Biological & pharmaceutical bulletin最新文献

Fruquintinib is a small-molecule tyrosine kinase inhibitor of vascular endothelial growth factor receptors (VEGFR) used in patients with metastatic colorectal cancer. Fruquintinib reportedly inhibits the phosphorylation of VEGFR-2 by >80% at plasma trough concentrations >176 ng/mL. Therefore, maintaining a stable trough concentration of fruquintinib is clinically necessary. To date, the only reported method for quantifying fruquintinib concentrations in human plasma is LC-MS/MS, which is challenging to use routinely in clinical settings given its high cost and technical demands. Therefore, in this study, we aimed to develop a method for determining fruquintinib levels in human plasma and validate it for therapeutic drug monitoring (TDM). For the analysis, a 50-μL human plasma sample was obtained, and protein precipitation was performed using acetonitrile extraction. Fruquintinib and acetanilide (internal standard) were separated on a reversed-phase column using a mobile phase consisting of 0.5% KH₂PO₄ (pH 2.6) and acetonitrile (69/31, v/v), pumped at a flow rate of 1.0 mL/min. The detection wavelength was set at 237 nm. The calibration curves for fruquintinib were linear (r² = 0.999) in the range of 50-2000 ng/mL. The accuracy and precision in all validation experiments adhered to the guidelines of the U.S. Food and Drug Administration. Using the validated method, we successfully measured fruquintinib concentrations in the plasma of a patient. This article presents a simple, novel, and sensitive HPLC-UV-based method for determining the plasma concentration of fruquintinib and confirms its applicability in the TDM of fruquintinib in the clinical setting.

Treatments to improve the prognosis of heart failure with preserved ejection fraction (HFpEF) are urgently needed. Tanshinone VI (TanVI) is a compound extracted from the roots of Salvia miltiorrhiza Bunge (Lamiaceae) that exerts inhibitory effects on the development of cardiac remodeling under experimental conditions. However, the therapeutic effects of TanVI on HFpEF remain unclear. The present study aims to investigate the therapeutic effects of TanVI in a mouse model of HFpEF. HFpEF mice were prepared by feeding C57BL/6N mice a high-fat diet and providing water containing N^[ω]-nitro-L-arginine methyl ester hydrochloride (L-NAME) for 15 weeks, and TanVI (3 mg/kg/d) or vehicle was administered intraperitoneally using an osmotic pump for 5 weeks until the end of the experiment. The administration of a high-fat diet and L-NAME resulted in cardiac diastolic dysfunction with cardiac hypertrophy and fibrosis. In contrast, treatment with TanVI markedly attenuated cardiac hypertrophy and fibrosis and prevented cardiac diastolic dysfunction. In HFpEF mouse hearts, the phosphorylation levels of mitogen-activated protein (MAP) kinases such as c-Raf, MEK1/2, and extracellular signal-regulated kinase 1/2 (ERK1/2), which regulate cardiac hypertrophy and fibrosis, were elevated. In contrast, treatment with TanVI reversed the phosphorylation levels of c-Raf, MEK1/2, and ERK1/2. The present study showed that TanVI prevented the development of HFpEF by reducing cardiac remodeling. Furthermore, our findings suggest, at least in part, that TanVI attenuates the development of HFpEF by inhibiting the MAP kinase signaling pathway.

Mirabegron, a β₃-adrenoceptor agonist used to treat overactive bladder, is associated with increased heart rate; however, the mechanism underlying its cardiac effect remains unclear. In this study, we investigated the β-adrenoceptor subtypes that are involved in the chronotropic effects of mirabegron in mouse and guinea pig atria. Mirabegron (0.03-10 μM) produced concentration-dependent positive chronotropic effects in both species, with maximum effects of 75.9% in mice and 27.7% in guinea pigs. Isoproterenol (0.1-100 nM), a nonselective β-adrenoceptor agonist, dobutamine (0.001-100 μM), a β₁-adrenoceptor agonist, and salbutamol (0.001-100 μM), a β₂-adrenoceptor agonist, induced concentration-dependent positive chronotropic effects, with the potency order of isoproterenol > dobutamine > mirabegron ≥ salbutamol in mice, and isoproterenol > dobutamine ≥ salbutamol > mirabegron in guinea pigs. Mirabegron-induced positive chronotropic effects were unaffected by 0.1% dimethyl sulfoxide in the mouse atria, but non-competitively antagonized by the selective β₃-adrenoceptor antagonist L748337 (100-1000 nM), with the slope of the Schild plot being 0.65. The selective β₂-adrenoceptor antagonist ICI118551 (30 nM) attenuated the positive chronotropic effects of mirabegron, producing a 3-fold rightward shift in the concentration-response curve. Conversely, the selective β₁-adrenoceptor antagonist CGP20172A (0.03-3 nM) strongly and non-competitively antagonized mirabegron-induced positive chronotropic effects in mouse and guinea pig atria. These results suggest that the positive chronotropic effects of mirabegron are primarily mediated through β₁-adrenoceptors, with minimal or no involvement of β₂- and β₃-adrenoceptors.

Proton pump inhibitors (PPIs) are implicated in the progression of chronic kidney disease (CKD), but the mechanism behind this is unclear. PPIs are known to inhibit organic anion transporters (OATs) and affect intestinal microbiota. PPI use may influence serum concentrations of indoxyl sulfate (IS), a uremic toxin that contributes to CKD. This study compares serum IS concentrations between Japanese patients receiving long-term PPI prescriptions and those receiving non-PPIs, evaluating the effect of long-term PPI therapies on serum IS concentrations. This single-center, cross-sectional study included patients with an estimated glomerular filtration rate (eGFR) of 15 to 44 mL/min/1.73 m,² who attended an outpatient visit at a nephrology and/or diabetes department between October 2022 and December 2023. Serum IS concentrations were measured by HPLC. The analysis included 29 patients in the PPI group and 28 in the non-PPI group; serum IS concentrations were significantly higher in the PPI group [median (interquartile range) 15.37 (9.69-19.80) µM] and non-PPI group [median (interquartile range) 10.66 (6.97-14.19) µM], p = 0.03. Multiple regression analysis was performed, linking prescription of PPIs and lower eGFR to higher serum IS levels. This study highlights an apparent association of long-term prescriptions of PPIs with high serum IS concentrations. However, more detailed studies are required to evaluate the contribution of intestinal microbiota and diet to this phenomenon.

Immune checkpoint inhibitors (ICIs), essential in cancer therapy, can cause severe immune-related adverse events (irAEs), including myocarditis with a high fatality rate. Currently, the pathogenesis, biomarkers, and risk factors of ICI-induced myocarditis (ICIM) are not fully understood. This exploratory study aimed to develop machine learning-based models to predict the onset of ICIM within 3 months of starting ICI therapy, using a large health insurance database. The models were constructed using the Light Gradient Boosting Machine (LightGBM) and Random Forest algorithms, incorporating clinical variables such as comorbidities and prior medication classifications. In this study, a strategy combining undersampling and bagging was used to minimize the impact of highly imbalanced datasets. The Random Forest model demonstrated superior performance compared with the LightGBM model, and the SHapley Additive exPlanations (SHAP) analysis for the Random Forest model revealed that the concurrent use of ICIs was the most important variable for predictions. Although predictive performance remains limited (AUROC ≈ 0.63), this exploratory framework demonstrates the feasibility of developing data-driven risk prediction models for ICIM. Future studies with expanded datasets and integration of laboratory parameters are warranted to improve predictive accuracy and potential clinical applicability.

Using a large health insurance database in Japan, we examined the real-world usage of budesonide enteric-coated capsules (BUD) in treating Crohn's disease. We analyzed data from the Japan Medical Data Center claims database for Crohn's disease patients prescribed BUD from April 2016 to March 2021, focusing on prescription status, adverse events (AEs), monitoring tests, and concomitant medications over 2 years following BUD initiation. Patients were categorized into two groups based on BUD usage duration: ≤1 year and >1 year. Of the 7364 registered patients, 1049 (14.2%) were prescribed BUD. Among the 562 followed for 2 years, 505 (89.9%) used BUD for ≤1 year and 57 (10.1%) for >1 year. Over 70% of the patients used at least one biologic, and more than 20% used at least two. The proportions of new thiopurine initiation were 22 and 9% in the ≤1-year and >1-year groups, respectively (p = 0.0181). We did not identify any obvious increase in AEs from long-term BUD use within the confines of our study design. However, regardless of prescription duration, over half of the patients lacked hepatitis B virus screening, glycated hemoglobin measurement, adrenal function quantification, or bone densitometry. Usage of strong CYP3A4 inhibitors was more frequent among patients in the BUD >1-year group. This study revealed that numerous Japanese patients received long-term BUD prescriptions. Although no apparent increase in AEs from long-term BUD was detected, we identified inadequate monitoring of AEs and drug interactions, as well as insufficient use of steroid-sparing agents.

Intravenous administration of branched-chain amino acid (BCAA)-enriched solution is contraindicated in patients with severe chronic kidney disease (CKD). However, there have been no reports on its risks in patients with mild-to-moderate CKD. In this study, we compared the incidence of acidosis between patients with mild-to-moderate CKD (estimated glomerular filtration rate [eGFR] ≥30 and <60 mL/min/1.73 m²) and patients without CKD (eGFR ≥60 mL/min/1.73 m²) who received intravenous BCAA-enriched solution after propensity score matching (PSM). A retrospective analysis of the medical records at Hiroshima University Hospital identified 608 patients who were treated with intravenous BCAA-enriched solutions between January 2005 and December 2010. The laboratory data for these patients were analyzed. After PSM, the incidence of acidosis was compared between 91 pairs of patients with mild-to-moderate CKD or no CKD using Fisher's exact test. The incidence of acidosis was significantly higher in the mild-to-moderate CKD group than in the non-CKD group (36.3 vs. 18.7%, p <0.05). The odds ratio for the incidence of acidosis in patients with mild-to-moderate CKD was 2.48 (95% confidence interval 1.26-4.88). Kaplan-Meier curves showed that the cumulative incidence of acidosis increased soon after initiation of intravenous BCAA-enriched solution in both groups. In conclusion, intravenous BCAA-enriched solution can cause acidosis even in patients without CKD, with an increased risk in patients with mild-to-moderate CKD, in whom this agent is not contraindicated. Therefore, intravenous BCAA-enriched solution should be administered with caution in patients with CKD, regardless of its severity.

Mineralocorticoid receptor (MR) blockers reduce cardiovascular complications as MRs play a crucial role in cardiovascular regulation. Diabetic cardiovascular complications are caused by vascular endothelial dysfunction. This study used a type 2 diabetic mouse model (DM) to investigate whether esaxerenone (ESAX), an MR blocker, ameliorates vascular endothelial dysfunction. ESAX (3 mg/kg/d) was administered via diet to KK-Ay mice or C57BL/6J mice, a nondiabetic control (Control), for 8 weeks, and metabolic parameters and blood pressure were measured. Vascular responses of the aortic segments were analyzed with acetylcholine, sodium nitroprusside, UK14304, or phenylephrine (PE). The other aortas were used for Western blot analysis. DM mice exhibited higher plasma glucose, insulin, metabolic parameters, and blood pressure levels than those of the Control mice. Parameters that did not include blood pressure were unaltered by DM or ESAX-administered DM (DM + ESAX). However, DM impaired UK14304-induced endothelial-dependent relaxation and nitric oxide production and elevated PE-induced contraction. ESAX administration ameliorated endothelial dysfunction and improved the protein kinase B (Akt) phosphorylation under α₂-agonist UK14304 stimulation in the aorta from DM mice compared with that of the Control mice. However, ESAX did not recover the increased G protein-coupled receptor kinase 2 (GRK2) expression and activity in the DM aorta. Furthermore, the DM-induced phosphorylation of serum and glucocorticoid-regulated kinase 1 (SGK1) was inhibited by ESAX. Overall, ESAX attenuates the development of DM-induced endothelial dysfunction by reducing SGK1 activity and enhancing Akt activity without affecting the GRK2 pathway. These results suggest that the vascular protective effects of ESAX could be employed for diabetic vascular complications.

The optimal pharmacokinetics (PK) of orally administered nanoparticles (NPs) varies depending on their application (e.g., drug delivery, adsorbent, and adjuvant). Therefore, engineering NPs to achieve optimal PK is essential for the development of drug designs. Some studies have demonstrated that individual NP factors change the intestinal absorption of NPs; however, no technology has been established to control the biodistribution of orally administered NPs. In this study, a database about the influence of NP characteristics on biodistribution after oral administration was provided. A library of N-isopropylacrylamide polymer NPs with various characteristics that could influence the biodistribution after oral administration, such as size, flexibility, hydrophobicity, surface charges, and surface chemistries, were prepared. NPs with various sizes were synthesized by tuning the surfactant concentration only during synthesis, whereas NPs with different flexibility, hydrophobicity, surface charge, and surface chemistry were synthesized by feeding the corresponding functional monomer. The total amount of NPs accumulated in the organs decreased with increasing NP size, rigidity, hydrophobicity, electric potential (whether positive or negative), and polyethylene glycol modification. The results indicated that the absorption of orally administered NPs can be controlled by optimizing the characteristics of NP such as size, flexibility, hydrophobicity, surface charge, and surface chemistry. The results of this study will provide useful information to design NP formulations.