepatic triple recycling pathways. Therefore, we investigated the regulatory impact of wogonin on BCRP and MRP2, as well as the roles of these transporters in wogonin's therapeutic efficacy in UC. Using dextran sulfate sodium (DSS)-induced UC model, we found that the anti-UC efficacy of wogonin was diminished in Bcrp-/--Mrp2-/- mice compared to wild-type (WT) mice. In these knockout mice, the content of wogonin was increased in the plasma but decreased in the colon tissues, suggesting that deficiencies in BCRP and MRP2 hinder the efflux of wogonin, resulting in elevated content in the plasma. Moreover, in vitro results showed that after knockout of BCRP and MRP2, the concentration of wogonin increased, and its UGT metabolite wogonoside decreased in both cells and mitochondria. These indicate that inhibiting efflux transporters suppresses cellular and mitochondrial glucuronidation metabolism. Interestingly, proteomic sequencing of mitochondrial subcellular organelles revealed that wogonin exhibited anti-UC effects by inhibiting afamin (AFM), with these effects modulated by BCRP and MRP2. These findings not only suggest a new mechanism for the anti-UC effects of wogonin, but also provide a pharmacological foundation for the clinical use of wogonin in treating UC.
枸杞素是一种对溃疡性结肠炎(UC)有疗效的类黄酮,其作用机制尚不完全清楚。先前的研究表明,三重循环途径的激活显著提高了黄酮类化合物的生物利用度。外排转运蛋白、BCRP和MRP2是肠肝三重循环途径中的关键调控分子。因此,我们研究了wogonin对BCRP和MRP2的调控作用,以及这些转运体在wogonin治疗UC中的作用。采用葡聚糖硫酸钠(DSS)诱导的UC模型,我们发现与野生型(WT)小鼠相比,wogonin在Bcrp-/- Mrp2-/-小鼠中的抗UC作用减弱。在这些基因敲除小鼠中,血浆中沃戈蛋白含量升高,而结肠组织中沃戈蛋白含量降低,这表明BCRP和MRP2的缺乏阻碍了沃戈蛋白的外排,导致血浆中沃戈蛋白含量升高。此外,体外实验结果显示,敲除BCRP和MRP2后,细胞和线粒体中沃根素浓度升高,其UGT代谢物沃根苷浓度降低。这表明抑制外排转运蛋白抑制细胞和线粒体糖醛酸化代谢。有趣的是,线粒体亚细胞细胞器的蛋白质组学测序显示,沃戈宁通过抑制AFM (AFM)表现出抗uc的作用,这些作用由BCRP和MRP2调节。这些发现不仅为提高该类黄酮的口服生物利用度提供了新的机制,也为临床应用枸杞素治疗UC提供了药理学基础。
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