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Editorial: Evaluating Impact of High-Cost Cancer Drugs at Regional Level: The Case of Veneto (Italy) 社论:在区域层面评估高成本抗癌药物的影响:威尼托(意大利)的案例
Pub Date : 2013-04-19 DOI: 10.2174/1874143601307010001
D. Gregori, D. Chiffi
In Italy, the National Health System (NHS) costs are controlled by the regional governments (which are financially accountable for health care expenditure, including hospital drug budgets), but agreements regarding price and discounts are decided in AIFA (Italian Medicine Agency). For this reason, some regional governments ask the pharmaceutical companies to produce a "Health Technology Assessment" before deciding to introduce a drug in the regional hospital list of accepted drugs. Thus, in terms of public policy maker and its decision process, the choice of well-specified points of view is an essential ingredient in the critical assessment of economic evaluation, which becomes more effective when information is presented in the general terms of a cost of illness analysis (COI), or, in a disaggregated way by means of a list of the costs and the
在意大利,国家卫生系统(NHS)的费用由地方政府控制(地方政府在财政上对卫生保健支出负责,包括医院药品预算),但有关价格和折扣的协议由AIFA(意大利药品管理局)决定。出于这个原因,一些地方政府要求制药公司在决定将一种药物引入地区医院的可接受药物清单之前,出具一份“卫生技术评估”。因此,就公共决策者及其决策过程而言,选择明确规定的观点是对经济评估进行批判性评估的一个重要组成部分,当信息以疾病成本分析(COI)的一般术语呈现时,或以成本和成本清单的分类方式呈现时,这种评估将变得更加有效
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引用次数: 0
Primary Sclerosing Cholangitis - Current Issues in Clinical Practice 原发性硬化性胆管炎-临床实践中的当前问题
Pub Date : 2012-06-17 DOI: 10.2174/1874143601206010045
L. Corless, H. Tsai
Aims: To review current issues in the diagnosis and treatment of primary sclerosing cholangitis. Methods: search of PubMed using the terms "primary sclerosing cholangitis", "PSC", "cholangitis" and "cholestasis", as well as by review of current guidelines from the major international liver societies. Results: Primary sclerosing cholangitis is still a challenging condition to diagnose and manage, but newer imaging modalities like MRCP and timing of liver transplantation point the way forward.
目的:综述原发性硬化性胆管炎的诊断和治疗现状。方法:使用PubMed检索术语“原发性硬化性胆管炎”、“PSC”、“胆管炎”和“胆汁淤淤症”,并查阅主要国际肝脏学会的现行指南。结果:原发性硬化性胆管炎仍然是一个具有挑战性的诊断和治疗条件,但新的成像方式,如MRCP和肝移植的时机指出了前进的方向。
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引用次数: 0
Intelligent Systems and the Systematization of Pharmacological Knowledge: Application of the In Vitro Retina Model 智能系统和药理学知识的系统化:体外视网膜模型的应用
Pub Date : 2012-05-21 DOI: 10.2174/1874143601206010034
V. M. F. Lima, José P. Castro, W. Hanke
In this century, the IT technology will spread intelligent systems based on cameras, sensors and computers across all fields of the human endeavor. The systematization of knowledge will reach new levels of organization and applications. Scientific knowledge will not be an exception. In this paper we present the results of validation tests made with the in vitro retina model in order to propose the systematization of pharmacological knowledge in experimental platforms supplied with data banks. Data banks can be made either for the speeding up of pre-clinical research or for the control of quality of pure substances or pharmaceutical preparations. These applications and other implementations of using the retinal spreading model in pharmacological research will be useful for the users, manufacturers and authorities of regulation of public health.
在本世纪,IT技术将把基于摄像头、传感器和计算机的智能系统推广到人类活动的所有领域。知识的系统化将在组织和应用方面达到新的水平。科学知识也不例外。在本文中,我们提出了用体外视网膜模型进行验证测试的结果,以便在提供数据库的实验平台中提出药理学知识的系统化。数据库既可以用于加快临床前研究,也可以用于控制纯物质或药物制剂的质量。这些应用和其他在药理学研究中使用视网膜扩散模型的实现将对用户、制造商和公共卫生监管当局有用。
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引用次数: 1
Neuroprotection in Parkinson's Disease: A Systematic Review of thePreclinical Data 帕金森病的神经保护:临床前数据的系统回顾
Pub Date : 2012-05-09 DOI: 10.2174/1874143601206010012
H. Douna, B. Bavelaar, H. Pellikaan, B. Olivier, T. Pieters
Aim: This study aimed to systematically review the preclinical data of neuroprotective agents for Parkinson's disease (PD) to support the translation of these compounds. Methods: The study consisted of two phases. In phase I, Pubmed and Scopus were systematically searched for neuroprotective agents for PD. In phase II, a systematic search was conducted for each substance identified in phase I. Articles were included if they used MPTP, 6-OHDA, rotenone or paraquat injury models. Results: Phase I led to the identification of 168 putative neuroprotective agents. Eventually ten compounds were included: melatonin, estrogen, nicotine, caffeine, riluzole, curcumin, coenzyme Q10, aspirin, EGCG and resveratrol. Phase II revealed 113 experimental studies and three reviews. Conclusion: This study clearly depicts the preclinical data of ten promising neuroprotective agents. While some of these compounds have already been tested in clinical use, none of them was studied in an appropriately designed trial to determine a neuroprotective effect. In expectation of qualitatively improved neuroprotection trials, the data from this study provide a firm foundation for future research.
目的:本研究旨在系统回顾帕金森病(PD)神经保护药物的临床前数据,以支持这些化合物的翻译。方法:研究分为两个阶段。在第一阶段,系统地检索Pubmed和Scopus,寻找PD的神经保护剂。在第二阶段,对第一阶段确定的每种物质进行了系统搜索。如果文章使用MPTP、6-OHDA、鱼藤酮或百草枯损伤模型,则将其纳入研究。结果:第一阶段鉴定出168种可能的神经保护剂。最终包括了10种化合物:褪黑激素、雌激素、尼古丁、咖啡因、利鲁唑、姜黄素、辅酶Q10、阿司匹林、EGCG和白藜芦醇。第二阶段共进行了113项实验研究和3项综述。结论:本研究清楚地描述了十种有前景的神经保护剂的临床前数据。虽然其中一些化合物已经在临床应用中进行了测试,但没有一种化合物在适当设计的试验中进行研究,以确定其神经保护作用。为了提高神经保护试验的质量,本研究的数据为未来的研究提供了坚实的基础。
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引用次数: 11
Functional Role of Glycosylation in a Human IgG4 Antibody Assessed by Surface Plasmon Resonance Technology 用表面等离子体共振技术评价糖基化在人IgG4抗体中的功能作用
Pub Date : 2012-05-09 DOI: 10.2174/1874143601206010027
R. B. Wong, M. Zeng, an-Horng Lee, T. S. Raju, K. Cheng
Fc glycosylation of immunoglobulins is necessary for antibody effector functions. These glycans of immunoglobulins are often referred as glycoforms and they can be heterogeneous due to the variations in glycosylation machinery present in the endoplastic reticulum (ER) and in the Golgi. In the absence of a generic culturing protocol that can render a consistent glycosylation pattern, monitoring glycoforms of monoclonal antibodies from cultured cells is becoming essential. Accordingly, quantification of glycosylated and deglycosylated heavy chains of an IgG4 monoclonal antibody was accomplished using an Agilent Bioanalyzer Lab-On-the-Chip electrophoresis system. In addition to the native antibody, completely deglycosylated antibody prepared by treating with PNGase F and a F(ab')2 fraction were evaluated for their antigen binding kinetics using Biacore surface Plasmon resonance (SPR). The equilibrium binding constants KD are found to be comparable at 1.81E-09M, 1.96E-09M, for the native and deglycosylated antibody, respectively, and 5.79E-10M for the F(ab')2. An in vitro biological activity employing a competition binding assay was also developed to demonstrate the role of the Fc glycan. The results confirm that for a neutralizing antibody therapeutic the biological activity of the native MAb-1 and deglycosylated antibody are comparable, thus indicating that the Fc glycan does not contribute to the antigen binding or the biological function. The kinetics and competitive assays performed on an SPR instrument are quick and reliable. Combined with the on-chip electrophoresis method they can be used as monitoring methods for process development and quality control.
免疫球蛋白的Fc糖基化是抗体效应作用所必需的。这些免疫球蛋白的聚糖通常被称为糖型,由于存在于内质网(ER)和高尔基体中的糖基化机制的变化,它们可能是异质的。在缺乏一个通用的培养方案,可以呈现一致的糖基化模式,监测单克隆抗体的糖型从培养细胞是必不可少的。因此,使用Agilent生物分析仪lab - on - chip电泳系统完成IgG4单克隆抗体糖基化和去糖基化重链的定量。除天然抗体外,用PNGase F和F(ab')2片段处理制备的完全去糖基化抗体,用Biacore表面等离子体共振(SPR)评价其抗原结合动力学。结果表明,天然抗体和去糖基化抗体的平衡结合常数KD分别为1.81E-09M和1.96E-09M, F(ab’)2的平衡结合常数KD为5.79E-10M。采用竞争结合测定法的体外生物活性也被开发来证明Fc聚糖的作用。结果证实,对于治疗性中和抗体,天然单克隆抗体-1和去糖基化抗体的生物活性是相当的,从而表明Fc聚糖不参与抗原结合或生物学功能。在SPR仪器上进行的动力学和竞争性分析快速可靠。与片上电泳法相结合,可作为工艺开发和质量控制的监测方法。
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引用次数: 1
CEACAM1 is a Privileged Cell Surface Antigen to Design Novel ScFv Mediated-Immunotherapies of Melanoma, Lung Cancer and Other Typesof Tumors CEACAM1是一种特殊的细胞表面抗原,可用于设计新的ScFv介导的黑色素瘤、肺癌和其他类型肿瘤的免疫疗法
Pub Date : 2012-04-26 DOI: 10.2174/1874143601206010001
M. Cianfriglia, V. Fiori, S. Dominici, S. Zamboni, M. Flego, M. Dupuis, A. Ascione, Mara Gellini, A. Mallano, M. Magnani
Carcinoembryonic antigen-related cell adhesion molecule 1 (CEACAM1) is a cell surface glycoprotein involved in intercellular binding, belonging to the immunoglobulin superfamily. It is involved in cell-cell recognition and modulates cellular processes that range from vascular angiogenesis to the regulation of insulin homeostasis and T-cell proliferation. Aberrant expression of CEACAM1 is often associated with progression and metastatic potential in melanoma, lung carcinoma and other types of tumor. Tumor-specific antigens such as CEACAM1 are ideal targets for cancer immunotherapy because they are over-expressed by the cancer cell and not on non-malignant tissues, minimizing the risk of autoimmune destruction. Many of the limitations of therapeutic use of rodent monoclonal antibodies (mAbs) can now be overcome by exploiting the use of recombinant antibody fragments and the advances in antibody engineering methods to improve tumor retention, reduce immunogenicity and modulate pharmacokinetics. In addition, a novel effective model of immunotherapeutic treatments of tumors includes antibody drug conjugates (ADCs) that combine specific mAbs and antibody fragments with cytotoxic drugs, proteins, enzymes, radionuclides and nanoparticles. This review aims to describe how these antibody engineering approaches can meet the challenges for generating new and effective antibody constructs for diagnosis and therapy of CEACAM1 expressing malignancies.
癌胚抗原相关细胞粘附分子1 (CEACAM1)是一种参与细胞间结合的细胞表面糖蛋白,属于免疫球蛋白超家族。它参与细胞-细胞识别,并调节从血管生成到胰岛素稳态和t细胞增殖的细胞过程。CEACAM1的异常表达通常与黑色素瘤、肺癌和其他类型肿瘤的进展和转移潜力有关。肿瘤特异性抗原(如CEACAM1)是癌症免疫治疗的理想靶点,因为它们在癌细胞中过度表达,而不是在非恶性组织中过度表达,从而最大限度地降低了自身免疫破坏的风险。现在,利用重组抗体片段和抗体工程方法的进步,可以克服啮齿动物单克隆抗体(mAbs)治疗使用的许多局限性,以改善肿瘤保留,降低免疫原性和调节药代动力学。此外,一种新的有效的肿瘤免疫治疗模型包括抗体药物偶联物(adc),它将特异性单克隆抗体和抗体片段与细胞毒性药物、蛋白质、酶、放射性核素和纳米颗粒结合起来。这篇综述的目的是描述这些抗体工程方法如何能够满足产生新的和有效的用于诊断和治疗表达CEACAM1的恶性肿瘤的抗体结构的挑战。
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引用次数: 5
Attenuation of Drug-Induced Loss of Righting Reflex Response by Pretreatment with a Nitric Oxide Donor 一氧化氮供体预处理对药物性翻正反射反应丧失的抑制作用
Pub Date : 2011-11-23 DOI: 10.2174/1874143601105010001
Yuhua Wang, R. Quock, R. Keegan
Background/Aims: The role of nitric oxide (NO) in general anesthetic drug action is controversial. The present study was carried out to determine the role of NO in the loss of righting reflex induced by injectable sedative and
背景/目的:一氧化氮(NO)在全身麻醉药物作用中的作用是有争议的。本研究旨在探讨一氧化氮(NO)在注射镇静药和镇痛药诱导的大鼠翻正反射丧失中的作用
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引用次数: 0
Inhibition of Inflammatory Cytokine Secretion by Plant-Derived Compounds Inuviscolide and Tomentosin: The Role of NFκB and STAT1~!2010-02-10~!2010-06-28~!2010-08-12~! 植物源化合物菊内酯和绒毛蛋白对炎性细胞因子分泌的抑制作用:nf - κ b和STAT1的作用2010-02-10 2010-06-28 2010-08-12
Pub Date : 2010-08-12 DOI: 10.2174/1874143601004010036
Galya Abrham, S. Dovrat, H. Bessler, S. Grossman, U. Nir, M. Bergman
The plant Inula viscosa has been shown to possess many important medicinal benefits, including anti-inflammatory, anti-oxidant, anti-bacterial, and anti-fungal activities, but the plant metabolites that mediate these effects and their mechanism of action are poorly understood. In a previous study, we demonstrated a reduced expression of the p65 subunit of nuclear factor kappa B (NFB) in melanoma cells treated with the purified sesquiterpene lactone compounds, Inuviscolide (Inv) and Tomentosin (Tom), extracted from Inula viscosa leaves. In this study, we tested the in- vitro effect of these purified compounds on the secretion of pro-inflammatory cytokines from human peripheral blood mononuclear cells (PBMCs) upon stimulation with lipopolysaccharide (LPS) or phorbol myristate acetate (PMA). Their possible mechanism of action was also studied. The results showed that both agents caused decreased production of IL-2, IL-1� , IFN� , and slightly increased secretion of TNF� , whereas secretion of IL-6 was not affected. The elevated levels of TNFdid not appear to affect the viability of human PBMCs. Western blot analysis revealed a reduction in the protein level of both the transcription factor component p65/RelA of nuclear factor-� B (NF B) and the signal transducer and activator of transcription 1 (STAT1) through proteosomal degradation. However, no change was observed in the expression level of the nuclear factor-� B component, p50 (NF B), or the signal transducer and activator of transcription 3 (STAT3). Taken together, our results indicate the possible future use of these agents as an anti-inflammatory treatment in cases where overstimulation of cytokine secretion is the basis for the pathological symptoms.
植物粘菊已被证明具有许多重要的药用价值,包括抗炎、抗氧化、抗菌和抗真菌活性,但介导这些作用的植物代谢物及其作用机制尚不清楚。在之前的一项研究中,我们证明了用从粘菊叶中提取的纯化倍半萜内酯化合物Inuviscolide (Inv)和Tomentosin (Tom)处理黑色素瘤细胞中核因子κ B (NFB) p65亚基的表达降低。在这项研究中,我们测试了这些纯化的化合物在体外受脂多糖(LPS)或肉豆蔻酸酯(PMA)刺激时对人外周血单核细胞(pmcs)分泌促炎细胞因子的影响。并对其可能的作用机理进行了探讨。结果表明,两种药物均可导致IL-2、IL-1、IFN的产生降低,TNF的分泌略有增加,而IL-6的分泌不受影响。tnf水平升高似乎并不影响人类pbmc的生存能力。Western blot分析显示,核因子- B (NFB)的转录因子组分p65/RelA和转录信号换能器和激活因子1 (STAT1)的蛋白水平通过蛋白体降解而降低。然而,核因子- β组分p50 (NFB)或转录信号转导和激活因子3 (STAT3)的表达水平未见变化。综上所述,我们的研究结果表明,在细胞因子分泌过度刺激是病理症状基础的情况下,这些药物可能在未来被用作抗炎治疗。
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引用次数: 20
Stress-Induced Hyperthermia in Translational Stress Research 转化应激研究中的应激诱导热疗
Pub Date : 2010-06-02 DOI: 10.2174/1874143601004010030
C. Vinkers, R. Penning, M. Ebbens, J. Helhammer, J. Verster, C. Kalkman, B. Olivier
The stress-induced hyperthermia (SIH) response is the transient change in body temperature in response to acute stress. This body temperature response is part of the autonomic stress response which also results in tachycardia and an increased blood pressure. So far, a SIH response has been found in a variety of species (including rodents, baboons, turtles, pigs, impalas and chimpanzees), and there are indications that stress exposure alters body temperature in humans. This review aims to assess the translational potential and the different aspects of the body temperature reaction in response to stress. If stress-induced temperature changes are consistent across species, the SIH paradigm may be employed in preclinical and clinical setups and provide a tool to examine the pharmacological, genetic and mechanistic background of stress at both the preclinical and the clinical level.
应激性热疗(SIH)反应是机体对急性应激反应的短暂性体温变化。这种体温反应是自主应激反应的一部分,它也会导致心动过速和血压升高。到目前为止,已经在许多物种(包括啮齿动物、狒狒、海龟、猪、黑斑羚和黑猩猩)中发现了SIH反应,并且有迹象表明压力暴露会改变人类的体温。这篇综述的目的是评估翻译潜力和体温反应的不同方面,以应对应激。如果压力引起的温度变化在不同物种之间是一致的,那么SIH模式可以用于临床前和临床设置,并提供一种在临床前和临床水平上检查压力的药理学,遗传学和机制背景的工具。
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引用次数: 14
Stress-Induced Hyperthermia, the Serotonin System and Anxiety 应激性热疗,血清素系统和焦虑
Pub Date : 2010-06-02 DOI: 10.2174/1874143601004010015
C. Vinkers, B. Olivier, J. Bouwknecht, L. Groenink, J. Olivier
The serotonin (5-HT) system plays a key role in the pathophysiology of psychiatric disorders including mood and anxiety disorders. A role for serotonin in stress-related disorders is further supported by the fact that clinically effective treatments for these disorders alter serotonergic neurotransmission. The therapeutic potential of serotonergic pharmacological interventions has resulted in a variety of preclinical approaches to study the serotonin system. Of these, the stress-induced hyperthermia (SIH) paradigm has been extensively used to study the serotonin system at a preclinical level. The SIH response uses the transient rise in body temperature in response to a stressor which can be reduced using anxiolytic drugs including benzodiazepines, CRF receptor antagonists and serotonergic ligands. The present review aims to discuss the acute and chronic effects of 5-HT ligands on the SIH response. Also, the SIH response in genetically modified mice that lack or overexpress specific serotonergic receptor subtypes or the serotonin transporter will be summarized. 5-HT1A receptor ligands reduce the SIH response, whereas acute administration of other serotonergic drugs (including 5-HT1B, 5-HT2 and 5-HT3 modulators and SSRIs) generally does not influence the SIH response. Also, the SIH paradigm is generally insensitive to detect the anxiolytic effects of chronic serotonergic antidepressants in rodents, and serotonergic drugs that have been found to reduce the SIH response acutely do so irrespective of the healthy or pathological status of an individual.
5-羟色胺(5-HT)系统在包括情绪和焦虑障碍在内的精神疾病的病理生理学中起着关键作用。5 -羟色胺在压力相关疾病中的作用进一步得到了临床有效治疗这些疾病改变5 -羟色胺能神经传递这一事实的支持。5 -羟色胺能药物干预的治疗潜力导致了各种临床前方法来研究5 -羟色胺系统。其中,应激性热疗(SIH)模式已被广泛用于临床前水平的血清素系统研究。SIH反应利用体温的短暂上升来应对压力源,可以使用抗焦虑药物,包括苯二氮卓类药物、CRF受体拮抗剂和5 -羟色胺能配体来降低压力源。本综述旨在讨论5-羟色胺配体对SIH反应的急性和慢性影响。此外,将总结缺乏或过度表达特定血清素能受体亚型或血清素转运体的转基因小鼠的SIH反应。5-HT1A受体配体可降低SIH反应,而其他5-羟色胺能药物(包括5-HT1B、5-HT2和5-HT3调节剂和SSRIs)的急性给药通常不会影响SIH反应。此外,SIH模式通常对检测啮齿动物慢性5 -羟色胺能抗抑郁药的焦虑作用不敏感,并且已经发现5 -羟色胺能药物可以急剧降低SIH反应,而不管个体的健康或病理状态如何。
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引用次数: 8
期刊
The Open Pharmacology Journal
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