Risk factors for linezolid - induced haematological toxicity in patients: a retrospective study.

INTRODUCTION: This single-center, observational cohort study aimed to investigate the risk factors associated with linezolid-induced hematological toxicity by analyzing the linezolid trough concentration (Cmin) obtained from patients undergoing treatment between January 2020 and December 2021. METHODOLOGY: A total of 111 eligible individuals were included in the study, of which 47 were diagnosed with linezolid-induced thrombocytopenia and 18 were diagnosed with linezolid-induced hemoglobin decrease. RESULTS: Binary logistic regression analysis revealed that creatinine clearance level (Ccr) < 50 mL/min/1.73 m2 (OR, 5.463; 95% CI, 1.249-23.888, p = 0.024) and Cmin > 7 mg/L (OR, 62.660; 95% CI, 14.293-274.708, p = 0.001) were risk factors associated with linezolid-induced thrombocytopenia. Area under the ROC curve for Cmin was 0.955, with a maximum Youden index of 0.837. The corresponding critical value was 6.94 mg/L (sensitivity 91.5%; specificity 92.2%). Ccr < 50 mL/min/1.73 m2 (OR, 7.282; 95% CI, 1.765-30.048, p = 0.006) and Cmin > 7mg/L (OR, 6.364; 95% CI, 1.937-20.910, p = 0.020) were found to be associated with linezolid-induced hemoglobin reduction. The area under the ROC curve for Cmin was 0.755, Youden index was 0.477 at the maximum, and the corresponding critical value was 7.53 mg/L (sensitivity 77.8%; specificity 69.9%). CONCLUSIONS: Renal insufficiency is a related risk factor for linezolid-induced hematological toxicity. Patients receiving linezolid treatment should be closely monitored with blood routine and plasma concentration, particularly in patients with moderate or severe renal insufficiency. The plasma trough concentration of linezolid could be a suitable predictor for linezolid-induced thrombocytopenia and anemia.

The protective effects of Acanthus ilicifolius alkaloid A and its derivatives on pro- and anti-inflammatory cytokines in rats with hepatic fibrosis.

This study was designed to investigate the protective effects of Acanthus ilicifolius alkaloid A [4-hydroxy-2-benzoxazolone (HBOA)] and its acetylated derivatives including 4-acetoxy-2-benzoxazolone (TC-2) and 3-acetyl-4-acetoxy-2-benzoxazolone (TC-3) on carbon tetrachloride (CCl4 )-induced liver fibrosis in rats. Sprague-Dawley rats were given CCl4 twice per week for 8 weeks to induce liver fibrosis. Then, they were treated with HBOA, TC-2, and TC-3 daily for 4 weeks, respectively. The serum indicators including total protein (TP), albumin (Alb), globulin, hyaluronic acid (HA), and laminin (LN) were measured by commercial kits. The messenger ribonucleic acid expression of adiponectin, peroxisome proliferator-activated receptor-γ (PPAR-γ), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), transforming growth factor-ß1 (TGF-ß1 ) and Toll-like receptor 4 (TLR4 ) was determined by reverse-transcriptase -PCR. The proteins of adiponectin, TGF-ß1 , α-smooth muscle actin (α-SMA), and TLR4 were also detected by the immunohistochemical assay. The results showed that HBOA, TC-2, and TC-3 significantly attenuated the fibrotic degree induced by CCl4 as evidenced by higher levels of TP, Alb, adiponectin, and PPAR-γ, which in turn decreased the proliferation of hepatic stellate cells. Moreover, those drugs markedly decreased the levels of HA, LN, TNF-α, IL-6, TGF-ß1 , α-SMA, and TLR4 . Our study indicates that HBOA, TC-2, and TC-3 have beneficial effects against liver fibrosis, and the mechanisms may be related to the inhibition of inflammatory response.

Association of IL-18 promoter gene polymorphisms with rheumatoid arthritis: a meta-analysis.

Interleukin-18(IL-18) plays a potential pathological role in rheumatoid arthritis (RA). The conclusions of the published reports on the relationship between single-nucleotide polymorphisms -607C/A (rs1946518) and -137G/C (rs187238) located in the IL-18 gene promoter and RA risk remain controversial. This meta-analysis was performed to evaluate the association between IL-18 gene promoter (-607A/C and -137C/G) polymorphisms and RA using (1) allele, (2) codominant, (3) dominant, and (4) recessive models. Literature search was conducted up to January, 2013, in PubMed, EMBASE, Spring-link, Web of Science, Wanfang (Chinese) and China National Knowledge Infrastructure (CNKI). A total of 10 studies from eight articles involving 2,662 cases and 2,168 controls for -607A/C polymorphism and 9 studies from six articles involving 1,331 cases and 1,468 controls for -137C/G polymorphism were considered in the meta-analysis. For the relationship of IL-18 -607A/C polymorphism with RA risk, significant association was observed in allele model (OR = 0.778, 95 % CI = 0.633-0.955) and dominant model (OR = 0.618, 95 % CI = 0.466-0.819). However, no significant association could be observed between -137C/G polymorphism and RA risk under all genetic models (allele model: OR = 0.940, 95 % CI = 0.777-1.138; codominant model: OR = 1.079, 95 % CI = 0.574-2.029; dominant model: OR = 0.913, 95 % CI = 0.779-1.069; recessive model: OR = 1.133, 95 % CI = 0.586-2.190). In the subgroup analysis by ethnicity, significant result was also found in Asian populations but not found in Caucasian populations for the relationship of IL-18 -607A/C polymorphism with RA risk; while no obvious association was found between IL-18 -137C/G polymorphism and RA risk. This meta-analysis indicates that IL-18 -607A/C polymorphism in promoter region may be associated with RA risk.