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Histamine H1-receptor-mediated modulation of NMDA receptors signaling responses. 组胺 H1 受体介导的 NMDA 受体信号反应调节。
IF 2.9 4区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2024-10-01 DOI: 10.1002/prp2.1216
J-M Arrang, V Armand

This study attempted to clarify the role of histamine H1 receptors in epilepsy by exploring the effects of agonists and inverse agonists on the rundown of the current induced by iterative applications of NMDA or GABA in primary neuronal culture. Mepyramine, a classical H1-receptor antagonist/inverse agonist, increased the NMDA current by about 40% during the first minutes of recording. This effect was concentration-dependent, maximal at 10 nM, and mimicked by triprolidine, another antagonist/inverse agonist. No endogenous histamine was detected in the cultures by a selective immunoassay; both compounds were acting as inverse agonists. Indicating a high constitutive activity of the H1 receptor in this system, histamine did not affect the NMDA rundown, including its settlement, but significantly reversed the effect of mepyramine. A similar pattern was obtained with 2,3 bromophenyl histamine, a selective H1-receptor agonist. The initial increase induced by the two inverse agonists was followed by the same rundown as in controls. H1- and NMDA receptors are colocalized in most cultured neuronal cells. Mepyramine and histamine did not affect the GABA rundown. Our findings suggest an interaction between H1- and NMDA receptors. Inactivation of the H1-receptor by its inverse agonists delays the settlement of the NMDA rundown, which may underlie their proconvulsant effect reported in clinics. Therefore, H1-receptor constitutive activity and the effect of histamine revealed in its absence, tend to facilitate the initiation of the rundown, which is consistent with the anticonvulsant properties of histamine via activation of H1-receptors reported in many studies.

本研究试图通过探讨激动剂和反向激动剂对原代神经元培养中迭代应用 NMDA 或 GABA 所诱导的电流骤降的影响,来阐明组胺 H1 受体在癫痫中的作用。经典的 H1 受体拮抗剂/反向激动剂美吡胺能在记录的最初几分钟内使 NMDA 电流增加约 40%。这种效应是浓度依赖性的,在 10 nM 时达到最大,并被另一种拮抗剂/反向激动剂曲普利啶模拟。通过选择性免疫测定,培养物中没有检测到内源性组胺;这两种化合物都是反向激动剂。组胺不影响 NMDA 崩溃(包括其沉降),但却能显著逆转甲氧苄啶的作用,这表明该系统中 H1 受体具有很高的组成活性。选择性 H1 受体激动剂 2,3-溴苯组胺也有类似的作用。这两种反向激动剂引起的最初升高随后出现了与对照组相同的下降。在大多数培养的神经细胞中,H1 受体和 NMDA 受体是共定位的。美吡胺和组胺并不影响 GABA 的隆升。我们的研究结果表明,H1-和NMDA受体之间存在相互作用。H1-受体的反向激动剂使H1-受体失活,从而延迟了NMDA的释放,这可能是临床上报道的H1-受体促惊厥效应的原因。因此,H1-受体的组成活性和组胺在其缺失时显示的效应往往会促进 "破环 "的启动,这与许多研究报告的组胺通过激活 H1-受体而产生的抗惊厥特性是一致的。
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引用次数: 0
Nutritional strategies for improving sarcopenia outcomes in older adults: A narrative review. 改善老年人肌肉疏松症疗效的营养策略:叙述性综述。
IF 2.9 4区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2024-10-01 DOI: 10.1002/prp2.70019
Beatriz R Goes-Santos, Brian P Carson, Guilherme Wesley Peixoto da Fonseca, Stephan von Haehling

Sarcopenia is characterized by a decline in muscle strength, generalized loss of skeletal muscle mass, and impaired physical performance, which are common outcomes used to screen, diagnose, and determine severity of sarcopenia in older adults. These outcomes are associated with poor quality of life, increased risk of falls, hospitalization, and mortality in this population. The development of sarcopenia is underpinned by aging, but other factors can lead to sarcopenia, such as chronic diseases, physical inactivity, inadequate dietary energy intake, and reduced protein intake (nutrition-related sarcopenia), leading to an imbalance between muscle protein synthesis and muscle protein breakdown. Protein digestion and absorption are also modified with age, as well as the reduced capacity of metabolizing protein, hindering older adults from achieving ideal protein consumption (i.e., 1-1.5 g/kg/day). Nutritional supplement strategies, like animal (i.e., whey protein) and plant-based protein, leucine, and creatine have been shown to play a significant role in improving outcomes related to sarcopenia. However, the impact of other supplements (e.g., branched-chain amino acids, isolated amino acids, and omega-3) on sarcopenia and related outcomes remain unclear. This narrative review will discuss the evidence of the impact of these nutritional strategies on sarcopenia outcomes in older adults.

肌肉疏松症的特征是肌肉力量下降、骨骼肌质量普遍丧失和身体机能受损,这些都是用于筛查、诊断和确定老年人肌肉疏松症严重程度的常见结果。这些结果与老年人生活质量低下、跌倒风险增加、住院和死亡有关。肌肉疏松症的发生是由衰老引起的,但其他因素也会导致肌肉疏松症,如慢性疾病、缺乏运动、膳食能量摄入不足、蛋白质摄入减少(与营养有关的肌肉疏松症),从而导致肌肉蛋白质合成与肌肉蛋白质分解之间的失衡。随着年龄的增长,蛋白质的消化和吸收也会发生变化,蛋白质的代谢能力也会降低,从而阻碍老年人达到理想的蛋白质摄入量(即每天每公斤 1-1.5 克)。营养补充策略,如动物性(即乳清蛋白)和植物性蛋白质、亮氨酸和肌酸,已被证明在改善与肌肉疏松症相关的结果方面发挥了重要作用。然而,其他补充剂(如支链氨基酸、分离氨基酸和欧米茄-3)对肌肉疏松症及相关结果的影响仍不清楚。本综述将讨论这些营养策略对老年人肌肉疏松症疗效影响的证据。
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引用次数: 0
Nicotine addiction and the influence of life adversity and acute stress on PYY: Prediction of early smoking relapse. 尼古丁成瘾以及生活逆境和急性压力对PYY的影响:预测早期复吸。
IF 2.9 4区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2024-10-01 DOI: 10.1002/prp2.70016
Amanda A Miller, Motohiro Nakajima, Briana N DeAngelis, Dorothy K Hatsukami, Mustafa al'Absi

Early life adversity (ELA) is associated with earlier initiation and maintenance of tobacco smoking and with a greater risk of subsequent relapse. There is growing evidence that appetite hormones, including peptide YY (PYY), which modulates craving and satiety responses, play a role in stress and addiction processes. This study employed a quasi-experimental design to examine the association between ELA and circulating PYY stress responses in smokers and nonsmokers (N = 152, ages 19-73 years) to examine the effects of nicotine addiction. Smokers initiated a quit attempt as part of the study and were classified as either abstinent smokers or relapsed smokers based on their nicotine use during the follow-up period. PYY levels were measured at five timepoints during three lab sessions and compared between nonsmokers and the two smoking groups (abstainers, relapsers): while smokers were using nicotine ad libitum, 24 h after smokers initiated a quit attempt, and 4 weeks after smokers initiated a quit attempt. Multivariate analyses showed the main effects of time on PYY, which decreased over time within each session. The main effects of ELA during the first (ad libitum smoking) and second (24-h post-cessation for smokers) sessions indicated that experiencing ELA was associated with lower PYY. No systematic effect of nicotine addiction or relapse was observed in this study. These findings suggest that adults with higher ELA may experience lower PYY. Additional research is needed to further explore the role of PYY in stress and addiction processes.

早期生活逆境(ELA)与更早开始吸烟和维持吸烟习惯有关,而且与随后复吸的更大风险有关。越来越多的证据表明,食欲激素(包括调节渴求和饱腹反应的肽YY(PYY))在压力和成瘾过程中发挥作用。本研究采用准实验设计,研究吸烟者和非吸烟者(152人,19-73岁)的ELA与循环PYY应激反应之间的关系,以探讨尼古丁成瘾的影响。作为研究的一部分,吸烟者开始尝试戒烟,并根据他们在随访期间使用尼古丁的情况被分为戒烟者和复吸者。在三次实验过程中的五个时间点测量了PYY水平,并在非吸烟者和两个吸烟组(戒烟者、复吸者)之间进行了比较:吸烟者在自由使用尼古丁时、吸烟者开始尝试戒烟后24小时以及吸烟者开始尝试戒烟后4周。多变量分析显示了时间对PYY的主要影响,在每个疗程中,PYY会随着时间的推移而减少。在第一个疗程(随意吸烟)和第二个疗程(吸烟者戒烟后 24 小时)中,ELA 的主效应表明,经历 ELA 与较低的PYY 有关。本研究未观察到尼古丁成瘾或复吸的系统性影响。这些研究结果表明,ELA较高的成年人PYY可能较低。还需要进行更多的研究,以进一步探讨PYY在压力和成瘾过程中的作用。
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引用次数: 0
Pharmacokinetics and pharmacodynamics of the factor XIa-inhibiting antibody osocimab in healthy male East Asian volunteers: Results from two phase 1 studies. 东亚男性健康志愿者体内 XIa 因子抑制抗体奥索西单抗的药代动力学和药效学:两项 1 期研究的结果。
IF 2.9 4区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2024-10-01 DOI: 10.1002/prp2.70012
Zhili Dong, Kensei Hashizume, Frauke Friedrichs, Pei Liu, Toshiaki Tanaka, Yuqin Liao

The pharmacokinetics, pharmacodynamics, immunogenicity, and safety of osocimab single doses in healthy Chinese and Japanese volunteers over 149 days were evaluated. Two phase 1 single-blinded, placebo-controlled studies with 27 Japanese and 50 Chinese participants were conducted. Osocimab was investigated with IV doses of 0.3, 1.25, and 2.5 mg/kg (Chinese study) and 0.3, 1.25, and 5.0 mg/kg (Japanese study), as well as SC doses of 3.0 and 6.0 mg/kg (Chinese study) and 6.0 mg/kg (Japanese study). The maximum plasma concentration was reached 1-3 h and 4-6 days after IV and SC administration, respectively. Osocimab exhibited a deviation from dose-proportional pharmacokinetics for AUC but not Cmax; higher doses had higher apparent clearance and disproportionately lower total exposure. A slightly lower exposure was observed in Japanese compared with Chinese volunteers after IV administration; conversely, relatively higher exposure in Japanese volunteers with SC dosing was identified. Osocimab was associated with a dose-dependent increase in activated partial thromboplastin time (aPTT). Maximal aPTT prolongations were observed 1-4 h and 2-6 days after IV and SC administration, respectively. Anti-drug antibodies of low titer were detected in 1/9 (11.1%) Japanese volunteers administered placebo and 26/40 (65.0%) Chinese volunteers administered osocimab. Adverse events were reported in 8/18 (44.4%) Japanese and 28/40 (70.0%) Chinese volunteers who received osocimab, as well as in 1/9 (11.1%) Japanese and 6/10 (60.0%) Chinese volunteers who received placebo. In conclusion, data did not suggest a clear dose-proportionality for osocimab within the investigated dose range. The effect of osocimab on aPTT was expected per its mechanism of action. Osocimab was generally well tolerated.

本研究评估了奥索西单抗单剂在中国和日本健康志愿者中 149 天的药代动力学、药效学、免疫原性和安全性。该研究进行了两项 1 期单盲安慰剂对照研究,分别有 27 名日本人和 50 名中国人参加。奥索西单抗的静脉注射剂量为 0.3、1.25 和 2.5 毫克/千克(中国研究)和 0.3、1.25 和 5.0 毫克/千克(日本研究),皮下注射剂量为 3.0 和 6.0 毫克/千克(中国研究)和 6.0 毫克/千克(日本研究)。静脉注射和皮下注射后 1-3 小时和 4-6 天分别达到最大血浆浓度。奥索西单抗的 AUC 与剂量比例药代动力学有偏差,但 Cmax 没有;剂量越大,表观清除率越高,总暴露量则不成比例地降低。与中国志愿者相比,日本志愿者静脉注射奥索西单抗的暴露量略低;相反,日本志愿者静脉注射奥索西单抗的暴露量相对较高。奥索西单抗与活化部分凝血活酶时间(aPTT)的剂量依赖性增加有关。静脉注射和皮下注射后 1-4 小时和 2-6 天分别观察到最大的 aPTT 延长。1/9(11.1%)名服用安慰剂的日本志愿者和26/40(65.0%)名服用奥索西单抗的中国志愿者检测到低滴度的抗药抗体。8/18(44.4%)名日本志愿者和 28/40(70.0%)名中国志愿者接受了奥索西单抗治疗,1/9(11.1%)名日本志愿者和 6/10 (60.0%)名中国志愿者接受了安慰剂治疗。总之,数据并未表明奥索西单抗在研究剂量范围内具有明显的剂量比例关系。根据其作用机制,奥索西单抗对 aPTT 的影响在意料之中。奥索西单抗的耐受性总体良好。
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引用次数: 0
Effect of mitochondrial coenzyme-Q10 precursor solanesol in gentamicin-induced experimental nephrotoxicity: Evidence from restoration of ETC-complexes and histopathological alterations. 线粒体辅酶-Q10 前体 Solanesol 对庆大霉素诱发的实验性肾毒性的影响:从 ETC 复合物的恢复和组织病理学改变中获得的证据。
IF 2.9 4区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2024-10-01 DOI: 10.1002/prp2.70022
Minakshi Sangwan, Hema Chaudhary, Sidharth Mehan, Zuber Khan, Ammar A Bahauddin, Bandar D Alrehaili, Hossein M Elbadawy, Mohannad A Almikhlafi, Acharan S Narula, Reni Kalfin, Hanna Wanas

Nephrotoxicity occurs when the body is exposed to certain drugs or toxins. When kidney damage occurs, the kidney fails to eliminate excess urine and waste. Solanesol (C45H74O) is a tri-sesquiterpenoid alcohol first isolated from tobacco, and it is widely distributed in plants of the Solanaceae family. Solanesol (SNL) is an intermediate in the synthesis of coenzyme Q10 (CoQ10), an antioxidant which protects nerve cells. This study investigated the protective effect of SNL at doses of 30 and 60 mg/kg in gentamicin-induced nephrotoxicity in Wistar albino rats. Animals were distributed into six groups and administered 100 mg/kg gentamicin-intraperitoneal injection for 14 days. Biochemical assessments were performed on kidney homogenate, blood, and serum. Treatment with SNL was shown as lower serum levels of creatinine, blood urea nitrogen (BUN), thiobarbituric acid reactive substances (TBARS), and Tumor necrosis factor alpha)TNF-α ((p < .001). It also restored reduced glutathione (GSH) and mitochondrial complex enzymatic activity as protective measures against gentamicin-induced nephrotoxicity. SNL were shown to reduce inflammation and oxidative stress markers (p < .001). Histological findings furtherly augmented the protective effects of SNL. Long-term SNL therapy also restored mitochondrial electron transport chain complex enzymes, such as complex-I (p < .001). In conclusion, these findings suggest that SNL can represent a protective therapeutic option for drug-induced nephrotoxicity, a long-term adverse effect of aminoglycoside antibiotics such as gentamicin.

当人体接触到某些药物或毒素时,就会产生肾毒性。当肾脏受损时,肾脏无法排出多余的尿液和废物。茄红素(Solanesol,C45H74O)是一种三倍半萜醇,最早从烟草中分离出来,广泛分布于茄科植物中。茄红素(SNL)是合成辅酶 Q10(CoQ10)的中间体,而辅酶 Q10 是一种保护神经细胞的抗氧化剂。本研究调查了剂量为 30 毫克/千克和 60 毫克/千克的 SNL 对庆大霉素诱导的 Wistar 白化大鼠肾毒性的保护作用。研究将大鼠分为六组,每组腹腔注射 100 毫克庆大霉素,连续 14 天。对肾脏匀浆、血液和血清进行了生化评估。接受 SNL 治疗的大鼠血清中肌酐、血尿素氮(BUN)、硫代巴比妥酸活性物质(TBARS)和肿瘤坏死因子α(TNF-α)的水平较低((p<0.05))。
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引用次数: 0
Risks of oral anticoagulants: Analysis of adverse drug reactions reported to the Portuguese National Pharmacovigilance System 口服抗凝剂的风险:向葡萄牙国家药物警戒系统报告的药物不良反应分析
IF 2.6 4区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2024-09-18 DOI: 10.1002/prp2.1235
Ana Sofia Martins, Cristina Monteiro, Ana Paula Duarte
Cardiovascular diseases are the leading cause of death globally, making the use of oral anticoagulants for prevention increasingly important. Historically, warfarin has played a significant role in this context. In recent years, introduction of new oral anticoagulants, such as rivaroxaban, apixaban, dabigatran, and edoxaban, has been seen. This study evaluates the risk associated with the use of oral anticoagulants by analyzing spontaneous adverse drug reactions reported to the Portuguese Pharmacovigilance System from 2012 to 2021. The study includes 951 adverse drug reactions reports, with the majority (n = 770; 80.97%) classified as serious. Of the 770 serious adverse drug reactions reports, the most commonly reported seriousness criterion was “Clinically Important” (n = 350; 45.45%). In terms of demographics, there was a higher reporting rate among the elderly population, with a greater prevalence of females. The System Organ Class group with the highest number of adverse drug reactions was “Gastrointestinal disorders,” with the most commonly reported Preferred Term being “Gastrointestinal hemorrhage,” and dabigatran was the most frequently reported drug. In summary, oral anticoagulants have adverse drug reactions that require continuous monitoring. Accurate identification and monitorization of adverse drug reactions is an important starting point to improve drug safety in population.
心血管疾病是导致全球死亡的主要原因,因此使用口服抗凝剂进行预防变得越来越重要。一直以来,华法林在这方面发挥着重要作用。近年来,利伐沙班、阿哌沙班、达比加群和埃多沙班等新型口服抗凝药物相继问世。本研究通过分析 2012 年至 2021 年葡萄牙药物警戒系统报告的自发性药物不良反应,评估了使用口服抗凝剂的相关风险。研究包括 951 份药物不良反应报告,其中大部分(n = 770;80.97%)被归类为严重不良反应。在 770 份严重药品不良反应报告中,最常报告的严重性标准是 "临床重要"(n = 350;45.45%)。从人口统计学来看,老年人群的报告率较高,女性的报告率也较高。药物不良反应数量最多的系统器官类别是 "胃肠功能紊乱",最常报告的首选术语是 "胃肠道出血",达比加群是最常报告的药物。总之,口服抗凝药存在药物不良反应,需要持续监测。准确识别和监测药物不良反应是提高人群用药安全的重要起点。
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引用次数: 0
Evaluating the quality of multiple‐choice question pilot database: A global educator‐created tool for concept‐based pharmacology learning 评估多选题试验数据库的质量:由全球教育工作者创建的基于概念的药理学学习工具
IF 2.6 4区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2024-09-13 DOI: 10.1002/prp2.70004
Adeladlew Kassie Netere, Tony Hughes, Anna‐Marie Babey, Martin Hawes, Janet Mifsud, John P. Kelly, Willmann Liang, Mark Hernandez, Kelly Karpa, Hesham Al‐Sallami, Lynette B. Fernandes, Patrik Aronsson, Carolina Restini, Fabiana Caetano Crowley, Elvan Djouma, Tina Hinton, Johnson J. Liu, Fatima Mraiche, Paul J. White
The Core Concepts of Pharmacology (CCP) initiative is developing educational resources to transform pharmacology education into a concept‐based approach. This study evaluated the quality of global educator‐created MCQs in generating items for the pharmacology concept inventory (PCI) instrument and developed as a resource for learning pharmacology fundamental concepts. A panel of 22 global pharmacology experts recruited from the CCP initiative research team participated in the MCQ pilot database design and evaluation. The quality analysis framework of the MCQs in the pilot database included four assessment tools: item writing guidelines (IWGs), Bloom's taxonomy, the CCP, and the MCQ design format. A two‐phase evaluation process was involved, including inter‐rater agreement on item quality, followed by resolving conflicts that occurred in quality assessment. The chi‐square (χ2) test of independence and Cramer's V correlation tests were utilized to measure the relationship among quality assessment attributes. About 200 MCQs were gathered and 98% underwent expert evaluation. Nearly 80% addressed one or more CCP, with 52% designed using a context‐dependent format. However, only 40% addressed higher levels of Bloom's cognitive domain and 10% adhered to all IWGs. A strong positive correlation was observed between the context‐based item format and its effectiveness in assessing the higher cognitive domain, the main CCP and improved IWGs adherence. Context‐based item construction can assess the higher cognitive skills and fundamental pharmacology concepts, showing potential for rigorous PCI development. The pilot database will store items to create the PCI, aiding the development of a concept‐based pharmacology curriculum.
药理学核心概念(CCP)计划正在开发教育资源,以便将药理学教育转变为基于概念的方法。本研究评估了全球教育工作者创建的 MCQ 在生成药理学概念清单 (PCI) 工具项目方面的质量,并将其开发为学习药理学基本概念的资源。由 CCP 计划研究团队招募的 22 位全球药理学专家组成的专家小组参与了 MCQ 试验数据库的设计和评估。试点数据库中 MCQ 的质量分析框架包括四个评估工具:项目编写指南 (IWG)、布卢姆分类法、CCP 和 MCQ 设计格式。评估过程分为两个阶段,包括评分者之间就题目质量达成一致,然后解决质量评估中出现的冲突。研究采用了卡方(χ2)独立性检验和克莱默 V 相关检验来测量质量评估属性之间的关系。共收集了约 200 个 MCQ,其中 98% 经过了专家评估。近 80% 的 MCQ 涉及一个或多个 CCP,其中 52% 的设计采用了上下文相关的格式。然而,只有 40% 的试题涉及布卢姆认知领域的较高层次,10% 的试题符合所有 IWG。基于情境的题目格式与其在评估较高层次认知领域、主要 CCP 和改进 IWGs 遵循度方面的有效性之间存在很强的正相关性。基于情境的项目构建可以评估高级认知技能和基本药理学概念,显示了严格的 PCI 开发潜力。试点数据库将存储用于创建 PCI 的项目,有助于开发基于概念的药理学课程。
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引用次数: 0
An improvement of the safety profile of SARS‐CoV‐2 vaccines is desirable 改善 SARS-CoV-2 疫苗的安全性是可取的
IF 2.6 4区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2024-09-12 DOI: 10.1002/prp2.70008
Josef Finsterer
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引用次数: 0
Pharmacokinetics, disposition, and biotransformation of the cardiac myosin inhibitor aficamten in humans 心肌酶抑制剂阿非坎顿在人体内的药代动力学、处置和生物转化
IF 2.6 4区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2024-09-11 DOI: 10.1002/prp2.70006
Donghong Xu, Punag Divanji, Adrienne Griffith, Rajaa Sukhun, Kathleen Cheplo, Jianlin Li, Polina German
Aficamten, a cardiac myosin inhibitor, is being developed for the treatment of patients with symptomatic hypertrophic cardiomyopathy (HCM). The purpose of this study was to determine the absorption, metabolism, and excretion of aficamten. Eight healthy male participants received a single oral dose of 20 mg aficamten (containing approximately 100 μCi of radiocarbon). Blood, urine, and feces samples were collected up to a maximum of Day 26. The pharmacokinetics of aficamten were characterized by moderate absorption, with a median tmax of 2.0 h postdose. The median t1/2 of aficamten was 99.6 h with similar t1/2 observed for metabolites and total radioactivity in plasma and whole blood. The overall total recovery of administered total radioactivity was 89.7% with 57.7% of the dose recovered in feces and 32.0% in urine. The main circulating metabolites in plasma included monohydroxylated metabolites M1a (CK‐3834282) and M1b (CK‐3834283) accounting for 10.5% and 36.4% of the total radioactivity AUC both with a median tmax of 5 h. The other major plasma metabolite was M5 (an oxygen‐linked glucuronide conjugate of M1a), which accounted for 10.3% of the total plasma radioactivity exposure, with a tmax of 24 h. In urine, M5 was the most abundant metabolite with 8.02% total radioactive dose (TRD), followed by M1a and M1b with 6.16% and 2.85% TRD, respectively; however, there were no metabolites in urine observed at >10% of dose. The major metabolite in feces was M18 representing 44.1% of the radioactive dose. These findings indicated that aficamten was eliminated by metabolism, and to a minor extent, by fecal excretion of unchanged aficamten with renal excretion playing a minor role. Feces were the principal route of excretion of the radioactive dose.
阿菲康坦是一种心肌肌球蛋白抑制剂,目前正在开发用于治疗症状性肥厚型心肌病(HCM)患者。本研究的目的是确定阿菲康坦的吸收、代谢和排泄情况。八名健康男性参加者单次口服了 20 毫克阿非坎顿(约含 100 μCi 放射性碳)。采集的血液、尿液和粪便样本最多可持续到第 26 天。阿非卡姆登的药代动力学特点是吸收适中,中位 tmax 为服药后 2.0 小时。阿非卡姆登的中位 t1/2 为 99.6 小时,血浆和全血中的代谢物和总放射性的 t1/2 与之相似。给药总放射性的总回收率为 89.7%,其中 57.7% 的剂量从粪便中回收,32.0% 从尿液中回收。血浆中的主要循环代谢物包括单羟化代谢物 M1a(CK-3834282)和 M1b(CK-3834283),分别占总放射性 AUC 的 10.5%和 36.4%,中位 tmax 均为 5 小时。在尿液中,M5是含量最高的代谢物,占总放射性剂量(TRD)的8.02%,其次是M1a和M1b,分别占TRD的6.16%和2.85%;然而,在尿液中没有观察到剂量达到>10%的代谢物。粪便中的主要代谢物是 M18,占放射性剂量的 44.1%。这些研究结果表明,阿非卡姆登是通过新陈代谢排出体外的,少量未改变的阿非卡姆登通过粪便排出体外,肾脏排泄起次要作用。粪便是放射性剂量的主要排泄途径。
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引用次数: 0
An open-label study to explore the optimal design of CYP3A drug-drug interaction clinical trials in healthy Chinese people. 一项开放标签研究,探索在健康中国人中进行 CYP3A 药物相互作用临床试验的最佳设计。
IF 2.9 4区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2024-08-01 DOI: 10.1002/prp2.1252
Jingcheng Chen, Jiangshuo Li, Jingxuan Wu, Yuqin Song, Lijun Li, Jianxiong Zhang, Ruihua Dong

A drug-drug interaction (DDI) trial of cytochrome P450 3A (CYP3A) is a necessary part of early-phase trials of drugs mainly metabolized by this enzyme, but CYP3A DDI clinical trials do not have a standard design, especially for Chinese people. We aimed to offer specific recommendations for CYP3A DDI clinical trial design. This was an open, three-cycle, self-controlled study. Healthy subjects were given different administration strategies of CYP3A4 perpetrators. In each cycle, blood samples were collected before and within 24 h after the administration of midazolam, the CYP3A indicator substrate. The plasma concentrations of midazolam and 1-hydroxymidazolam was obtained using liquid chromatography tandem mass spectrometry assay. For CYP3A inhibition, itraconazole exposure with a loading dose could increase the exposure of midazolam by 3.21-fold based on maximum plasma concentration (Cmax), 8.37-fold based on area under the curve Pharmacology Research & Perspectives for review only from zero to the time point (AUC0-t), and 11.22-fold based on area under the curve from zero to infinity (AUC0-∞). The data were similar for itraconazole pretreatment without a loading dose. For CYP3A induction, the exposure of rifampin for 7 days decreased the plasma concentration of midazolam ~0.27-fold based on Cmax, ~0.18-fold based on AUC0-t, and ~0.18-fold based on AUC0-∞. Midazolam exposure did not significantly change when the pretreatment of rifampin increased to 14 days. This study showed that itraconazole pretreatment for 3 days without a loading dose was enough for CYP3A inhibition, and pretreatment with rifampin for 7 days could induce near-maximal CYP3A levels.

细胞色素P450 3A(CYP3A)药物相互作用(DDI)试验是主要由该酶代谢的药物早期试验的必要组成部分,但CYP3A DDI临床试验并没有标准的设计,尤其是针对中国人。我们旨在为 CYP3A DDI 临床试验设计提供具体建议。这是一项开放式、三周期、自控研究。给健康受试者使用不同的 CYP3A4 致效剂给药策略。在每个周期中,在服用 CYP3A 指示底物咪达唑仑之前和之后 24 小时内采集血样。使用液相色谱串联质谱法测定咪达唑仑和 1-hydroxymidazolam 的血浆浓度。在 CYP3A 抑制方面,根据最大血浆浓度(Cmax)计算,伊曲康唑的负荷剂量可使咪达唑仑的暴露量增加 3.21 倍;根据从零到时间点的曲线下面积(AUC0-t)计算,可使咪达唑仑的暴露量增加 8.37 倍;根据从零到无穷大的曲线下面积(AUC0-∞)计算,可使咪达唑仑的暴露量增加 11.22 倍。伊曲康唑预处理无负荷剂量时的数据类似。就 CYP3A 诱导而言,利福平暴露 7 天后,咪达唑仑的血浆浓度按 Cmax 计算下降了 ~0.27 倍,按 AUC0-t 计算下降了 ~0.18 倍,按 AUC0-∞ 计算下降了 ~0.18 倍。当利福平的预处理时间增加到 14 天时,咪达唑仑的暴露量没有明显变化。本研究表明,伊曲康唑预处理 3 天且不加负荷剂量足以抑制 CYP3A,而利福平预处理 7 天可诱导接近最大的 CYP3A 水平。
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