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Stratified analysis of the association between anti-obesity medications and digestive adverse events: a real-world study based on the FDA adverse event reporting system database 抗肥胖药物与消化系统不良事件关系的分层分析:基于美国食品药物管理局不良事件报告系统数据库的真实世界研究
Pub Date : 2024-09-12 DOI: 10.1186/s40360-024-00789-9
Qing Yang, Junyan Wang, Menghuan Wang, Shuyu Zhang, Qin-Qin He
Numerous digestive system adverse events (dsAEs) have been observed during the use of anti-obesity medications (AOMs), leading to concerns about the safety of these medications. However, most current studies are limited to the association of one class of drugs with specific digestive disorders, and there is no cascading analysis of AOMs in the digestive system. This study aims to use data from the United States Food and Drug Administration Adverse Event Reporting System (FAERS) for a stratified analysis of the reported associations between AOMs and dsAEs. We analyzed adverse event reports submitted to FAERS between January 2015 and December 2023 related to obesity treatment. It is important to note that FAERS data cannot establish causality or incidence rates. Pharmacovigilance (PV) signals were detected by disproportionate analyses through proportionate reporting ratio (PRR), reporting odds ratios (ROR), and information components (IC) to detect dsAEs associated with AOMs. Reporting rates, severity, and response outcomes of digestive adverse events were compared across AOMs by multivariate logistic regression analysis. Among 34,396 adverse events (AEs) related to obesity treatment, 8844 dsAEs were analyzed. Comparing with semaglutide and liraglutide, tirzepatide exhibited fewer reported dsAEs while semaglutide and liraglutide showed a high correlation with non-lethal pancreatitis reports. Bupropion-naltrexone (31.65%) reported the highest number of dsAEs, and a PV signal was detected in mouth and lips AEs (ROR = 2.97, 95% CI: 2.42–3.6). Orlistat (ROR = 3.30, 95% CI: 3.08–3.55) exhibited the highest association with gastrointestinal AEs compared to other AOMs. PV signal for hepatobiliary AEs (ROR = 6.13, 95% CI: 3.45–10.88) with phentermine-topiramate still needs further clarification. Tirzepatide may be considered for patients with a history of digestive system disease or an elevated risk of pancreatitis based on the pattern of reported dsAEs. Caution is needed for the orofacial AEs when using bupropion-naltrexone. Orlistat has a higher reporting rate of gastrointestinal AEs, but these events are typically less severe. Phentermine-topiramate’s association with liver impairment requires further clinical investigation. This article provides insights into the reported associations between AOMs and dsAEs, which may aid clinicians in making more informed decisions about individualizing medication and managing potential adverse events.
在使用抗肥胖药物(AOMs)期间观察到了许多消化系统不良事件(dsAEs),从而引发了对这些药物安全性的担忧。然而,目前的大多数研究仅限于某一类药物与特定消化系统疾病之间的关联,并没有对消化系统的 AOMs 进行逐级分析。本研究旨在利用美国食品和药物管理局不良事件报告系统(FAERS)的数据,对所报告的AOMs与dsAEs之间的关联进行分层分析。我们分析了2015年1月至2023年12月期间向FAERS提交的与肥胖症治疗相关的不良事件报告。值得注意的是,FAERS 数据无法确定因果关系或发病率。药物警戒(PV)信号是通过比例报告比(PRR)、报告几率比(ROR)和信息成分(IC)的不成比例分析来检测与AOMs相关的dsAEs。通过多变量逻辑回归分析比较了不同 AOMs 消化系统不良事件的报告率、严重程度和反应结果。在与肥胖症治疗相关的 34,396 例不良事件 (AE) 中,分析了 8844 例 dsAE。与塞马鲁肽和利拉鲁肽相比,替扎帕肽报告的dsAE较少,而塞马鲁肽和利拉鲁肽与非致命性胰腺炎报告的相关性较高。布洛芬-纳曲酮(31.65%)报告的 dsAEs 数量最多,在口唇 AEs 中检测到 PV 信号(ROR = 2.97,95% CI:2.42-3.6)。与其他 AOMs 相比,奥利司他(ROR = 3.30,95% CI:3.08-3.55)与胃肠道 AEs 的关联度最高。酚妥拉明-托吡酯与肝胆AEs的PV信号(ROR = 6.13,95% CI:3.45-10.88)仍需进一步澄清。根据报告的 dsAEs 模式,有消化系统疾病史或胰腺炎风险较高的患者可考虑服用替扎帕肽。使用安非他酮-纳曲酮时需谨慎对待口面部 AEs。奥利司他的胃肠道 AE 报告率较高,但这些事件通常不太严重。芬特明-托吡酯与肝功能损害的关系还需要进一步的临床研究。本文对所报告的 AOMs 与 dsAEs 之间的关联进行了深入分析,这可能有助于临床医生在个体化用药和管理潜在不良事件方面做出更明智的决定。
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引用次数: 0
Safety assessment of asenapine in the FAERS database: real adverse event analysis and discussion on neurological and psychiatric side effects FAERS 数据库中的阿塞那平安全性评估:真实不良事件分析及神经和精神副作用讨论
Pub Date : 2024-08-12 DOI: 10.1186/s40360-024-00772-4
Liuyin Jin, Jiali Gu, Yun Wu, Hua Xia, Guoming Xie, Guidong Zhu
This study aims to comprehensively assess the safety of Asenapine by conducting an comprehensive statistical analysis of adverse event reports in the FAERS database, with a particular focus on potential adverse reactions related to its use in the treatment of psychiatric disorders. Event reports from the first quarter of 2009 to the third quarter of 2023 were collected and analyzed. Detailed examinations of gender, age, reporter identity, and other aspects were conducted to reveal the fundamental characteristics of Asenapine-related adverse events. Signal mining techniques were employed to systematically evaluate various adverse reactions associated with Asenapine. The study found that adverse event reports involving Asenapine were more common among female patients, with the age group mainly distributed between 18 and 45 years. Physicians were the primary reporters of adverse events, and psychiatric disorders, neurological disorders, and gastrointestinal disorders were the most common areas affected by adverse reactions. In addition to known adverse reactions, potential risks not mentioned in the drug label were identified, such as anosognosia, attentional drift, and psychogenic compensation disorder. Asenapine carries the risk of various adverse reactions alongside its therapeutic effects. In clinical practice, physicians should closely monitor the occurrence of neurological disorders, psychiatric disorders, and gastrointestinal system disorders.
本研究旨在通过对 FAERS 数据库中的不良事件报告进行综合统计分析,全面评估阿塞那平的安全性,尤其关注与治疗精神疾病有关的潜在不良反应。我们收集并分析了 2009 年第一季度至 2023 年第三季度的事件报告。对性别、年龄、报告者身份等方面进行了详细检查,以揭示阿塞那平相关不良事件的基本特征。研究采用了信号挖掘技术来系统评估与阿塞那平相关的各种不良反应。研究发现,涉及阿塞那平的不良事件报告在女性患者中更为常见,年龄主要分布在 18 至 45 岁之间。医生是不良事件的主要报告者,精神障碍、神经系统疾病和胃肠道疾病是不良反应最常见的影响领域。除了已知的不良反应外,还发现了药物标签中未提及的潜在风险,如认知障碍、注意力偏移和精神代偿障碍。阿塞那平在发挥治疗作用的同时,也有可能出现各种不良反应。在临床实践中,医生应密切监测神经系统疾病、精神疾病和胃肠道系统疾病的发生情况。
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引用次数: 0
A systematic review and Bayesian analysis of the adverse effects of dienogest 对地诺孕酮不良反应的系统回顾和贝叶斯分析
Pub Date : 2024-08-01 DOI: 10.1186/s40360-024-00767-1
Rui-Rui Li, Qing Xi, Lei Tao, Wei Sheng, Cheng-Cheng Zhao, Yu-Jie Wu
Endometriosis and adenomyosis are two common diseases that impair women’s health, and dienogest is one of the pharmacologic treatments which is the first-line therapeutic option for patients with pelvic pain and individuals who have no desire for immediate pregnancy. The goal of this study was to summarize the current evidence of adverse events associated with dienogest as well as the prevalence of these adverse events during treatment with dienogest. Several databases (PubMed, Embase, Cochrane Central and Clinicaltrials.gov, etc.) and the US FDA Adverse Event Reporting System (FAERS) Public Dashboard were searched on May 31, 2023, using the topic words alongside free words of dienogest and “adverse reaction”. Studies were incorporated into this research if they reported or assessed safety issues or adverse reactions of dienogest during the period of endometriosis treatment or adenomyosis therapy. The extracted information comprised trial design, dienogest and control group demographics, as well as reported side effects. This systematic review comprehended 39 publications in total. The mean age of patients in the included studies was 34.43 years. The follow-up duration varied from 3 to 60 months. Most adverse reactions were common and not serious, and the most common adverse reactions during dienogest medication were abnormal uterine bleeding (55%, 95% CI 37–73%), amenorrhea (17%, 95% CI 2–42%) and swelling (13%, 95% CI 3–28%). Uncommon adverse reactions included dysmenorrhea (0.2%, n = 1), dyspepsia (0.4%, n = 1), and (lower) abdominal pain (1%, 95% CI 0–3%), urticaria (1%, 95% CI 0–3%) and peritonitis (1%, n = 1). Serious adverse reactions including decreased lumbar spine Bone Mineral Density (BMD), depression, peritonitis and so on have been reported. Heterogeneity assessment revealed that patient number and study design are influencing factors to adverse reaction prevalence. Moreover, abdominal pain, diarrhea, nausea and vomiting, back pain and anemia are side effects reported both in the FAERS database and in the systematic review. Dienogest’s most frequent side effects were not severe. Dienogest is generally safe for treating endometriosis and adenomyosis. Nevertheless, people should be aware of serious adverse reactions, such as decreased lumbar spine BMD and hemorrhagic shock.
子宫内膜异位症和子宫腺肌症是损害妇女健康的两种常见疾病,而地诺孕酮是其中一种药物治疗方法,是盆腔疼痛患者和无立即怀孕意愿者的一线治疗选择。本研究的目的是总结与地诺孕酮相关的不良事件的现有证据,以及使用地诺孕酮治疗期间这些不良事件的发生率。研究人员于 2023 年 5 月 31 日在多个数据库(PubMed、Embase、Cochrane Central、Clinicaltrials.gov 等)和美国 FDA 不良事件报告系统(FAERS)公共仪表板中使用主题词以及自由词 "地诺孕特 "和 "不良反应 "进行了检索。如果研究报告或评估了在子宫内膜异位症或子宫腺肌症治疗期间使用地诺孕酮的安全性问题或不良反应,则将其纳入本研究。提取的信息包括试验设计、地诺孕酮和对照组的人口统计学特征以及报告的副作用。本系统性综述共收录了 39 篇文献。纳入研究的患者平均年龄为 34.43 岁。随访时间从 3 个月到 60 个月不等。服用地诺孕酮期间最常见的不良反应是异常子宫出血(55%,95% CI 37-73%)、闭经(17%,95% CI 2-42%)和肿胀(13%,95% CI 3-28%)。不常见的不良反应包括痛经(0.2%,n = 1)、消化不良(0.4%,n = 1)、(下)腹痛(1%,95% CI 0-3%)、荨麻疹(1%,95% CI 0-3%)和腹膜炎(1%,n = 1)。严重不良反应包括腰椎骨矿密度(BMD)下降、抑郁、腹膜炎等。异质性评估显示,患者人数和研究设计是不良反应发生率的影响因素。此外,腹痛、腹泻、恶心和呕吐、背痛和贫血都是 FAERS 数据库和系统综述中报告的副作用。地诺孕酮最常见的副作用并不严重。戴诺司特治疗子宫内膜异位症和子宫腺肌症一般是安全的。不过,人们应注意严重的不良反应,如腰椎 BMD 减少和失血性休克。
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引用次数: 0
A systematic review of the drug-drug interaction between Statins and Quinolones 他汀类药物与喹诺酮类药物相互作用的系统回顾
Pub Date : 2024-07-10 DOI: 10.1186/s40360-024-00760-8
Jifang Zhou, Lixia Yu, Huimin Xu
Statins are widely used in cardiovascular disease (CVD) as a common lipid-lowering drug, while quinolones are widely used for the treatment of infectious diseases. It is common to see CVD in combination with infectious diseases, therefore it is often the case that statins and quinolones are used in combination. Data suggest combinations of statin and quinolone may be associated with potentially life-threatening myopathy, rhabdomyolysis and acute hepatitis. This systematic review aims to characterize data regarding patients affected by the statin-quinolone interaction. The purpose of this systematic review was to collect and evaluate the evidence surrounding statin-quinolone drug interactions and to discuss related risk mitigation strategies. The following databases were searched: PubMed (Medline), Embase, Scopus, and Cochrane Library. The systematic electronic literature search was conducted with the following search terms. In this study, three types of search terms were used: statins-related terms, quinolones-related terms, and drug interactions-related terms. There were 16 case reports that met the criteria for qualitative analysis. Patients were involved in the following adverse reactions: rhabdomyolysis (n = 12), acute hepatitis (n = 1), muscle weakness (n = 1), hip tendinopathy (n = 1), or myopathy (n = 1). In the included literature, patients vary in the dose and type of statins they take, including simvastatin (n = 10) at a dose range of 20–80 mg/d and atorvastatin (n = 4) at a dose of 80 mg/d. There were 2 patients with unspecified statin doses, separately using simvastatin and atorvastatin. The quinolones in combination were ciprofloxacin (n = 9) at a dose range of 800–1500 mg/d, levofloxacin (n = 6) at a dose range of 250–1000 mg/d, and norfloxacin (n = 1) in an unspecified dose range. 81% of the case patients were over 60 years of age, and about 1/3 had kidney-related diseases such as diabetic nephropathy, post-transplantation, and severe glomerulonephritis. Nearly two-third of the patients were on concomitant cytochrome P450 3A4 (CYP3A4) inhibitors, P-glycoprotein (P-gp) inhibitors, or organic anion transporting polypeptide 1B1 (OATP1B1) inhibitors. Patients treated with statin-quinolone combination should be monitored more closely for changes in aspartate aminotransferase or creatine kinase (CK) levels, and muscle symptoms, especially in patients with ciprofloxacin or levofloxacin, with simvastatin and high-dose atorvastatin, over 60 years of age, with kidney-related diseases, and on concomitant CYP3A4 inhibitors.
他汀类药物作为一种常见的降脂药物被广泛用于心血管疾病(CVD),而喹诺酮类药物则被广泛用于治疗感染性疾病。心血管疾病合并感染性疾病的情况很常见,因此他汀类药物和喹诺酮类药物经常被联合使用。有数据表明,他汀类药物和喹诺酮类药物合用可能会导致肌病、横纹肌溶解症和急性肝炎等潜在的生命危险。本系统综述旨在描述受他汀类药物与喹诺酮类药物相互作用影响的患者的相关数据。本系统综述旨在收集和评估他汀类药物与喹诺酮类药物相互作用的相关证据,并讨论相关的风险缓解策略。检索了以下数据库:PubMed(Medline)、Embase、Scopus 和 Cochrane 图书馆。系统性电子文献检索使用了以下检索词。本研究使用了三种检索词:他汀类药物相关词、喹诺酮类药物相关词和药物相互作用相关词。有 16 份病例报告符合定性分析的标准。患者涉及以下不良反应:横纹肌溶解(12 例)、急性肝炎(1 例)、肌无力(1 例)、髋关节肌腱病(1 例)或肌病(1 例)。在收录的文献中,患者服用他汀类药物的剂量和类型各不相同,其中辛伐他汀(10 例)的剂量范围为 20-80 毫克/天,阿托伐他汀(4 例)的剂量为 80 毫克/天。有 2 名患者的他汀类药物剂量不详,分别使用辛伐他汀和阿托伐他汀。联合使用的喹诺酮类药物有环丙沙星(9 例),剂量范围为 800-1500 毫克/天;左氧氟沙星(6 例),剂量范围为 250-1000 毫克/天;诺氟沙星(1 例),剂量范围不详。81%的病例患者年龄超过60岁,约1/3的患者患有与肾脏相关的疾病,如糖尿病肾病、移植后肾病和严重肾小球肾炎。近三分之二的患者同时服用细胞色素 P450 3A4 (CYP3A4) 抑制剂、P-糖蛋白 (P-gp) 抑制剂或有机阴离子转运多肽 1B1 (OATP1B1) 抑制剂。使用他汀-喹诺酮类复方制剂治疗的患者应更密切地监测天冬氨酸氨基转移酶或肌酸激酶(CK)水平的变化以及肌肉症状,尤其是使用环丙沙星或左氧氟沙星、辛伐他汀和大剂量阿托伐他汀、60 岁以上、患有肾脏相关疾病以及同时服用 CYP3A4 抑制剂的患者。
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引用次数: 0
Sustained release delivery of favipiravir through statistically optimized, chemically cross-linked, pH-sensitive, swellable hydrogel 通过统计优化、化学交联、pH 值敏感、可膨胀的水凝胶持续释放法非拉韦
Pub Date : 2024-04-29 DOI: 10.1186/s40360-024-00752-8
Arooj Khan, Muhammad Zaman, Muhammad Ahsan Waqar, Asif Mahmood, Talal Shaheer, Rai Muhammad Sarfraz, Kanwal Shahzadi, Azmat Ali Khan, Amer M. Alanazi, Milton Kumar Kundu, Md Rabiul Islam, Athanasios Alexiou, Marios Papadakis
In the current work, favipiravir (an antiviral drug) loaded pH-responsive polymeric hydrogels were developed by the free redical polymerization technique. Box-Behnken design method via Design Expert version 11 was employed to furnish the composition of all hydrogel formulations. Here, polyethylene glycol (PEG) has been utilized as a polymer, acrylic acid (AA) as a monomer, and potassium persulfate (KPS) and methylene-bisacrylamide (MBA) as initiator and cross-linker, respectively. All networks were evaluated for in-vitro drug release (%), sol-gel fraction (%), swelling studies (%), porosity (%), percentage entrapment efficiency, and chemical compatibilities. According to findings, the swelling was pH sensitive and was shown to be greatest at a pH of 6.8 (2500%). The optimum gel fraction offered was 97.8%. A sufficient porosity allows the hydrogel to load a substantial amount of favipiravir despite its hydrophobic behavior. Hydrogels exhibited maximum entrapment efficiency of favipiravir upto 98%. The in-vitro release studies of drug-formulated hydrogel revealed that the drug release from hydrogel was between 85 to 110% within 24 h. Drug-release kinetic results showed that the Korsmeyer Peppas model was followed by most of the developed formulations based on the R2 value. In conclusion, the hydrogel-based technology proved to be an excellent option for creating the sustained-release dosage form of the antiviral drug favipiravir.
在当前的研究工作中,利用游离红光聚合技术开发了负载法非拉韦(一种抗病毒药物)的 pH 值响应型聚合物水凝胶。所有水凝胶配方的组成都是通过 Design Expert 11 版的盒式贝肯设计法确定的。聚乙二醇(PEG)用作聚合物,丙烯酸(AA)用作单体,过硫酸钾(KPS)和亚甲基双丙烯酰胺(MBA)分别用作引发剂和交联剂。对所有网络进行了体外药物释放(%)、溶胶-凝胶成分(%)、溶胀研究(%)、孔隙率(%)、夹持效率百分比和化学相容性评估。研究结果表明,溶胀对 pH 值很敏感,pH 值为 6.8 时溶胀最大(2500%)。最佳凝胶成分为 97.8%。尽管水凝胶具有疏水性,但足够的孔隙率使其能够装载大量的法非拉韦。水凝胶对法比拉韦的最大吸附效率高达 98%。药物释放动力学结果表明,根据 R2 值,所开发的大多数配方都遵循 Korsmeyer Peppas 模型。总之,水凝胶技术被证明是制造抗病毒药物法非拉韦缓释制剂的最佳选择。
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引用次数: 0
Blocking group 2 innate lymphoid cell activation and macrophage M2 polarization: potential therapeutic mechanisms in ovalbumin-induced allergic asthma by calycosin 阻断第 2 组先天性淋巴细胞活化和巨噬细胞 M2 极化:钙黄素对卵清蛋白诱发的过敏性哮喘的潜在治疗机制
Pub Date : 2024-04-22 DOI: 10.1186/s40360-024-00751-9
Chunyan Tian, Qi Liu, Xiaoyu Zhang, Zhuying Li
Calycosin, a flavonoid compound extracted from Astragalus membranaceus, has shown anti-asthma benefits in house dust mite-induced asthma. Recent studies have suggested that innate-type cells, including group 2 innate lymphoid cells (ILC2s) and macrophages, serve as incentives for type 2 immunity and targets for drug development in asthma. This work focuses on the effects of calycosin on the dysregulated ILC2s and macrophages in allergic asthma. In vivo, the asthmatic mouse model was established with ovalbumin (OVA) sensitization and challenge, and calycosin was intraperitoneally administered at doses of 20 and 40 mg/kg. In vivo, mouse primary ILC2s were stimulated with interleukin (IL)-33 and mouse RAW264.7 macrophages were stimulated with IL-4 and IL-13 to establish the cell models. Cells were treated with calycosin at doses of 5 and 10 µM. In vivo, we observed significantly reduced numbers of eosinophils, neutrophils, monocyte macrophages and lymphocytes in the bronchoalveolar lavage fluid (BALF) of OVA-exposed mice with 40 mg/kg calycosin. Histopathological assessment showed that calycosin inhibited the airway inflammation and remodeling caused by OVA. Calycosin markedly decreased the up-regulated IL-4, IL-5, IL-13, IL-33, and suppression tumorigenicity 2 (ST2) induced by OVA in BALF and/or lung tissues of asthmatic mice. Calycosin repressed the augment of arginase 1 (ARG1), IL-10, chitinase-like 3 (YM1) and mannose receptor C-type 1 (MRC1) levels in the lung tissues of asthmatic mice. In vivo, calycosin inhibited the IL-33-induced activation as well as the increase of IL-4, IL-5, IL-13 and ST2 in ILC2s. Calycosin also repressed the increase of ARG1, IL-10, YM1 and MRC1 induced by IL-4 and IL-13 in RAW264.7 macrophages. In addition, we found that these changes were more significant in 40 mg/kg calycosin treatment than 20 mg/kg calycosin. Collectively, this study showed that calycosin might attenuate OVA-induced airway inflammation and remodeling in asthmatic mice via preventing ILC2 activation and macrophage M2 polarization. Our study might contribute to further study of asthmatic therapy.
萼萼苷是从黄芪中提取的一种黄酮类化合物,对屋尘螨诱发的哮喘有抗哮喘的作用。最近的研究表明,先天型细胞,包括第 2 组先天性淋巴细胞(ILC2s)和巨噬细胞,是第 2 型免疫的诱因,也是哮喘药物开发的目标。这项研究的重点是钙黄绿素对过敏性哮喘中失调的 ILC2s 和巨噬细胞的影响。在体内,通过卵清蛋白(OVA)致敏和挑战建立了哮喘小鼠模型,并以 20 和 40 mg/kg 的剂量腹腔注射钙黄素。在体内,用白细胞介素(IL)-33刺激小鼠原代ILC2,用IL-4和IL-13刺激小鼠RAW264.7巨噬细胞,以建立细胞模型。用 5 µM 和 10 µM 剂量的钙黄绿素处理细胞。在体内,我们观察到嗜酸性粒细胞、中性粒细胞、单核巨噬细胞和淋巴细胞的数量在使用 40 毫克/千克钙黄素的 OVA 暴露小鼠支气管肺泡灌洗液(BALF)中明显减少。组织病理学评估显示,钙磷脂抑制了由 OVA 引起的气道炎症和重塑。萼萼素能显著降低哮喘小鼠BALF和/或肺组织中由OVA诱导的IL-4、IL-5、IL-13、IL-33和抑制肿瘤生成2(ST2)的上调。萼萼素能抑制哮喘小鼠肺组织中精氨酸酶 1(ARG1)、IL-10、几丁质酶样 3(YM1)和甘露糖受体 C 型 1(MRC1)水平的升高。在体内,萼萼素能抑制 IL-33 诱导的活化以及 ILC2 中 IL-4、IL-5、IL-13 和 ST2 的增加。萼萼素还抑制了IL-4和IL-13诱导的RAW264.7巨噬细胞中ARG1、IL-10、YM1和MRC1的增加。此外,我们还发现,与 20 毫克/千克的钙黄绿素相比,40 毫克/千克的钙黄绿素对这些变化的抑制作用更为显著。总之,本研究表明,钙黄素可通过阻止ILC2活化和巨噬细胞M2极化,减轻OVA诱导的哮喘小鼠气道炎症和重塑。我们的研究可能有助于哮喘治疗的进一步研究。
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引用次数: 0
Treatment for Covid-19 with SARS-CoV-2 neutralizing antibody BRII-196(Ambavirumab) plus BRII-198(Lomisivir): a retrospective cohort study 用SARS-CoV-2中和抗体BRII-196(安巴韦鲁单抗)加BRII-198(洛米西韦)治疗Covid-19:一项回顾性队列研究
Pub Date : 2024-04-19 DOI: 10.1186/s40360-024-00753-7
Qin Yalan, Hao Lingfang, Liu Xisong, Liang Run, Zhang Junjing, Zhang’ An
Monoclonal antibody therapy for Covid-19 springs up all over the world and get some efficiency. This research aims to explore the treating effect of BRII-196(Ambavirumab) plus BRII-198(Lomisivir) on Covid-19. In this retrospective cohort research, patients received standard care or plus BRII-196 /BRII-198 monoclonal antibodies. General comparison of clinical indexes and prognosis between Antibody Group and Control Group was made. Further, according to the antibody using time and patients’ condition, subgroups included Early antibody group, Late antibody group, Mild Antibody Group, Mild Control Group, Severe Antibody Group and Severe Control Group. Length of stay(LOS) and interval of Covid-19 nucleic acid from positive to negative of Antibody Group were 12.0(IQR 9.0–15.0) and 14.0(IQR 10.0–16.0) days, less than those(13.0 (IQR 11.0–18.0) and 15.0 (IQR 12.8–17.0) days) of Control Group(p = 0.004, p = 0.004). LOS(median 10days) of Early Antibody Group was the shortest, significantly shorter than that of Control Group (median 13days)(p < 0.001). Interval(median 12days) of Covid-19 nucleic acid from positive to negative of Early Antibody Group also was significantly shorter than that of Control Group(median 15days) and Late Antibody Group(median 14days)(p = 0.001, p = 0.042). LOS(median 12days) and interval(median 13days) of Covid-19 nucleic acid from positive to negative of Mild Antibody Group was shorter than that of Mild Control Group(median 13days; median 14.5days)(p = 0.018, p = 0.033). The neutralizing antibody therapy, BRII-196 plus BRII-198 could shorten LOS and interval of Covid-19 nucleic acid from positive to negative. However, it didn’t show efficacy for improving clinical outcomes among severe or critical cases.
针对Covid-19的单克隆抗体疗法在全球兴起并取得了一定的疗效。本研究旨在探讨BRII-196(安巴韦鲁单抗)联合BRII-198(洛米西韦)对Covid-19的治疗效果。在这项回顾性队列研究中,患者接受标准治疗或BRII-196/BRII-198单克隆抗体治疗。对抗体组和对照组的临床指标和预后进行了总体比较。此外,根据使用抗体的时间和患者的病情,分为早期抗体组、晚期抗体组、轻度抗体组、轻度对照组、重度抗体组和重度对照组。抗体组的住院时间(LOS)和Covid-19核酸从阳性到阴性的间隔时间分别为12.0(IQR 9.0-15.0)天和14.0(IQR 10.0-16.0)天,少于对照组的13.0(IQR 11.0-18.0)天和15.0(IQR 12.8-17.0)天(P = 0.004,P = 0.004)。早期抗体组的生命周期(中位 10 天)最短,明显短于对照组(中位 13 天)(p < 0.001)。早期抗体组 Covid-19 核酸从阳性到阴性的时间间隔(中位 12 天)也明显短于对照组(中位 15 天)和晚期抗体组(中位 14 天)(P = 0.001,P = 0.042)。轻度抗体组的病程(中位 12 天)和 Covid-19 核酸从阳性到阴性的间隔(中位 13 天)均短于轻度对照组(中位 13 天;中位 14.5 天)(p = 0.018,p = 0.033)。BRII-196加BRII-198的中和抗体疗法可以缩短LOS和Covid-19核酸从阳性到阴性的间隔时间。然而,该疗法在改善重症或危重病例的临床预后方面并未显示出疗效。
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引用次数: 0
Determination of drug-related problems according to PAIR criteria in dialysis patients: a cross-sectional study in tertiary care hospital 根据 PAIR 标准确定透析患者的药物相关问题:一项在三级医院进行的横断面研究
Pub Date : 2024-04-18 DOI: 10.1186/s40360-024-00754-6
Aysel Pehlivanli, Sayeste Akkan Eren, Sule Sengul, Bilgen Basgut, Sehsuvar Erturk, A. Tanju Ozcelikay
Dialysis patients are at high risk for drug-related problems (DRPs), which have significant consequences for their morbidity, mortality, and quality of life. Improved clinical outcomes can be achieved by preventing, identifying, and resolving these problems. This is a retrospective observational study. In this study, the PAIR instrument (Pharmacotherapy Assessment in Chronic Renal Disease) was validated for use in Turkish. Validation consisted of three stages: translation back-translation with expert panel evaluation, reliability analysis using the test-retest method, and conceptual validity with both Pharmaceutical Care Network Europe (PCNE) and PAIR used to determine DRPs prevalence. In total, 104 patients (mean ± SD age, 54.1 ± 15.8 years; 53.8% male) were included in the study. An expert panel evaluated the items in the criterion based on their intelligibility, service of purpose, differentiation, and cultural suitability during the translation stage. Content validity index (CVI) score was found to be 0.95. The reliability analysis was performed by applying the test-retest method and calculating correlation coefficient on 30 randomly selected patients one month later. Correlation coefficient (p) was found to be 0.8. To evaluate conceptual validity, 104 patients’ pharmacotherapy plans were assessed using both the PAIR and PCNE criteria. The prevalence of DRPs according to PAIR criteria (100.0%) and PCNE (73.1%) were statistically significantly different (p < 0.001). As a result, PAIR criteria can identify clinically relevant DRPs in patients with CKD and is a new, validated tool to be used in Turkey, but may not be adequate for patients receiving dialysis. Therefore, it needs to be reviewed and updated for dialysis patients.
透析患者是药物相关问题 (DRP) 的高危人群,这些问题对他们的发病率、死亡率和生活质量都有重大影响。通过预防、识别和解决这些问题,可以改善临床疗效。这是一项回顾性观察研究。在这项研究中,PAIR 工具(慢性肾病药物治疗评估)在土耳其进行了验证。验证包括三个阶段:翻译与专家小组评估的反向翻译、使用测试-重复测试法进行可靠性分析,以及使用欧洲药品护理网络 (PCNE) 和 PAIR 进行概念验证,以确定 DRP 的流行程度。共有 104 名患者(平均 ± SD 年龄,54.1 ± 15.8 岁;53.8% 为男性)参与了研究。在翻译阶段,专家小组根据可理解性、服务目的、区分度和文化适宜性对标准中的项目进行了评估。结果发现,内容效度指数(CVI)为 0.95。一个月后,对随机抽取的 30 名患者采用重测法进行了信度分析,并计算了相关系数。相关系数(p)为 0.8。为了评估概念有效性,研究人员使用 PAIR 和 PCNE 标准对 104 名患者的药物治疗计划进行了评估。根据 PAIR 标准(100.0%)和 PCNE 标准(73.1%),DRP 的发生率在统计学上有显著差异(p < 0.001)。因此,PAIR 标准可识别慢性肾脏病患者中与临床相关的 DRP,是一种可在土耳其使用的经过验证的新工具,但对于接受透析的患者可能并不适用。因此,需要针对透析患者对该标准进行审查和更新。
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引用次数: 0
Effects of nicotine on microRNA-124 expression in bile duct ligation-induced liver fibrosis in rats 尼古丁对胆管结扎诱发大鼠肝纤维化的 microRNA-124 表达的影响
Pub Date : 2024-03-28 DOI: 10.1186/s40360-024-00749-3
Khalil Hajiasgharzadeh, Parviz Shahabi, Elham Karimi-Sales, Mohammad Reza Alipour
Nicotine, the main compound of smoking may exert its effects by changing the expression of microRNAs (miRNAs). This study was conducted to further investigate the molecular mechanisms of miRNA-dependent effects of nicotine in an animal model of liver fibrosis. The bile duct ligation (BDL) approach was used to create a model of liver fibrosis. Twenty-four male Wistar rats were used in the study. The effects of nicotine administration on miRNA-124 expression, as well as alpha-smooth muscle actin (liver fibrosis marker) and chemokine ligand 2 (an inflammatory chemokine), were investigated using RT-qPCR. In addition, the mRNA and protein expression of signal transducer and activator of transcription 3 (STAT-3; as a potential target for miRNA-124) were investigated by RT-qPCR and immunofluorescence, respectively. Liver enzyme activity levels were measured using a colorimetric assay. In addition, the effects of nicotine on the process of liver fibrosis were investigated with histological studies. The development of liver fibrosis in BDL rats and nicotine administration led to a decrease in miRNA-124 expression. The decrease in the expression is accompanied by the increase in the expression of fibrotic and proinflammatory genes. Also, an increase in STAT-3 mRNA and protein expression was observed in the fibrotic rats that received nicotine. In addition, the significant increase in bilirubin and liver enzymes in fibrotic rats worsens with nicotine administration. The results of histological studies also confirm these results. Considering that miRNA-124 is an anti-inflammatory miRNA, it can be concluded that the decrease in its expression due to nicotine exposure leads to an increase in inflammatory processes and subsequently to an increase in liver fibrosis.
尼古丁是吸烟的主要化合物,可能通过改变微RNA(miRNA)的表达来发挥其作用。本研究旨在进一步研究尼古丁在肝纤维化动物模型中依赖于miRNA效应的分子机制。研究采用胆管结扎(BDL)法建立肝纤维化模型。研究使用了24只雄性Wistar大鼠。研究人员利用 RT-qPCR 技术研究了尼古丁给药对 miRNA-124 以及α-平滑肌肌动蛋白(肝纤维化标志物)和趋化因子配体 2(一种炎性趋化因子)表达的影响。此外,还分别用 RT-qPCR 和免疫荧光法检测了信号转导和转录激活因子 3(STAT-3,miRNA-124 的潜在靶标)的 mRNA 和蛋白质表达。肝酶活性水平采用比色法测定。此外,还通过组织学研究探讨了尼古丁对肝纤维化过程的影响。BDL大鼠肝纤维化的发展和尼古丁的施用导致了miRNA-124表达的减少。在表达减少的同时,纤维化和促炎基因的表达也增加了。此外,在接受尼古丁治疗的纤维化大鼠中,还观察到 STAT-3 mRNA 和蛋白质表达的增加。此外,服用尼古丁后,纤维化大鼠胆红素和肝酶的显著增加也会加剧。组织学研究结果也证实了这些结果。考虑到 miRNA-124 是一种抗炎 miRNA,可以得出结论,尼古丁暴露导致 miRNA-124 表达减少,会导致炎症过程增加,进而导致肝纤维化加重。
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引用次数: 0
Dapagliflozin promotes white adipose tissue browning though regulating angiogenesis in high fat induced obese mice 达帕格列净通过调节高脂诱导肥胖小鼠的血管生成促进白色脂肪组织褐变
Pub Date : 2024-03-19 DOI: 10.1186/s40360-024-00747-5
Lin Xiang, Min Liu, Guangda Xiang, Ling Yue, Junxia Zhang, Xiaoli Xu, Jing Dong
Browning of white adipose tissue (WAT) is become an appealing target for therapeutics in the treatment of obesity and related metabolic diseases. Dapagliflozin is widely used in the treatment of type 2 diabetes, and it is also found that the drug exhibits regulate systemic metabolism such as obesity, insulin resistance and hepatic steatosis. However, the precise role of dapagliflozin on WAT remodeling remains to be elucidated. The current study aimed to explore the role of dapagliflozin on WAT browning in high-fat diet (HFD)-induced obese mice. Male C57BL/6J mice (n = 6 per group) were used to establish obesity model by following feeding with HFD for 6 weeks. The mice were randomly treated with or without dapagliflozin for the experimental observation. The volume and fat fraction of WAT were quantified, H&E, UCP-1 staining and immunohistochemistry were conducted to investigate the white-to-brown fat conversion and angiogenesis in WAT respectively. Quantitative real-time polymerase chain reaction (qPCR) was employed to explore the mRNA expression levels of genes related to fat browning and angiogenesis in WAT. Subsequently, 3T3-L1 cells were used to explore the effect of dapagliflozin on preadipocytes differentiation in vitro. Our results demonstrated that dapagliflozin could reduce body weight gain and promote WAT browning in HFD induced obese mice via regulating lipogenesis and angiogenesis in WAT. Furthermore, dapagliflozin reduce cells differentiation, up-regulate the expression of WAT browning and angiogenesis genes in 3T3-L1 adipocytes in vitro. In conclusion, dapagliflozin can potentially promote WAT browning in HFD induced obese mice via improving lipogenesis and angiogenesis in WAT.
白脂肪组织(WAT)褐变已成为治疗肥胖症和相关代谢疾病的诱人靶点。达帕格列净(Dapagliflozin)被广泛用于治疗 2 型糖尿病,研究还发现该药物可调节肥胖、胰岛素抵抗和肝脂肪变性等全身代谢。然而,达帕格列净对WAT重塑的确切作用仍有待阐明。本研究旨在探讨达帕格列净对高脂饮食(HFD)诱导的肥胖小鼠WAT褐变的作用。雄性C57BL/6J小鼠(n = 6只/组)经高脂饮食喂养6周后建立肥胖模型。小鼠随机接受或不接受达帕格列净治疗进行实验观察。对小鼠WAT的体积和脂肪率进行量化,并通过H&E、UCP-1染色和免疫组化分别研究WAT中白色脂肪向棕色脂肪的转化和血管生成。采用实时定量聚合酶链反应(qPCR)检测脂肪褐变和血管生成相关基因的 mRNA 表达水平。随后,利用 3T3-L1 细胞探讨达帕格列净对体外前脂肪细胞分化的影响。我们的研究结果表明,达帕格列净可通过调节脂肪生成和血管生成,降低HFD诱导的肥胖小鼠的体重增加,促进WAT棕色化。此外,达帕格列净还能减少细胞分化,上调体外3T3-L1脂肪细胞中WAT褐变和血管生成基因的表达。总之,达帕格列酮可通过改善脂肪细胞的脂肪生成和血管生成,促进HFD诱导的肥胖小鼠脂肪细胞的棕色化。
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引用次数: 0
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BMC Pharmacology and Toxicology
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