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[Mechanisms of Cell Toxicity Caused by Degraded Microplastics]. [降解微塑料对细胞造成毒性的机理]。
IF 0.3 4区 医学 Q4 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2024-01-01 DOI: 10.1248/yakushi.23-00152-3
Yuya Haga, Sota Manabe, Hirofumi Tsujino, Haruyasu Asahara, Kazuma Higashisaka, Yasuo Tsutsumi

Microplastics (MPs), defined as plastic particles less than 5 mm in size, are ubiquitous in the environment. The accumulation of MPs in various environmental compartments, such as the ocean, soil, and air, has raised considerable concerns regarding their impact on ecological systems, including marine life and human health. Notably, MPs have been detected in marine organisms such as shellfish and fish, and have even been found in the human body, including in the blood and placenta. Moreover, considering that MPs have been detected in drinking water, human exposure to these particles in daily life is inevitable. To assess the risk posed by MPs to human health, it is essential to consider their physiological and chemical properties, including size, shape, surface modification, and material composition. However, current risk analyses focus primarily on spherical MPs with smooth surfaces, which differ substantially from most of the MPs detected in the environment. Environmental factors, such as ocean waves and ultraviolet radiation, alter the properties of MPs, including size, shape, and surface characteristics. In this review, we summarize current research on MPs, with a particular emphasis on the effects of MP degradation on human health. Furthermore, we generated MPs with surface degradation and evaluated their impact on cell toxicity, along with the underlying biological mechanisms.

微塑料(MPs)是指尺寸小于 5 毫米的塑料颗粒,在环境中无处不在。微塑料在海洋、土壤和空气等不同环境区划中的积累引起了人们对其对生态系统(包括海洋生物和人类健康)影响的极大关注。值得注意的是,在贝类和鱼类等海洋生物体内检测到了多溴联苯醚,甚至在人体内(包括血液和胎盘)也发现了多溴联苯醚。此外,考虑到饮用水中也检测到了多溴联苯醚,人类在日常生活中不可避免地会接触到这些微粒。要评估 MPs 对人体健康造成的风险,必须考虑其生理和化学特性,包括尺寸、形状、表面改性和材料成分。然而,目前的风险分析主要集中在表面光滑的球形多孔微粒上,这与环境中检测到的大多数多孔微粒有很大不同。环境因素(如海浪和紫外线辐射)会改变 MPs 的属性,包括大小、形状和表面特征。在本综述中,我们总结了目前有关 MPs 的研究,并特别强调了 MP 降解对人类健康的影响。此外,我们还生成了表面降解的 MPs,并评估了它们对细胞毒性的影响以及潜在的生物机制。
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引用次数: 0
[Prevention and Treatment of Cancer with Vitamin A and Its Derivatives: Cell Differentiation and Proliferation]. [用维生素 A 及其衍生物预防和治疗癌症:细胞分化与增殖]。
IF 0.3 4区 医学 Q4 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2024-01-01 DOI: 10.1248/yakushi.23-00184
Noriko Takahashi

Normal differentiation and proliferation of cells are essential for maintaining homeostasis. Following the successful completion of whole genome sequencing, protein modification has been attracted increasing attention in order to understand the roles of protein diversification in protein function and to elucidate molecular targets in mechanisms of signal transduction. Vitamin A is an essential nutrient for health maintenance. It is present as β-carotene in green and yellow vegetables and retinyl ester in animal products and absorbed into the body from the intestines. After ingestion, it is converted to retinol and oxidized in target cells to retinal, which plays critical roles in vision. It is then further oxidized to retinoic acid (RA), which exhibits a number of effects prior to being metabolized by cytochrome P450 and excreted from the body. Since RA exhibits cell differentiation-inducing actions, it is used as a therapeutic agent for patients with acute promyelocytic leukemia. The current paper describes: (1) HL60 cell differentiation and cell differentiation induction therapy by RA; (2) roles played by RA and retinal and their mechanisms of action; (3) retinoylation, post-translational protein-modified by RA, a novel non-genomic RA mechanism of action without RA receptor; (4) new actions of β-carotene and retinol in vivo and (5) potent anticancer effects of p-dodecylaminophenol (p-DDAP), a novel vitamin A derivative created from the RA derivative fenretinide. We propose that nutritional management of vitamin A can be effective at preventing and treating diseases, and that p-DDAP is a promising anticancer drug.

细胞的正常分化和增殖对维持体内平衡至关重要。随着全基因组测序的成功完成,蛋白质修饰越来越受到关注,人们希望了解蛋白质多样化在蛋白质功能中的作用,并阐明信号转导机制中的分子靶标。维生素 A 是维持健康的必需营养素。它以 β-胡萝卜素的形式存在于绿色和黄色蔬菜中,以视黄醇酯的形式存在于动物产品中,并从肠道被人体吸收。摄入后,它会转化为视黄醇,并在靶细胞中氧化成视黄醛,视黄醛对视力起着关键作用。然后,视黄醇被进一步氧化成视黄酸(RA),在被细胞色素 P450 代谢并排出体外之前,视黄酸会产生一系列作用。由于视黄酸具有诱导细胞分化的作用,因此被用作急性早幼粒细胞白血病患者的治疗药物。本文介绍了(1) HL60 细胞分化和 RA 的细胞分化诱导疗法;(2) RA 和视黄醛的作用及其作用机制;(3) 视黄醛化,RA 翻译后蛋白质修饰,一种没有 RA 受体的新型非基因组 RA 作用机制;(4) β-胡萝卜素和视黄醇在体内的新作用;以及 (5) 对十二烷基氨基苯酚(p-DDAP)的强效抗癌作用。我们认为,维生素 A 的营养管理可以有效预防和治疗疾病,而对十二烷基氨基苯酚是一种很有前途的抗癌药物。
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引用次数: 0
[Mast Cell-Neutrophil Communication Regulates Allergic Diseases]. [肥大细胞-中性粒细胞通讯调节过敏性疾病】。]
IF 0.3 4区 医学 Q4 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2024-01-01 DOI: 10.1248/yakushi.23-00154-2
Ryo Suzuki

Allergic diseases (e.g., food allergies) are a growing problem, with increasing numbers of individuals experiencing them worldwide. Congruently, the adverse reactions (e.g., anaphylaxis) associated with the administration of vaccines against emerging infectious diseases such as coronavirus disease 2019 (COVID-19) have become a familiar problem. Allergic diseases, which have a wide variety of symptoms, are difficult to prevent or cure; treatment is currently limited to therapeutic drugs or allergen immunotherapy. Therefore, elucidating new allergic regulatory factors that control the allergic (i.e., mast cell) responses is important. While investigating the regulatory mechanisms of the wide range of allergic responses of mast cells, we found that the affinity of allergens to immunoglobin E (IgE) regulates allergic inflammation through the differences in the secretory responses of mast cells and the types and interactions of the cells infiltrating the tissues. Here, we present our recent findings regarding the affinity of allergens to IgE in regulating allergic inflammation, heterogeneous secretory granules inducing diverse secretory responses, and mast cells interacting with neutrophils, thereby regulating the various allergic responses.

过敏性疾病(如食物过敏)是一个日益严重的问题,全世界越来越多的人患有这种疾病。与此相呼应的是,与接种 2019 年冠状病毒病(COVID-19)等新发传染病疫苗相关的不良反应(如过敏性休克)也已成为人们所熟知的问题。过敏性疾病的症状多种多样,难以预防或治愈;目前的治疗方法仅限于治疗药物或过敏原免疫疗法。因此,阐明控制过敏(即肥大细胞)反应的新过敏调节因子非常重要。在研究肥大细胞各种过敏反应的调控机制时,我们发现过敏原与免疫球蛋白 E(IgE)的亲和力通过肥大细胞分泌反应的差异以及浸润组织的细胞类型和相互作用来调控过敏性炎症。在此,我们将介绍过敏原与 IgE 的亲和性在调节过敏性炎症、异质性分泌颗粒诱导多种分泌反应以及肥大细胞与中性粒细胞相互作用从而调节各种过敏反应方面的最新研究成果。
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引用次数: 0
[Syntheses and Structure-Activity Relationship Studies of Antitumor Bicyclic Hexapeptide RA-VII Analogues]. [抗肿瘤双环六肽 RA-VII 类似物的合成及结构-活性关系研究]。
IF 0.3 4区 医学 Q4 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2024-01-01 DOI: 10.1248/yakushi.23-00208
Yukio Hitotsuyanagi

A series of antitumor bicyclic hexapeptide RA-VII analogues modified at residue 2, 3, or 6 were prepared by the chemical transformation of the hydroxy, methoxy, or carboxy groups or the aromatic rings of natural peptides RA-II, III, V, VII, and X. Analogues with modified side chains or peptide backbones, which cannot be prepared by the chemical transformation of their natural peptides, and newly isolated peptides from Rubia cordifolia roots were synthesized by using protected cycloisodityrosines prepared by the degradation of bis(thioamide) obtained from RA-VII or the diphenyl ether formation of boronodipeptide under the modified Chan-Lam coupling reaction conditions. Studies of the conformational features of the analogues and the newly isolated peptides and their relationships with cytotoxic activities against the HCT-116, HL-60, KATO-III, KB, L1210, MCF-7, and P-388 cell lines revealed the following: the methoxy group at residue 3 is essential for the potent cytotoxic activity; the methyl group at Ala-2 and Ala-4 but not at D-Ala-1 is required to establish the bioactive conformation; the N-methyl group at Tyr-5 is necessary for the peptides to adopt the active conformation preferentially; and the orientation of Tyr-5 and/or Tyr-6 phenyl rings has a significant effect on the cytotoxic activity.

通过对天然肽 RA-II、III、V、VII 和 X 的羟基、甲氧基、羧基或芳香环进行化学转化,制备了一系列在残基 2、3 或 6 上修饰的抗肿瘤双环六肽 RA-VII 类似物。利用从 RA-VII 中获得的双(硫代酰胺)降解制备的受保护环异酪氨酸,或在改进的 Chan-Lam 偶联反应条件下硼二肽的二苯醚形成,合成了无法通过天然肽的化学转化制备的具有修饰侧链或肽骨的类似物,以及从茜草根中新分离出的肽。通过研究类似物和新分离肽的构象特征及其与 HCT-116、HL-60、KATO-III、KB、L1210、MCF-7 和 P-388 细胞系的细胞毒活性之间的关系,发现了以下几点:残基 3 上的甲氧基是产生强效细胞毒活性的必要条件;Ala-2 和 Ala-4 上的甲基(而非 D-Ala-1 上的甲基)是建立生物活性构象的必要条件;Tyr-5 上的 N 甲基是肽优先采用活性构象的必要条件;Tyr-5 和/或 Tyr-6 苯环的取向对细胞毒活性有显著影响。
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引用次数: 0
[Development of Membrane Permeability Coefficient by Means of Novel Molecular Dynamics Methods]. [利用新型分子动力学方法开发膜渗透系数]。
IF 0.3 4区 医学 Q4 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2024-01-01 DOI: 10.1248/yakushi.23-00191-3
Ryuhei Harada, Yuki Mitsuta, Yasuteru Shigeta

The membrane permeability, and its evaluation, is crucial factor in the process of uptake of compounds from outside to inside the cell and in the inhibition of the activity of disease-causing target proteins. Although molecular dynamics (MD) simulations have been shown to be able to reproduce the conformational changes of compounds occurring during membrane permeation, it is still challenging to extract the membrane permeability at an affordable computational workload solely by conventional MD. Indeed, the time scale accessible by MD is far below the one characterizing the actual permeation process. Phenomena occurring in living organisms escaping the reach of standard MD are generally referred to as biological rare events, and the membrane permeation process is one of them. To overcome this time-scale problem, several enhanced sampling methods have been proposed over the years to improve conformational sampling. In this review, a hybrid sampling method that combines the parallel cascade selection MD (PaCS-MD) and the outlier flooding method (OFLOOD), introduced and developed by our group, is proposed as a tool to study the membrane permeation from structural sampling (rare-event sampling). The obtained trajectories are used to estimate the free energy profiles for the membrane permeation and to compute the membrane permeation coefficients. Moreover, we present an example of application of the free energy reaction network method as a versatile way for incorporating explicitly into reaction coordinates the degrees of freedom related to internal motion.

膜渗透性及其评估是化合物从细胞外吸收到细胞内以及抑制致病靶蛋白活性过程中的关键因素。虽然分子动力学(MD)模拟已被证明能够再现化合物在膜渗透过程中发生的构象变化,但仅靠传统的 MD,要在可承受的计算工作量下提取膜渗透性仍具有挑战性。事实上,MD 所能达到的时间尺度远远低于实际渗透过程的时间尺度。在生物体内发生的、超出标准 MD 范围的现象通常被称为生物罕见事件,而膜渗透过程就是其中之一。为了克服这一时间尺度问题,多年来提出了几种增强采样方法来改进构象采样。在这篇综述中,我们提出了一种结合了平行级联选择 MD(PaCS-MD)和离群点淹没法(OFLOOD)的混合采样方法,作为从结构采样(罕见事件采样)研究膜渗透的工具。获得的轨迹用于估算膜渗透的自由能曲线和计算膜渗透系数。此外,我们还介绍了自由能反应网络方法的一个应用实例,该方法是将与内部运动相关的自由度明确纳入反应坐标的一种通用方法。
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引用次数: 0
[High Purity Solvents for qNMR Measurement]. [用于 qNMR 测量的高纯度溶剂]。
IF 0.3 4区 医学 Q4 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2024-01-01 DOI: 10.1248/yakushi.23-00151-4
Yasuhiro Muto, Toru Miura, Yoshiaki Iwamoto

Quantitative NMR (qNMR) has been adopted by documentary standards, including the Japanese Pharmacopoeia (JP), United States Pharmacopoeia (USP), and International Organization for Standardization (ISO), owing to its reliability and efficiency. Note that qNMR can be used for quantifying target components using the signal integration ratio of an analyte to a reference. In qNMR, a modern NMR instrument with high resolution and sensitivity is used to record reliable spectra. This instrument can detect small signals from impurities in a solvent, which may result in inaccurate signal integration in the spectrum. In this study, we investigated the influence of solvent quality on qNMR accuracy focusing on organic impurities, water content, and deuteration ratio. If signals from organic impurities and signals from the analyte overlap, the duplication of signal integration will directly affect the qNMR analytical result. To examine overlapping, we performed blank solvent tests. Additionally, a high water content and low deuteration ratio affect the detection sensitivity, thus reducing the signal-to-noise (S/N) ratio of the target. Thus, these factors must be considered to obtain accurate qNMR results.

定量核磁共振(qNMR)因其可靠性和高效性,已被日本药典 (JP)、美国药典 (USP) 和国际标准化组织 (ISO) 等文献标准所采用。请注意,qNMR 可用于利用分析物与参照物的信号积分比来量化目标成分。在 qNMR 中,使用具有高分辨率和灵敏度的现代 NMR 仪器来记录可靠的光谱。该仪器可检测到溶剂中杂质的微小信号,这可能会导致光谱中的信号积分不准确。在这项研究中,我们研究了溶剂质量对 qNMR 精确度的影响,重点是有机杂质、含水量和氘化比。如果有机杂质信号和被分析物信号重叠,信号积分的重复将直接影响 qNMR 分析结果。为了检查重叠情况,我们进行了空白溶剂测试。此外,高含水量和低氘化比会影响检测灵敏度,从而降低目标物的信噪比 (S/N)。因此,要获得准确的 qNMR 结果,必须考虑这些因素。
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引用次数: 0
[Development of Preventive Methods for Drug-induced Cardiotoxicity Using a Large-scale Medical Information Database]. [利用大型医疗信息数据库开发药物诱发心脏毒性的预防方法]。
IF 0.3 4区 医学 Q4 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2024-01-01 DOI: 10.1248/yakushi.23-00164-2
Hirofumi Hamano, Yoshito Zamami, Soichiro Ushio, Takahiro Niimura, Mitsuhiro Goda, Yuki Izawa-Ishizawa, Keisuke Ishizawa

Cancer therapies have evolved considerably thereby substantially improving the survival of patients with cancer. However, cardiotoxicity, such as myocarditis and heart failure, induced by anticancer drugs, including immune checkpoint inhibitor(ICI)s and doxorubicin, present serious challenges. Numerous observations have indicated increased risks of cardiotoxicity- and cancer-related mortality in patients with drug-induced cardiotoxicity. Therefore, the prevention and management of drug-induced cardiotoxicity should be prioritized to enable sustainable long-term treatment while preserving patients' quality of life. Recently, medical research has been primarily focused on elucidation of therapeutic benefits and adverse events using medical big data, including worldwide databases of adverse events. The aim of the present study was to establish prevention strategies for drug-induced cardiotoxicity and advance data analytics. A data-driven approach was adopted to comprehensively analyze patient data and drug-induced cardiotoxicity. These data analytics revealed numerous risk factors, leading to the development of drugs that mitigate these factors. Furthermore, many unknown adverse events with molecularly targeted drugs were brought to light. Consequently, the importance of managing adverse events, guided by insights from data science, is predicted to increase. In this symposium review, we introduce our research exemplifying pharmaceutical studies utilizing medical big data. In particular, we discuss in detail the risk factors associated with myocarditis induced by immune checkpoint inhibitors along with prophylactic agents to mitigate doxorubicin-induced cardiotoxicity.

癌症疗法有了长足的发展,从而大大提高了癌症患者的生存率。然而,包括免疫检查点抑制剂(ICI)和多柔比星在内的抗癌药物诱发的心肌炎和心力衰竭等心脏毒性带来了严峻的挑战。大量观察结果表明,药物引起的心脏毒性会增加患者心脏毒性和癌症相关死亡率的风险。因此,预防和管理药物诱发的心脏毒性应放在首位,以便在保持患者生活质量的同时,实现可持续的长期治疗。最近,医学研究主要集中在利用医疗大数据(包括全球不良事件数据库)阐明治疗效果和不良事件。本研究旨在建立药物诱发心脏毒性的预防策略,并推进数据分析。研究采用数据驱动方法,全面分析患者数据和药物诱发的心脏毒性。这些数据分析揭示了许多风险因素,从而开发出可减轻这些因素的药物。此外,还揭示了分子靶向药物的许多未知不良事件。因此,在数据科学洞察力的指导下管理不良事件的重要性预计将会增加。在本次专题讨论会的综述中,我们将介绍利用医疗大数据进行制药研究的实例研究。特别是,我们将详细讨论与免疫检查点抑制剂诱发的心肌炎相关的风险因素,以及减轻多柔比星诱发的心脏毒性的预防药物。
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引用次数: 0
[Modulation of Aggregation and Immunogenicity of a Protein: Based on the Study of Hen Lysozyme]. [一种蛋白质的聚集和免疫原性的调节:基于母鸡溶菌酶的研究]。
IF 0.3 4区 医学 Q4 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2024-01-01 DOI: 10.1248/yakushi.23-00192
Tadashi Ueda

This study focuses on the modulation of protein aggregation and immunogenicity. As a starting point for investigating long-range interactions within a non-native protein, the effects of perturbing denatured protein states on their aggregation, including the formation of amyloid fibrils, were evaluated. The effects of adducts, sugar modifications, and stabilization on protein aggregation were then examined. We also investigated how protein immunogenicity was affected by enhancing protein conformational stability and other factors.

这项研究的重点是调节蛋白质的聚集和免疫原性。作为研究非原生蛋白质内部长程相互作用的起点,研究人员评估了扰动变性蛋白质状态对其聚集(包括淀粉样纤维的形成)的影响。然后研究了加合物、糖修饰和稳定化对蛋白质聚集的影响。我们还研究了增强蛋白质构象稳定性和其他因素对蛋白质免疫原性的影响。
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引用次数: 0
[Electrophysiological and Pharmacological Research on Neural Activity in the Neocortex and Hippocampus During Sleep]. [睡眠期间新皮层和海马神经活动的电生理学和药理学研究]。
IF 0.3 4区 医学 Q4 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2024-01-01 DOI: 10.1248/yakushi.23-00169
Nobuyoshi Matsumoto

Sleep is fundamental for living animals. Although they are not conscious during sleep, their brains are continuously working. This neural activity during sleep can be reflected by neural oscillations closely related to cognitive function. While the relationship between neural activity in sleep and cognition has been extensively investigated, it is not fully understood how neural activity in sleep and relevant memory are modulated by specific receptors. In particular, I focused on melatonin receptors and their agonist, ramelteon. While the effects of ramelteon on sleep have been widely documented, it is still poorly understood how ramelteon affects learning and memory as well as neural activity in sleep. To address this question, I first recorded neural oscillations in the neocortex of rats treated with ramelteon and found that ramelteon promoted non-rapid eye movement (NREM) sleep and increased fast gamma power in the primary motor cortex during NREM sleep. I then evaluated the behavioral performance of ramelteon-treated mice using the novel object recognition task and the spontaneous alternation task, demonstrating that ramelteon enhanced object recognition memory and spatial working memory. These results shed light on new aspects of the functions of melatonin receptors.

睡眠对于有生命的动物来说至关重要。虽然动物在睡眠时没有意识,但它们的大脑却在持续工作。睡眠中的神经活动可以通过与认知功能密切相关的神经振荡反映出来。虽然人们对睡眠中的神经活动与认知之间的关系进行了广泛的研究,但对睡眠中的神经活动和相关记忆如何受特定受体的调节还不完全清楚。我特别关注褪黑激素受体及其激动剂雷美替胺。虽然雷美替胺对睡眠的影响已被广泛记录,但人们对雷美替胺如何影响学习和记忆以及睡眠中的神经活动仍知之甚少。为了解决这个问题,我首先记录了接受雷美替胺治疗的大鼠新皮层的神经振荡,发现雷美替胺促进了非快速眼动(NREM)睡眠,并增加了NREM睡眠期间初级运动皮层的快速伽马功率。然后,我用新物体识别任务和自发交替任务评估了服用雷美替胺的小鼠的行为表现,结果表明雷美替胺增强了物体识别记忆和空间工作记忆。这些结果揭示了褪黑素受体功能的新方面。
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引用次数: 0
Plasma Venetoclax Concentrations in Patients with Acute Myeloid Leukemia Treated with CYP3A4 Inhibitors. 使用 CYP3A4 抑制剂治疗的急性髓性白血病患者的血浆 Venetoclax 浓度。
IF 0.3 4区 医学 Q4 PHARMACOLOGY & PHARMACY Pub Date : 2024-01-01 DOI: 10.1248/yakushi.24-00018
Ayaka Otsuki, Masaki Kumondai, Daisuke Kobayashi, Masafumi Kikuchi, Yugo Ueki, Yuji Sato, Nagomi Hayashi, Ayaka Yagi, Yasushi Onishi, Koichi Onodera, Satoshi Ichikawa, Noriko Fukuhara, Hisayuki Yokoyama, Masamitsu Maekawa, Nariyasu Mano

Venetoclax (VEN) is used in patients with acute myeloid leukemia (AML) and is primarily metabolized by CYP3A4, a major drug-metabolizing enzyme. Patients with AML simultaneously administered VEN and CYP3A4 inhibitors require a more appropriate management of drug-drug interactions (DDIs). Here, we report two cases of patients with AML (54-year-old man and 22-year-old woman) administrated VEN and CYP3A4 inhibitors, such as posaconazole, cyclosporine, or danazol. In the first case, we evaluated the appropriateness of timing for adjusting VEN dosage subsequent to the cessation of posaconazole. Consequently, modifying the VEN dosage in conjunction with the cessation of Posaconazole simultaneously may result in elevated plasma VEN levels. In the second case, plasma VEN concentrations were markedly elevated when co-administered with several CYP3A4 inhibitors. Additionally, in vitro assays were conducted for reverse translational studies to analyze CYP3A4 inhibition. CYP3A4 inhibition by combinatorial administration of cyclosporine A and danazol was demonstrated in vitro, which potentially explains the increasing plasma VEN concentrations observed in clinical settings. Although the acquisition of therapeutic effects is a major priority for patients, frequent therapeutic drug monitoring and dosage adjustments considering DDIs would be important factors in chemotherapy.

Venetoclax(VEN)用于急性髓性白血病(AML)患者,主要通过 CYP3A4(一种主要的药物代谢酶)代谢。同时服用 VEN 和 CYP3A4 抑制剂的急性髓性白血病患者需要对药物相互作用(DDIs)进行更适当的管理。在此,我们报告了两例同时服用 VEN 和 CYP3A4 抑制剂(如泊沙康唑、环孢素或达那唑)的急性髓细胞白血病患者(男性 54 岁,女性 22 岁)。在第一个病例中,我们评估了在停用泊沙康唑后调整 VEN 剂量的时机是否合适。因此,在停用泊沙康唑的同时调整 VEN 的剂量可能会导致血浆 VEN 水平升高。在第二种情况中,当与几种 CYP3A4 抑制剂同时服用时,血浆中的 VEN 浓度明显升高。此外,为分析 CYP3A4 抑制作用,还进行了体外测定以进行逆转录研究。体外研究表明,环孢素 A 和达那唑联合用药可抑制 CYP3A4,这可能是临床观察到 VEN 血浆浓度升高的原因。虽然获得疗效是患者的首要任务,但频繁的治疗药物监测和考虑 DDIs 的剂量调整将是化疗中的重要因素。
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引用次数: 0
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Yakugaku zasshi : Journal of the Pharmaceutical Society of Japan
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