BACKGROUND The efficacy of novel glucose-lowering drugs in treating non-alcoholic fatty liver disease(NAFLD)is unknown.AIM To evaluate the efficacy of glucose-lowering drugs dipeptidyl peptidase-4(DPP-4)inhibitors,glu...BACKGROUND The efficacy of novel glucose-lowering drugs in treating non-alcoholic fatty liver disease(NAFLD)is unknown.AIM To evaluate the efficacy of glucose-lowering drugs dipeptidyl peptidase-4(DPP-4)inhibitors,glucagon-like peptide-1 receptor agonists(GLP-1 RAs),and sodiumglucose cotransporter 2(SGLT2)inhibitors in treating NAFLD and to perform a comparison between these treatments.METHODS Electronic databases were systematically searched.The inclusion criteria were:Randomized controlled trials comparing DPP-4 inhibitors,GLP-1 RAs,or SGLT2 inhibitors against placebo or other active glucose-lowering drugs in NAFLD patients,with outcomes of changes in liver enzyme[alanine aminotransferase(ALT)and/or aspartate aminotransferase(AST)]from baseline.RESULTS Nineteen studies were finally included in this meta-analysis.Compared with placebo or other active glucose-lowering drug treatment,treatment with DPP-4 inhibitors,GLP-1 RAs,and SGLT2 inhibitors all led to a significant decrease in ALT change and AST change from baseline.The difference between the DPP-4 inhibitor and SGLT2 inhibitor groups in ALT change was significant in favor of DPP-4 inhibitor treatment(P<0.05).The trends of reduction in magnetic resonance imaging proton density fat fraction and visceral fat area changes were also observed in all the novel glucose-lowering agent treatment groups.CONCLUSION Treatment with DPP-4 inhibitors,GLP-1 RAs,and SGLT2 inhibitors resulted in improvements in serum ALT and AST levels and body fat composition,indicating a beneficial effect in improving liver injury and reducing liver fat in NAFLD patients.展开更多
BACKGROUND Insulin antibodies(IAs)affect blood glucose control in patients receiving insulin therapy.AIM To investigate the relationship between different hypoglycemic treatments and IAs in patients with type 2 diabet...BACKGROUND Insulin antibodies(IAs)affect blood glucose control in patients receiving insulin therapy.AIM To investigate the relationship between different hypoglycemic treatments and IAs in patients with type 2 diabetes mellitus(T2DM).METHODS This cross-sectional,retrospective study included 1863 patients with T2DM who were receiving exogenous insulin therapy.All patients received stable antidiabetic therapy in the last 3 months and IA levels were measured using an iodine-125 array.RESULTS A total of 1863 patients were enrolled.There were 902(48.4%)patients who had positive IAs(IA level>5%),with a mean IA level of 11.06%(10.39%-11.72%).IA levels were positively correlated with high fasting blood glucose(odds ratio=1.069,P<0.001).The proportion of positive IAs was lowest in patients using glargine only(31.9%)and highest in patients using human insulin only(70.3%),P<0.001.The IA levels in patients using sulfonylureas/glinides(8.3%),metformin(9.6%),and dipeptidyl peptidase-4 inhibitors(8.2%)were all lower than in patients without these drugs(all P<0.05).CONCLUSION Nearly half of patients on insulin therapy have positive IA antibodies,and IA antibody levels are associated with blood glucose control.Insulin glargine and a combination of oral glucose-lowering drugs were correlated with lower IA levels.展开更多
The sex-based differences between the effects of two novel sugar-based drug candidates,a sulfated polymannuroguluronate(SPMG-911)and an acidic oligosaccharide sugar chain compound(AOSC-971),on the enzymes CYP 1A2,CYP2...The sex-based differences between the effects of two novel sugar-based drug candidates,a sulfated polymannuroguluronate(SPMG-911)and an acidic oligosaccharide sugar chain compound(AOSC-971),on the enzymes CYP 1A2,CYP2E1 and CYP3A4 of Chinese human liver microsome were investigated.The results showed that neither SPMG-911 nor AOSC-971 have any effect on CYP3A4,AOSC-971 induced the CYP 2E1 in men but have no effect on CYP1A2,SPMG-911 inhibit the CYP1A2 also in men but have no effect on CYP2E1.The results are useful for their safety evaluation,as well as for the prediction of inter-drug interactions associated with the two drugs.展开更多
Chemotherapy is an effortless and frequently used approach in cancer therapy.However,in most cases,it can only prolong life expectancy and does not guarantee a complete cure.Furthermore,chemotherapy is associated with...Chemotherapy is an effortless and frequently used approach in cancer therapy.However,in most cases,it can only prolong life expectancy and does not guarantee a complete cure.Furthermore,chemotherapy is associated with severe adverse effects,one of the major complications of effective cancer therapy.In addition,newly published research outputs show that cancer stem cells are involved in cancer disease progression,drug resistance,metastasis,and recurrence and that they are functional in the trans-differentiation capacity of cancer stem cells to cancer cells in response to treatments.Novel strategies are therefore required for better management of cancer therapy.The prime approach would be to synthesize and develop novel drugs that need extensive resources,time,and endurance to be brought into therapeutic use.The subsequent approach would be to screen the anti-cancer activity of avail-able non-cancerous drugs.This concept of repurposing non-cancer drugs as an alternative to current cancer therapy has become popular in recent years because using existing anticancer drugs has several adverse effects.Micronutrients have also been investigated for cancer ther-apy due to their significant anti-cancer effects with negligible or no side effects and availabil-ity in food sources.In this paper,we discuss an ideal hypothesis for screening available non-cancerous drugs with anticancer activity,with a focus on cancer stem cells and their clinical application for cancer treatment.Further,drug repurposing and the combination of micronu-trients that can target both cancers and cancer stem cells may result in a better therapeutic approach leading to maximum tumor growth control.展开更多
目的系统评价癌症相关静脉血栓栓塞(VTE)患者使用新型口服抗凝剂(NOAC)的有效性和安全性。方法检索PubMed、Cochrane Library、Embase、Web of Science、中国知网、万方数据库,检索时限为各数据库建库起至2023年8月,收集低分子肝素(LMWH...目的系统评价癌症相关静脉血栓栓塞(VTE)患者使用新型口服抗凝剂(NOAC)的有效性和安全性。方法检索PubMed、Cochrane Library、Embase、Web of Science、中国知网、万方数据库,检索时限为各数据库建库起至2023年8月,收集低分子肝素(LMWH,对照组)对比NOAC(试验组)治疗癌症相关VTE患者疗效的随机对照试验(RCT),对纳入临床研究进行资料提取后,采用RevMan 5.0统计软件进行Meta分析。结果共计纳入7项RCT,合计3790例癌症相关VTE患者。与对照组相比,试验组患者的VTE复发率(RR=0.65,95%CI为0.51~0.82,P=0.0004)显著降低,而其大出血发生率略高于对照组,但差异无统计学意义(RR=1.13,95%CI为0.83~1.53,P=0.45)。试验组患者的临床相关非主要大出血(RR=1.69,95%CI为1.34~2.13,P<0.00001)、消化道出血(RR=1.96,95%CI为1.15~3.34,P=0.01)发生率均较对照组显著升高。两组患者颅内出血发生率、全因死亡率、致死性肺栓塞发生率比较,差异均无统计学意义(P>0.05)。结论对于癌症相关VTE患者,NOAC在预防VTE复发方面优于LMWH,在大出血、颅内出血、全因死亡、致死性肺栓塞方面不劣于LMWH。展开更多
Dihydrofolate reductase (DHFR) is an enzyme that catalyzes the reduction of dihydrofolate (DHF) to tetrahydrofolate (THF). Chemotherapy drugs such as methotrexate help to slow the progression of cancer by limiting the...Dihydrofolate reductase (DHFR) is an enzyme that catalyzes the reduction of dihydrofolate (DHF) to tetrahydrofolate (THF). Chemotherapy drugs such as methotrexate help to slow the progression of cancer by limiting the ability of dividing cells to make nucleotides by competitively inhibiting DHFR. Nonsteroidal anti-inflammatory drugs (NSAIDs) have been previously reported to exhibit competitive inhibition of DHFR, in addition to their primary action on cyclooxygenase enzymes. This interaction interferes with the enzymatic reduction of dihydrofolate to tetrahydrofolate, thereby impeding the folate metabolism pathway essential for nucleotide synthesis and cell proliferation. This activity stems from their structural resemblance to the p-aminobenzoyl-l-glutamate (pABG) moiety of folate, a substrate of DHFR. It has been established that NSAIDs containing a salicylate group (which has structural similarities to pABG), such as diflunisal, exhibit stronger DHFR-binding activity. In this study, we synthesized salicylate derivatives of naproxen with the aim of exploring their potential as inhibitors of DHFR. The interactions between these derivatives and human DHFR were characterized using a combination of biochemical, biophysical, and structural methods. Through polyacrylamide gel electrophoresis (PAGE) analysis, enzymatic assays, and quantitative ELISA, we investigated the binding affinity and inhibitory potency of the synthesized salicylate derivatives towards DHFR. The findings of this study suggest the potential of salicylate derivatives of naproxen as promising candidates for the inhibition of DHFR, thereby offering novel therapeutic opportunities for modulating the inflammatory process through multiple pathways. Further optimization of these derivatives could lead to the development of more efficacious dual-targeted analogs with enhanced therapeutic benefits.展开更多
Chronic hepatitis B constitutes a substantial disease burden worldwide.The steps advocated by the World Health Organization in 2016 to eradicate hepatitis B by 2030 has failed to achieve significant progress,especiall...Chronic hepatitis B constitutes a substantial disease burden worldwide.The steps advocated by the World Health Organization in 2016 to eradicate hepatitis B by 2030 has failed to achieve significant progress,especially with respect to immu-nization coverage and linkage to care.The lack of governmental and public awar-eness regarding the long-term implications of hepatitis B burden cause under-funding of developmental projects.The presently approved treatment modalities have limited efficacy in complete viral eradication,hence the need for newer molecules to achieve functional cure(sustained undetectable hepatitis B surface antigen(HBsAg)and hepatitis B virus DNA in peripheral blood after a finite period of therapy).However,preliminary results from trials of novel therapies show their inadequacy to achieve this end by themselves but better performance with a low baseline serum HBsAg with nucleos(t)ide analogues(NA)treatment which need to be combined with/without pegylated interferon as an immu-nomodulator.Such therapy is limited by cost and adverse events and need to show incremental benefit over the standard of care(long-term NA therapy)with respect to efficacy and drug toxicities,making the development process tenuous.Thus,while such therapies continue to be tested,strategies should still focus on prevention of transmission by non-pharmaceutical measures,vaccination and increasing linkage to care.展开更多
基金The Capital's Funds for Health Improvement and Research,No.CFH2020-2-7131.
文摘BACKGROUND The efficacy of novel glucose-lowering drugs in treating non-alcoholic fatty liver disease(NAFLD)is unknown.AIM To evaluate the efficacy of glucose-lowering drugs dipeptidyl peptidase-4(DPP-4)inhibitors,glucagon-like peptide-1 receptor agonists(GLP-1 RAs),and sodiumglucose cotransporter 2(SGLT2)inhibitors in treating NAFLD and to perform a comparison between these treatments.METHODS Electronic databases were systematically searched.The inclusion criteria were:Randomized controlled trials comparing DPP-4 inhibitors,GLP-1 RAs,or SGLT2 inhibitors against placebo or other active glucose-lowering drugs in NAFLD patients,with outcomes of changes in liver enzyme[alanine aminotransferase(ALT)and/or aspartate aminotransferase(AST)]from baseline.RESULTS Nineteen studies were finally included in this meta-analysis.Compared with placebo or other active glucose-lowering drug treatment,treatment with DPP-4 inhibitors,GLP-1 RAs,and SGLT2 inhibitors all led to a significant decrease in ALT change and AST change from baseline.The difference between the DPP-4 inhibitor and SGLT2 inhibitor groups in ALT change was significant in favor of DPP-4 inhibitor treatment(P<0.05).The trends of reduction in magnetic resonance imaging proton density fat fraction and visceral fat area changes were also observed in all the novel glucose-lowering agent treatment groups.CONCLUSION Treatment with DPP-4 inhibitors,GLP-1 RAs,and SGLT2 inhibitors resulted in improvements in serum ALT and AST levels and body fat composition,indicating a beneficial effect in improving liver injury and reducing liver fat in NAFLD patients.
基金Supported by The National Key R and D Program of China,No.2018YFC1314103The National Natural Science Foundation of China,No.81870563 and No.82270838.
文摘BACKGROUND Insulin antibodies(IAs)affect blood glucose control in patients receiving insulin therapy.AIM To investigate the relationship between different hypoglycemic treatments and IAs in patients with type 2 diabetes mellitus(T2DM).METHODS This cross-sectional,retrospective study included 1863 patients with T2DM who were receiving exogenous insulin therapy.All patients received stable antidiabetic therapy in the last 3 months and IA levels were measured using an iodine-125 array.RESULTS A total of 1863 patients were enrolled.There were 902(48.4%)patients who had positive IAs(IA level>5%),with a mean IA level of 11.06%(10.39%-11.72%).IA levels were positively correlated with high fasting blood glucose(odds ratio=1.069,P<0.001).The proportion of positive IAs was lowest in patients using glargine only(31.9%)and highest in patients using human insulin only(70.3%),P<0.001.The IA levels in patients using sulfonylureas/glinides(8.3%),metformin(9.6%),and dipeptidyl peptidase-4 inhibitors(8.2%)were all lower than in patients without these drugs(all P<0.05).CONCLUSION Nearly half of patients on insulin therapy have positive IA antibodies,and IA antibody levels are associated with blood glucose control.Insulin glargine and a combination of oral glucose-lowering drugs were correlated with lower IA levels.
文摘The sex-based differences between the effects of two novel sugar-based drug candidates,a sulfated polymannuroguluronate(SPMG-911)and an acidic oligosaccharide sugar chain compound(AOSC-971),on the enzymes CYP 1A2,CYP2E1 and CYP3A4 of Chinese human liver microsome were investigated.The results showed that neither SPMG-911 nor AOSC-971 have any effect on CYP3A4,AOSC-971 induced the CYP 2E1 in men but have no effect on CYP1A2,SPMG-911 inhibit the CYP1A2 also in men but have no effect on CYP2E1.The results are useful for their safety evaluation,as well as for the prediction of inter-drug interactions associated with the two drugs.
基金funding by the Indian Council of Medical Research(ICMR)(No.5/9/1108/2013-Nut)project grants,Department of Biotechnology(No.6242-P24/RGCB1PMD/DBT/ARJN/2015)ICMR-National Institute of Nutrition Intramural project(No.15-BS05)+1 种基金ICMR-Department of Health Research(No.5/9/1327/2020-Nut)Indian Council of Medical Research(ICMR)(No.3/1/3/PDF(24)/2021-HRD-4).
文摘Chemotherapy is an effortless and frequently used approach in cancer therapy.However,in most cases,it can only prolong life expectancy and does not guarantee a complete cure.Furthermore,chemotherapy is associated with severe adverse effects,one of the major complications of effective cancer therapy.In addition,newly published research outputs show that cancer stem cells are involved in cancer disease progression,drug resistance,metastasis,and recurrence and that they are functional in the trans-differentiation capacity of cancer stem cells to cancer cells in response to treatments.Novel strategies are therefore required for better management of cancer therapy.The prime approach would be to synthesize and develop novel drugs that need extensive resources,time,and endurance to be brought into therapeutic use.The subsequent approach would be to screen the anti-cancer activity of avail-able non-cancerous drugs.This concept of repurposing non-cancer drugs as an alternative to current cancer therapy has become popular in recent years because using existing anticancer drugs has several adverse effects.Micronutrients have also been investigated for cancer ther-apy due to their significant anti-cancer effects with negligible or no side effects and availabil-ity in food sources.In this paper,we discuss an ideal hypothesis for screening available non-cancerous drugs with anticancer activity,with a focus on cancer stem cells and their clinical application for cancer treatment.Further,drug repurposing and the combination of micronu-trients that can target both cancers and cancer stem cells may result in a better therapeutic approach leading to maximum tumor growth control.
文摘目的系统评价癌症相关静脉血栓栓塞(VTE)患者使用新型口服抗凝剂(NOAC)的有效性和安全性。方法检索PubMed、Cochrane Library、Embase、Web of Science、中国知网、万方数据库,检索时限为各数据库建库起至2023年8月,收集低分子肝素(LMWH,对照组)对比NOAC(试验组)治疗癌症相关VTE患者疗效的随机对照试验(RCT),对纳入临床研究进行资料提取后,采用RevMan 5.0统计软件进行Meta分析。结果共计纳入7项RCT,合计3790例癌症相关VTE患者。与对照组相比,试验组患者的VTE复发率(RR=0.65,95%CI为0.51~0.82,P=0.0004)显著降低,而其大出血发生率略高于对照组,但差异无统计学意义(RR=1.13,95%CI为0.83~1.53,P=0.45)。试验组患者的临床相关非主要大出血(RR=1.69,95%CI为1.34~2.13,P<0.00001)、消化道出血(RR=1.96,95%CI为1.15~3.34,P=0.01)发生率均较对照组显著升高。两组患者颅内出血发生率、全因死亡率、致死性肺栓塞发生率比较,差异均无统计学意义(P>0.05)。结论对于癌症相关VTE患者,NOAC在预防VTE复发方面优于LMWH,在大出血、颅内出血、全因死亡、致死性肺栓塞方面不劣于LMWH。
文摘Dihydrofolate reductase (DHFR) is an enzyme that catalyzes the reduction of dihydrofolate (DHF) to tetrahydrofolate (THF). Chemotherapy drugs such as methotrexate help to slow the progression of cancer by limiting the ability of dividing cells to make nucleotides by competitively inhibiting DHFR. Nonsteroidal anti-inflammatory drugs (NSAIDs) have been previously reported to exhibit competitive inhibition of DHFR, in addition to their primary action on cyclooxygenase enzymes. This interaction interferes with the enzymatic reduction of dihydrofolate to tetrahydrofolate, thereby impeding the folate metabolism pathway essential for nucleotide synthesis and cell proliferation. This activity stems from their structural resemblance to the p-aminobenzoyl-l-glutamate (pABG) moiety of folate, a substrate of DHFR. It has been established that NSAIDs containing a salicylate group (which has structural similarities to pABG), such as diflunisal, exhibit stronger DHFR-binding activity. In this study, we synthesized salicylate derivatives of naproxen with the aim of exploring their potential as inhibitors of DHFR. The interactions between these derivatives and human DHFR were characterized using a combination of biochemical, biophysical, and structural methods. Through polyacrylamide gel electrophoresis (PAGE) analysis, enzymatic assays, and quantitative ELISA, we investigated the binding affinity and inhibitory potency of the synthesized salicylate derivatives towards DHFR. The findings of this study suggest the potential of salicylate derivatives of naproxen as promising candidates for the inhibition of DHFR, thereby offering novel therapeutic opportunities for modulating the inflammatory process through multiple pathways. Further optimization of these derivatives could lead to the development of more efficacious dual-targeted analogs with enhanced therapeutic benefits.
文摘Chronic hepatitis B constitutes a substantial disease burden worldwide.The steps advocated by the World Health Organization in 2016 to eradicate hepatitis B by 2030 has failed to achieve significant progress,especially with respect to immu-nization coverage and linkage to care.The lack of governmental and public awar-eness regarding the long-term implications of hepatitis B burden cause under-funding of developmental projects.The presently approved treatment modalities have limited efficacy in complete viral eradication,hence the need for newer molecules to achieve functional cure(sustained undetectable hepatitis B surface antigen(HBsAg)and hepatitis B virus DNA in peripheral blood after a finite period of therapy).However,preliminary results from trials of novel therapies show their inadequacy to achieve this end by themselves but better performance with a low baseline serum HBsAg with nucleos(t)ide analogues(NA)treatment which need to be combined with/without pegylated interferon as an immu-nomodulator.Such therapy is limited by cost and adverse events and need to show incremental benefit over the standard of care(long-term NA therapy)with respect to efficacy and drug toxicities,making the development process tenuous.Thus,while such therapies continue to be tested,strategies should still focus on prevention of transmission by non-pharmaceutical measures,vaccination and increasing linkage to care.
