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Aspects of the Safe Use of Antibacterial Drugs in Community-Acquired Pneumonia: the Implications of Drug-Drug Interactions 社区获得性肺炎中抗菌药物的安全使用:药物-药物相互作用的影响
Pub Date : 2022-08-05 DOI: 10.37489/0235-2990-2022-67-3-4-46-52
A. Taube, B. Romanov, E. V. Shubnikova, R. Alyautdin, M. Zhuravleva, O. A. Demidova, E. Demchenkova
Background. Drug-drug interactions can seriously affect the safety profile of a drug and are an important problem worldwide. Due to the aging of the population, the increasing frequency of polypharmacy, as well as the spread of self-medication, adverse events that are difficult to identify may occur. It is hard to establish a causal relationship between the administration of a certain drug and the occurrence of an adverse event; it may also lead to the conversion of the adverse event into an adverse drug reaction. The risk of drug-drug interactions increases with combination therapy, as a result of misuse of a drug (off-label use), as well as in the absence of full disclosure from physician and patient about potential drug-drug interactions.One of the ways to detect an adverse reaction to a drug is a method of «spontaneous messages», when notification cards issued according to the regulated form are sent from subjects of drug circulation to the national centers for pharmacovigilance, then to the global database of the World Health Organization VigiBase.The aim of the work was a comprehensive analysis of the content compliance of the information presented in the instructions for the medical use of antibacterial drugs on potential drug-drug interactions with validated signals from the WHO global VigiBase database.Material and Methods. The study used information and analytical comparative non-quantitative, graphical, logical methods of analysis, as well as regression analysis. Objects of the study: instructions for medical use for international generic drugs ampicillin, amoxicillin, azithromycin, clarithromycin.Results. The contents of the instructions for use concerning possible interactions of ampicillin, amoxicillin, azithromycin, clarithromycin upon administration with other drugs were studied. Subsequently, a comparative analysis of the obtained data on drug-drug interactions of antibiotics with other drugs was carried out with signals of drug-drug interactions were validated by VigiBase.Conclusion. The study showed that a detailed description of the risks of potential drug-drug interactions in the instructions for medical use with the aim of informing doctors, patients, and caregivers helps to prevent the use of undesirable combinations, thereby reducing the risk of adverse reactions when drugs are used together. The study found that most of the identified information on the safe use of drugs was missing in the instructions for medical use.
背景。药物-药物相互作用会严重影响药物的安全性,是一个世界性的重要问题。由于人口老龄化、多种用药频率的增加以及自我用药的普及,可能会出现难以识别的不良事件。很难在服用某种药物与不良事件的发生之间建立因果关系;它还可能导致不良事件转化为药物不良反应。由于药物滥用(超说明书使用),以及医生和患者没有充分披露潜在的药物-药物相互作用,联合治疗的药物-药物相互作用的风险增加。检测药物不良反应的方法之一是"自发信息"方法,即根据规定的表格从药物流通主体发送通知卡到国家药物警戒中心,然后发送到世界卫生组织VigiBase的全球数据库。这项工作的目的是全面分析抗菌药物医疗使用说明书中关于潜在药物-药物相互作用的信息的内容是否符合世卫组织全球VigiBase数据库的验证信号。材料和方法。本研究采用了信息分析、比较分析、非定量、图形化、逻辑分析以及回归分析等方法。研究对象:国际仿制药氨苄西林、阿莫西林、阿奇霉素、克拉霉素的医疗使用说明书。对使用说明书中氨苄西林、阿莫西林、阿奇霉素、克拉霉素与其他药物可能发生的相互作用内容进行了研究。随后,对获得的抗生素与其他药物相互作用数据进行对比分析,并通过vigibase对药物相互作用信号进行验证。研究表明,在医疗使用说明书中详细说明潜在的药物-药物相互作用的风险,以便告知医生、患者和护理人员,有助于防止使用不良组合,从而减少药物一起使用时不良反应的风险。研究发现,在医疗使用说明中,大多数已确定的关于药物安全使用的信息都缺失了。
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引用次数: 0
Post-COVID Syndrome in Children Residing in the Kabardino-Balkarian Republic 居住在卡巴尔达-巴尔干共和国儿童的后冠状病毒综合征
Pub Date : 2022-08-05 DOI: 10.37489/0235-2990-2022-67-3-4-42-45
L. Temmoeva, Z. Alieva, Z. A. Kambachokova, N. M. Temmoev, D. A. Kardanova, D. S. Khozhaeva, A. L. Deshev, D. S. Malkarova, M. K. Dzhabrailova, A. T. Sheriev
A study which included 97 children who had COVID-19 during the period from September 2021 to January 2022 was conducted. This article discusses the symptoms occurring after COVID-19 infection. The analysis of the results showed that the largest proportion among sick children was in patients with reduced cognitive functions, an increased level of neuroticism, depressed state and emotional instability. The most common comorbidities were the diseases of the gastrointestinal tract, respiratory and cardiovascular systems.
对2021年9月至2022年1月期间感染COVID-19的97名儿童进行了一项研究。本文讨论了COVID-19感染后出现的症状。分析结果显示,患病儿童中认知功能下降、神经质、抑郁状态和情绪不稳定的比例最大。最常见的合并症是胃肠道、呼吸系统和心血管系统疾病。
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引用次数: 1
Antibiotic Therapy of Brucellosis. Current State and Prospects for Improvement 布鲁氏菌病的抗生素治疗。现状与改进前景
Pub Date : 2022-08-05 DOI: 10.37489/0235-2990-2022-67-3-4-77-84
I. A. Shchipeleva, E. Markovskaya, О. F. Kretenchuk
Human brucellosis is a particularly dangerous socially significant infection that still poses a serious threat to public health due to a wide range of clinical manifestations, severe course, and the development of serious complications of infection that may lead to disability, which, in turn, causes significant damage to the economy. Treatment issues remain debatable, since the pathogen's ability to cause intracellular parasitism complicates effective antibiotic therapy. The review presents the data on in vitro activity and effic acy when using tetracyclines, rifampicin, fluoroquinolones, aminoglycosides, carbapenems, macrolides, cephalosporins, chloramphenicol, and trimethoprim/sulfamethoxazole as monotherapy agents. The data on the effectiveness of the use of antibacterial drugs in various combinations, and the inclusion of immunomodulators in the treatment regimen are presented. Information concerning promising modern developments that facilitate better penetration of antibacterial drugs into phagocytic cells is considered. Some results of searching for sources of new means of antibacterial therapy of brucellosis are presented.
人类布鲁氏菌病是一种特别危险的具有社会意义的感染,由于具有广泛的临床表现、严重的病程以及可能导致残疾的严重感染并发症的发展,仍然对公共卫生构成严重威胁,而残疾又会对经济造成重大损害。治疗问题仍然存在争议,因为病原体引起细胞内寄生的能力使有效的抗生素治疗复杂化。综述了四环素类、利福平类、氟喹诺酮类、氨基糖苷类、碳青霉烯类、大环内酯类、头孢菌素类、氯霉素类和甲氧苄啶/磺胺甲恶唑类单药的体外活性和疗效数据。在各种组合中使用抗菌药物的有效性的数据,以及在治疗方案中纳入免疫调节剂。考虑到有关促进抗菌药物更好地渗透到吞噬细胞中的有前途的现代发展的信息。本文介绍了寻找布鲁氏菌病抗菌治疗新手段来源的一些结果。
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引用次数: 0
Medical Rehabilitation of Elderly and Senior Patients with COVID-19-Associated Pneumonia 新冠肺炎相关老年患者医学康复研究
Pub Date : 2022-08-05 DOI: 10.37489/0235-2990-2022-67-3-4-36-41
M. Ivanova, V. Ivanov, Yu. M. Shcheglova, A. Kovalenko, E. Talikova
The aim of the study was to evaluate the effectiveness of including remaxol in the medical rehabilitation of elderly and senior patients with COVID-19-associated pneumonia and changes in liver enzyme activity.Material and methods: 116 patients (56 men and 60 women) were examined. All patients underwent a complex of medical rehabilitation on an outpatient basis on the 10–12th day after discharge from the hospital and in the presence of 2 negative results of PCR tests for SARS-CoV-2, which included, in addition to the recommended measures (drug therapy and exercise therapy), vacuum labile massage according to the author's methodology and a course of hepatoprotective drugs. Depending on the latter, the patients were divided into two groups: I — the main group (n=60) — received remaxol in the drug treatment regimen: 400 ml, intravenously, drip, in a course of 10 days, II – comparison (n=56) — ademetionine: 400 ml, intravenously, drip, in 0.9% saline, in a course 10 days. Before rehabilitation and at its end, the following tests were carried out: Stange and Genchi tests; quality of life was assessed using the SF-36 questionnaire. Laboratory studies included determination of the following indicators levels: ALT, AST, their ratio, alkaline phosphatase, GGT, total and direct bilirubin, LDH, albumin and total protein levels.Results. The inclusion of hepatoprotectors in the medical rehabilitation of the patients of this group contributes to a decrease in cytolytic and cholestatic syndromes, which is more pronounced in patients who received remaxol: (a decrease in AST by 1.5 times (from 35.4±1.4 to 23.5±l), and ALT — by 1.8 times (from 38.7±1.3 to 21.5±0.4 IU/l), as well as normalization of bilirubin metabolism: a decrease of total bilirubin by 2.1 times (from 32.1± 0.6 to 14.8±0.9 µmol/l) and of direct — by 2.5 times (from 7.1±0.6 to 2.8±0.1 µmol/l). A pronounced increase in resistance to hypoxia was noted during the therapy with the drug (according to Stange and Genche), which contributed to an improvement in psychophysiological indicators of patients’ quality of life (according to the SF-36 questionnaire). The obtained results, along with the safety of the drug, allow us to recommend its use in patients with this pathology.
本研究的目的是评估纳入瑞马索对中老年covid -19相关性肺炎患者医学康复的效果及肝酶活性的变化。材料和方法:116例患者(男56例,女60例)。出院后10 - 12天,所有患者在SARS-CoV-2 PCR检测结果为阴性的情况下,在门诊进行了综合医疗康复,除建议的措施(药物治疗和运动治疗)外,还包括根据作者的方法进行真空不稳定按摩和一个疗程的保肝药物治疗。根据后者的情况,将患者分为两组:I -主要组(n=60) -在药物治疗方案中接受利马索:400 ml,静脉滴注,为期10天;II -比较组(n=56) -腺苷:400 ml,静脉滴注,加入0.9%生理盐水,为期10天。在康复前和康复结束时,进行了以下测试:奇异和根奇测试;使用SF-36问卷评估患者的生活质量。实验室检查包括:ALT、AST及其比值、碱性磷酸酶、GGT、总胆红素和直接胆红素、LDH、白蛋白和总蛋白水平的测定。在本组患者的医学康复中纳入肝保护剂有助于降低溶细胞和胆汁淤积综合征,在接受利美索治疗的患者中更为明显:(AST降低1.5倍(从35.4±1.4降至23.5±l), ALT -降低1.8倍(从38.7±1.3降至21.5±0.4 IU/l),胆红素代谢正常化;总胆红素降低2.1倍(从32.1±0.6µmol/l到14.8±0.9µmol/l),直接降低2.5倍(从7.1±0.6µmol/l到2.8±0.1µmol/l)。根据Stange和Genche的研究,在药物治疗期间,患者对缺氧的抵抗力明显增强,这有助于改善患者的生活质量的心理生理指标(根据SF-36问卷)。所获得的结果,以及药物的安全性,使我们能够推荐其用于患有这种病理的患者。
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引用次数: 1
Biapenem Activity Against Meropenem-Resistant Klebsiella pneumoniae and Pseudomonas aeruginosa 双阿培南对耐美罗培南肺炎克雷伯菌和铜绿假单胞菌的活性研究
Pub Date : 2022-08-05 DOI: 10.37489/0235-2990-2022-67-3-4-23-28
E. M. Gordina, S. Bozhkova, V. V. Shabanova
Currently, the diversity of resistant strains with a certain set of resistance mechanisms is growing, and the frequency of their distribution is increasing. One of the options for finding optimal ways to treat severe infections, including orthopedic infections caused by Klebsiella pneumoniae and Pseudomonas aeruginosa, is the use of new drugs with possible activity against resistant strains.The aim of the study is comparative evaluation of biapenem antibacterial activity against meropenem-resistant K.pneumoniae and P.aeruginosa.Materials and Methods. A total of 14 K.pneumoniae and 18 P.aeruginosa isolates were included in the study. The determination of sensitivity to biapenem and meropenem was carried out via determining the minimum inhibitory concentrations (MIC) for each microorganism by the method of serial dilutions in accordance with ISO 20776-1-2010. Carbapenemases genes (MBL:VIM-, IMP- and NDM-types; OXA-48; KPC) were detected by commercially available real-time PCR.Results. The highest MIC value of meropenem was registered in the carbapenemase-producing K.pneumoniae strain (NDM and OXA-48) and amounted to 512 mg/l, while the MIC value of biapenem in this isolate was 256 mg/l. The MIC50 of meropenem was determined to be 16 mg/l, while in case of biapenem it was 4 mg/l. MIC90 of meropenem against P.aeruginosa was 512 mg/l, of biapenem — 256 mg/l. Among all meropenem-resistant strains included in this study, 28.6% K.pneumoniae and 22.2% P.aeruginosa isolates showed sensitivity to biapenem, the rest were resistant to this drug or sensitive at increased exposure.Conclusion. Comparative analysis of the antibacterial activity against meropenem-resistant K.pneumoniae and P.aeruginosa showed that MIC50/90 of biapenem is several times lower than that of meropenem. Sensitivity to this drug was recorded in 25% of the studied isolates resistant to meropenem (4 — K.pneumoniae and 4 — P.aeruginosa), which increases the possibility of using this drug in the treatment of patients with orthopedic infections.
目前,具有一定耐药机制的耐药菌株多样性不断增加,分布频率不断增加。寻找治疗严重感染的最佳方法之一,包括肺炎克雷伯菌和铜绿假单胞菌引起的骨科感染,是使用可能对耐药菌株有活性的新药。比较评价双阿培南对耐美罗培南肺炎克雷伯菌和铜绿假单胞菌的抑菌活性。共分离出肺炎克雷伯菌14株和铜绿假单胞菌18株。根据ISO 20776-1-2010,采用连续稀释法测定各微生物的最低抑菌浓度(MIC),测定双阿培南和美罗培南的敏感性。碳青霉烯酶基因(MBL:VIM-、IMP-和ndm型;OXA-48;采用市售实时pcr法检测KPC。产碳青霉烯酶肺炎克雷伯菌(NDM和OXA-48)中美罗培南的MIC值最高,为512 mg/l,比阿培南的MIC值最高,为256 mg/l。测定美罗培南的MIC50为16 mg/l,比阿培南的MIC50为4 mg/l。美罗培南对铜绿假单胞菌的MIC90为512 mg/l,比阿培南为256 mg/l。在本研究纳入的所有美洛培南耐药菌株中,28.6%的肺炎克雷伯菌和22.2%的铜绿假单胞菌对美洛培南敏感,其余对美洛培南耐药或增加暴露后敏感。对耐美罗培南肺炎克雷伯菌和铜绿假单胞菌的抑菌活性比较分析表明,双阿培南的MIC50/90比美罗培南低数倍。在所研究的对美罗培南(4 -肺炎克雷伯菌和4 -铜绿假单胞菌)耐药的分离株中有25%对该药敏感,这增加了使用该药治疗骨科感染患者的可能性。
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引用次数: 1
To the 80th Anniversary of Gramicidin C Сreation: From the Study of the Asymmetry of Bacterial Molecules to the Discovery of Antimicrobial Peptides 纪念革兰西菌素C诞生80周年Сreation:从细菌分子不对称的研究到抗菌肽的发现
Pub Date : 2022-08-05 DOI: 10.37489/0235-2990-2022-67-3-4-85-92
B. Andryukov, N. Besednova, T. Zaporozhets
In 1942, G. F. Gause and M. G. Brazhnikova created one of the first antibiotics in the Soviet Union — gramicidin C. In the same year, its successful use started in front-line hospitals in the treatment of complications of wound infections. Thanks to it, the lives of hundreds of thousands of soldiers and officers were saved. Gramicidin C has passed the test of time, and today this antibiotic is effectively used in the treatment of infectious and inflammatory diseases, as well as purulent wounds. In this regard, the 80th anniversary is a good reason to recall the history of the creation of this peptide antibiotic possessing bactericidal action based on the presence of the D-isomer of the amino acid phenylalanine in the producing bacteria. However, the study of ways to overcome the spreading antibiotic resistance in bacteria, as well as the search for alternative antimicrobial strategies are currently on the agenda. For this reason, it is appropriate to recall that the study of the molecular structure of gramicidin C gave impetus not only to the discovery of a whole family of cyclic peptide antibiotics, but also to the discovery of the ability of various organisms to nonribosomal synthesis of biologically active peptides containing D-amino acids with a pronounced antimicrobial effect. Their development is already a vital task today, and the use of peptides is considered a real and promising alternative to traditional antibiotics. Thus, gramicidin C, obtained at the dawn of the era of antibiotics, became a harbinger of the birth of a fundamentally new and promising antimicrobial strategy.
1942年,g·f·高斯和m·g·布拉齐尼科娃发明了苏联最早的抗生素之一——革兰霉素c。同年,革兰霉素c在一线医院成功用于治疗伤口感染并发症。由于它,成千上万的士兵和军官的生命得到了拯救。革兰西菌素C已经通过了时间的考验,今天这种抗生素被有效地用于治疗感染性和炎症性疾病,以及化脓性伤口。在这方面,80周年纪念日是一个很好的理由来回顾这种具有杀菌作用的肽抗生素的创造历史,这种作用是基于产生细菌中氨基酸苯丙氨酸的d -异构体的存在。然而,研究如何克服细菌中抗生素耐药性的蔓延,以及寻找替代的抗微生物策略,目前都在议程上。因此,有必要回顾一下,对gramicidin C的分子结构的研究不仅推动了整个环肽抗生素家族的发现,而且还发现了各种生物体非核糖体合成含有d -氨基酸的生物活性肽的能力,这些肽具有显著的抗菌作用。它们的开发已经是今天的一项重要任务,多肽的使用被认为是传统抗生素的一个真正的和有前途的替代品。因此,gramicidin C在抗生素时代的曙光中获得,成为一种全新的、有前途的抗菌策略诞生的先兆。
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引用次数: 0
Assessment of Antimycobacterial Activity of Newly Synthesized Pyrimidine Derivatives Against Mycobacterium tuberculosis 新合成的嘧啶衍生物对结核分枝杆菌的抑菌活性评价
Pub Date : 2022-08-04 DOI: 10.37489/0235-2990-2022-67-3-4-4-15
M. Samotrueva, N. M. Gabitova, G. N. Genatullina, A. A. Starikova, O. Bashkina, A. Tyrkov, A. Ozerov, I. Tyurenkov
Background. The current trend of growing antibiotic resistance among pathogenic microorganisms remains one of the urgent and significant problems of mankind. The constant spread of resistant strains of microorganisms requires the development of innovative methods and the search for medicinal compounds with a highly effective mechanism of action. One of these multi-resistant pathogens that are difficult to eradicate is the causative agent of tuberculosis — Mycobacterium tuberculosis. The aim is to study the effect of newly synthesized pyrimidine derivatives on the growth of Mycobacterium tuberculosis culture, as well as on the structural changes in cells.Material and methods. In order to assess the effect of a number of pyrimidine derivatives on the growth of Mycobacterium tuberculosis culture, 6 samples of 5-(arylmethylene) hexahydropyrimidine-2,4,6-triones (TAG1 — TAG6), 7 samples of 5-hetarylmethylidene-2,4,6-triones (TAG7 — TAG13), and 2 new samples of 3-(2-Benzyloxy-2-oxoethyl)quinazoline-4(3H)-one and 3-[2-(1-Naphthyl)-2-oxoethyl]quinazoline-4(3H)-one were screened under the laboratory ciphers VMA-13-03 and VMA-13-04 in the course of the study. M.tuberculosis H37RV strain was used as a test culture; it was provided by the bacteriological laboratory of the Regional Infectious Clinical Hospital named after A. M. Nichoga. A 4-week culture of M.tuberculosis, synchronized by cold (+4°C) for 72 hours, was used to prepare a suspension of mycobacteria. The number of mycobacteria in the suspension was determined using the McFarland 0.5 turbidity standard. 0.2 ml of M.tuberculosis working suspension was added to each tube of a series of successive dilutions of the studied substances, including the control. The study was carried out in 4 series of replicates. The minimum bactericidal concentration of the compounds, at which no colony growth was detected, as well as the minimum inhibitory concentration, at which mycobacterium growth was delayed by 50% compared to the control, were determined. Smears were prepared from the sediment for staining using theZiehl-Neelsen method to determine the presence of acid-resistant and non-acid-resistant forms of mycobacteria, as well as to study the effect of pyrimidines and a comparison drug on structural changes in M.tuberculosis cells.Results. In the course of the study, the TAG4, TAG6, and TAG8 compounds were found to have the closest antibacterial activity to the comparison drug isoniazid, according to the indicator of mycobacteria growth retardation. The greatest bactericidal activity against M.tuberculosis was observed in TAG4, TAG7, and VMA–13–04. The remaining compounds have shown minimal inhibitory effect on the growth of M.tuberculosis. Microscopic studies have shown that under the influence of TAG3, TAG4, TAG7, TAG12, VMA-13-03, and VMA-13-04, the main structural components of M.tuberculosis cells undergo fragmentation and morphological changes compared to mycobacterium cells without exposure.Conclusion. A
背景。当前病原微生物对抗生素的耐药性日益增长的趋势仍然是人类面临的紧迫而重大的问题之一。耐药微生物菌株的不断传播要求开发创新方法并寻找具有高度有效作用机制的药物化合物。其中一种难以根除的多重耐药病原体是结核病的病原体——结核分枝杆菌。目的是研究新合成的嘧啶衍生物对结核分枝杆菌培养物生长的影响以及对细胞结构变化的影响。材料和方法。为了评估一系列嘧啶衍生物的影响对结核分枝杆菌的生长文化6 5 - (arylmethylene) hexahydropyrimidine-2样品,4,6-triones(标签1 - TAG6), 7 5-hetarylmethylidene-2样品,4,6-triones (TAG7 - TAG13),和2个新样品3 - (2-Benzyloxy-2-oxoethyl) quinazoline-4 (3 h)——和3 - [2 - (1-Naphthyl) 2-oxoethyl] quinazoline-4 (3 h)——筛选下实验室密码VMA-13-03和VMA-13-04在研究过程中。以结核分枝杆菌H37RV株为试验培养物;它由以A. M. Nichoga命名的地区感染临床医院的细菌学实验室提供。采用4周的结核分枝杆菌培养,低温(+4℃)同步培养72小时,制备分枝杆菌悬浮液。采用麦克法兰0.5浊度标准测定悬浮液中分枝杆菌的数量。每管加入0.2 ml结核分枝杆菌工作悬液,连续稀释所研究的物质,包括对照组。试验分4个系列重复进行。确定了化合物的最低杀菌浓度,在此条件下未检测到菌落生长,以及最低抑制浓度,在此条件下分枝杆菌的生长比对照组延迟50%。用ziehl - neelsen染色法测定结核分枝杆菌耐酸和非耐酸形式的存在,并研究嘧啶和比较药物对结核分枝杆菌细胞结构变化的影响。在研究过程中,根据分枝杆菌生长迟缓指标,发现TAG4、TAG6和TAG8化合物的抑菌活性与对照药物异烟肼最接近。TAG4、TAG7和VMA-13-04对结核分枝杆菌的抑菌活性最强。其余化合物对结核分枝杆菌生长的抑制作用最小。显微镜下研究表明,在TAG3、TAG4、TAG7、TAG12、VMA-13-03和VMA-13-04的影响下,结核分枝杆菌细胞的主要结构成分与未暴露的分枝杆菌细胞相比发生碎裂和形态变化。结果表明,所研究的化合物均具有抑菌活性。实验室代号TAG1、TAG4、TAG7、TAG13的化合物对结核分枝杆菌生长的抑制作用性质与异烟肼相当,其中TAG3化合物的抑制作用甚至略高于对照药物。实验室编号为VMA-13-03和VMA-13-04的化合物抗结核作用最不明显。实验室编码为TAG5、TAG6、TAG11和TAG12的化合物抑菌活性最低。
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引用次数: 0
The Effect of Rifampicin on the Induction of MDR1/P-gp Activity in Proinflammatory Human Macrophages 利福平对促炎巨噬细胞MDR1/P-gp活性的诱导作用
Pub Date : 2022-08-04 DOI: 10.37489/0235-2990-2022-67-3-4-16-22
E. N. Pavlova, M. Erokhina, E. Rybalkina, D. Potashnikova, A. Masyutin, L. Lepekha, A. Ergeshov
Background. The effect on the activity of the multidrug resistance protein P-glycoprotein (P-gp, MDR1 gene) in pro-inflammatory (M1) human macrophages is considered one of the promising strategies for increasing the effectiveness of the treatment in patients with pulmonary tuberculosis: P-gp activity is considered a factor that reduces intracellular accumulation of rifampicin (RIF), a substrate for P-gp. The aim of this work was to reveal the effect of the therapeutic concentration of RIF on the activity of P-gp in M1 human macrophages. The objectives were as follows: to determine the expression levels of the MDR1 gene, P-gp protein, as well as its functional activity at different periods of cell differentiation and under the influence of RIF.Material and methods. The following cell lines were used in the work: suspension cells of promonocytic leukemia THP-1 and THP-1 macrophages induced by phorbol ether according to the pro-inflammatory phenotype. Suspension cells of myeloid leukemia K562/IS-9 transfected with the MDR1 gene were used as a comparison group. An important factor is the choice of the experimental concentration of RIF: the average concentration of the drug in patients with pulmonary tuberculosis was 10 µg/ml. The methods of RT-PCR, immunocytochemistry, and flow cytometry were used in the work.Results and discussion. The induction of MDR1 gene expression in M1 macrophages under short-term exposure to a therapeutic concentration of RIF was revealed. This effect is typical only for THP-1 macrophages, in which a significant functional activity of P-gp is registered. This induction does not occur in the cells with no detectable P-gp activity (THP-1 suspension cells). This indicates the presence of different mechanisms of RIF influence on MDR1, which can be used to develop a strategy for P-gp inhibition in inflammatory macrophages.Conclusion. Given the key role of macrophages in tuberculosis, further evaluation of MDR1/P-gp in the surgical material of patients with pulmonary tuberculosis is necessary, which makes it possible to draw a conclusion that it is necessary to develop and apply drug strategies aimed at blocking the functional activity of P-gp and choosing more effective anti-tuberculosis therapy regimens. 
背景。对促炎(M1)人巨噬细胞中多药耐药蛋白p -糖蛋白(P-gp, MDR1基因)活性的影响被认为是提高肺结核患者治疗有效性的有希望的策略之一:P-gp活性被认为是减少细胞内利福平(RIF)积累的一个因素,RIF是P-gp的底物。这项工作的目的是揭示RIF治疗浓度对M1人巨噬细胞P-gp活性的影响。目的:测定MDR1基因P-gp蛋白在细胞分化不同时期和RIF影响下的表达水平及其功能活性。材料和方法。本研究采用以下细胞系:根据促炎表型,采用原性粒细胞白血病THP-1悬浮细胞和佛波醚诱导的THP-1巨噬细胞。以转染MDR1基因的髓系白血病K562/IS-9悬浮细胞为对照组。一个重要的因素是RIF实验浓度的选择:肺结核患者的药物平均浓度为10µg/ml。采用RT-PCR、免疫细胞化学、流式细胞术等方法。结果和讨论。在短期暴露于治疗浓度的RIF下,M1巨噬细胞诱导MDR1基因表达。这种效应仅在THP-1巨噬细胞中是典型的,在THP-1巨噬细胞中,P-gp具有显著的功能活性。没有检测到P-gp活性的细胞(THP-1悬浮细胞)不发生这种诱导。这表明RIF对MDR1的影响存在不同的机制,可用于开发抑制炎性巨噬细胞P-gp的策略。鉴于巨噬细胞在结核病中的关键作用,有必要进一步评估MDR1/P-gp在肺结核患者手术材料中的作用,从而有可能得出结论,有必要开发和应用旨在阻断P-gp功能活性的药物策略,并选择更有效的抗结核治疗方案。
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引用次数: 1
Immunogenicity, Safety, and Clinical Effectiveness of the 23-Valent Pneumococcal Polysaccharide Vaccine in Patients With Spondyloarthritis (Preliminary Data) 23价肺炎球菌多糖疫苗对脊柱炎患者的免疫原性、安全性和临床疗效(初步数据)
Pub Date : 2022-04-16 DOI: 10.37489/0235-2990-2022-67-1-2-39-44
M. Baranova, N. Muravyeva, B. Belov, M. Cherkasova, Z. Verizhnikova, T. Korotaeva
Background. Immunosuppressive drugs are widely used for the treatment of patients with spondyloarthritis (SpA) to effectively control the activity of the disease. At the same time, the use of these drugs is associated with an increased risk of developing infections of the upper and lower respiratory tract, which can be prevented by vaccination. The aim of the study was to evaluate the immunogenicity, safety, and clinical efficacy of the 23-valent pneumococcal  polysaccharide vaccine (PPV-23) in patients with SpA. Material and methods. The study included 54 patients with SpA: 39 with ankylosing spondylitis, and 15 with psoriatic arthritis. Most patients had a history of two or more cases of lower respiratory tract infections, 2 patients reported a monthly exacerbation of chronic sinusitis, one patient reported the development of otitis every 2–3 months. 72% of patients received immunosuppressive therapy at the time of inclusion in the study. PPV-23 was administered in the amount of 1 dose (0.5 ml) against the background of ongoing antirheumatic therapy. The level of antibodies to pneumococcal capsular polysaccharide was determined using the EIA PCP IgG kit (TestLine Clinical Diagnostics s.r.o., Czech Republic) at baseline, after 1, 3, and 12 months after vaccination. The tolerability of PPV-23, the effect of vaccination on SpA activity (according to the dynamics of the BASDAI index), and the incidence of upper and lower respiratory tract infections were assessed. Results. The concentration of antibodies to pneumococcal capsular polysaccharide was significantly higher 1, 3, and 12 months after vaccination compared to baseline. There was no negative effect of vaccination on the activity of SpA and the emergence of «new» autoimmune disorders. The vaccine was well tolerated by 76% of patients., Only one patient developed pneumonia during the observation period. Patients suffering from frequent sinusitis and otitis reported the absence of these infections after vaccination. Conclusions. Preliminary results of the study indicate sufficient immunogenicity, safety, and clinical efficacy of PPV-23 in patients with SpA.
背景。免疫抑制药物被广泛用于治疗脊柱炎(SpA)患者,以有效控制疾病的活动性。与此同时,这些药物的使用与发生上呼吸道和下呼吸道感染的风险增加有关,这可以通过接种疫苗来预防。本研究的目的是评估23价肺炎球菌多糖疫苗(PPV-23)在SpA患者中的免疫原性、安全性和临床疗效。材料和方法。该研究包括54例SpA患者:39例强直性脊柱炎患者,15例银屑病关节炎患者。大多数患者有2例或2例以上下呼吸道感染史,2例患者报告慢性鼻窦炎每月加重,1例患者报告每2 - 3个月出现中耳炎。在纳入研究时,72%的患者接受了免疫抑制治疗。PPV-23在持续抗风湿病治疗的背景下以1剂(0.5 ml)的剂量给药。使用EIA PCP IgG试剂盒(TestLine Clinical Diagnostics s.r.o,捷克共和国)在基线、接种疫苗后1、3和12个月检测肺炎球菌荚膜多糖抗体水平。评估PPV-23的耐受性、疫苗接种对SpA活性的影响(根据BASDAI指数的动态)以及上呼吸道和下呼吸道感染的发生率。结果。与基线相比,接种疫苗后1、3和12个月的肺炎球菌荚膜多糖抗体浓度显著升高。接种疫苗对SpA活性和“新的”自身免疫性疾病的出现没有负面影响。76%的患者对疫苗耐受良好。观察期间仅有1例患者出现肺炎。经常患有鼻窦炎和中耳炎的患者在接种疫苗后报告没有这些感染。结论。研究的初步结果表明PPV-23在SpA患者中具有足够的免疫原性、安全性和临床疗效。
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引用次数: 2
Mobile Genetic Elements of Prokaryotes and Their Role in the Formation of Antibiotic Resistance in Pathogenic Bacteria 原核生物的可移动遗传元件及其在病原菌抗生素耐药性形成中的作用
Pub Date : 2022-04-16 DOI: 10.37489/0235-2990-2022-67-1-2-62-74
B. Andryukov, N. Besednova, T. Zaporozhets
The emergence and spread of antibiotic-resistant pathogenic bacterial strains in recent decades is an alarming trend and a serious challenge for the future of mankind around the world. The horizontal transfer and spread of antibiotic resistance genes among microorganisms through mobile genetic elements (MGEs), an extremely diverse group of prokaryotic mobilomas capable of moving DNA molecules intra- or intercellularly, aggravate the situation. MGEs play a central role in the phenotypic adaptation of bacteria, providing resistance to antibiotics and physical parameters of the environment, acquiring pathogenicity factors, and transforming metabolic pathways. However, the importance of MGEs is often overlooked when planning the strategies to contain the spread of antimicrobial resistance in pathogens. The aim of this review is to briefly characterize the main types of MGEs (plasmids, transposons, bacteriophages, integrons, and introns) involved in the formation of antibiotic resistance in pathogenic bacteria, with an emphasis on the members of the Enterobacteriaceae family. In the final part of the review, promising modern strategies for combating antimicrobial resistance based on the use of antiplasmid approaches and CRISPR/Cas  technologies are considered.
近几十年来,耐抗生素致病菌菌株的出现和传播是一个令人震惊的趋势,也是对世界各地人类未来的严重挑战。抗生素耐药基因通过移动遗传元件(MGEs)在微生物中水平转移和传播,这是一组能够在细胞内或细胞间移动DNA分子的极其多样化的原核生物移动瘤,加剧了这种情况。MGEs在细菌的表型适应中发挥核心作用,提供对抗生素和环境物理参数的抗性,获得致病性因子,并改变代谢途径。然而,在规划控制病原体中抗菌素耐药性传播的战略时,往往忽视了MGEs的重要性。本综述的目的是简要描述主要类型的MGEs(质粒、转座子、噬菌体、整合子和内含子)参与致病菌抗生素耐药性的形成,重点是肠杆菌科的成员。在回顾的最后一部分,基于抗质粒方法和CRISPR/Cas技术的使用,考虑了有前途的对抗抗菌素耐药性的现代策略。
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引用次数: 2
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Antibiotics and Chemotherapy
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