Pharmacokinetics and bioequivalence of ezetimibe tablet in healthy Chinese subjects under fasting and fed conditions.

OBJECTIVE: The purpose of this study is to evaluate the pharmacokinetics (PK) parameters of an ezetimibe 10 mg (test drug) and assess its bioequivalence to the branded reference product in healthy Chinese subjects under fasting and fed conditions. MATERIALS AND METHODS: A single-center, randomized, open-label, four-period, two-sequence, full replicate crossover study was conducted in 88 healthy Chinese subjects under fasting or fed conditions. Subjects received a single oral dose of 10 mg ezetimibe tablet as test or reference formulation. There was a minimum 14-day washout period between each dose. Blood samples were collected at prescribed time intervals, the plasma concentration of free ezetimibe and total ezetimibe (ezetimibe + ezetimibe glucuronide) was determined by a validated ultra performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) method. Pharmacokinetik and bioavailability parameters were estimated via non-compartmental methods. Adverse events were also recorded. RESULTS: 40 and 48 eligible healthy subjects were enrolled in the fasted and fed study. Under fasting state, total ezetimibe with 90% confidence intervals (CIs) of Cmax, AUC0-t, and AUC0-∞ were 87.17% (81.99 - 92.66%), 95.98% (92.38-99.72%), and 96.04% (91.37 - 100.95%), respectively. Under fed state, total ezetimibe with 90% confidence intervals (CIs) of Cmax, AUC0-t, and AUC0-∞ were 98.71% (90.11 - 108.13%), 98.32% (94.71 - 102.06%), and 97.90% (92.68 - 103.42%), respectively. The 90% CIs of the ratio of geometric means (GMRs) of Cmax, AUC0-t, AUC0-∞ of the test and reference formulation in both fasting and fed conditions fell within the conventional bioequivalence criteria of 0.80 - 1.25. No severe adverse events were observed. CONCLUSION: The test and reference 10-mg ezetimibe tablets were bioequivalent under fasting and fed conditions in Chinese subjects. Both preparations showed good safety and tolerability.

Sensitivity, Specificity, and Safety of a Novel ESAT6-CFP10 Skin Test for Tuberculosis Infection in China: 2 Randomized, Self-Controlled, Parallel-Group Phase 2b Trials.

BACKGROUND: Diagnostics to identify tuberculosis infection are limited. We aimed to assess the diagnostic accuracy and safety of ESAT6-CFP10 (EC) skin test for tuberculosis infection in Chinese adults. METHODS: We conducted 2 randomized, parallel-group clinical trials in healthy participants and tuberculosis patients. All participants were tested with the T-SPOT.TB test, then received an EC skin test and tuberculin skin test (TST). The diameter of skin indurations and/or redness at injection sites were measured at different time periods. A bacillus Calmette Guerin (BCG) model was established to assess the diagnosis of tuberculosis infection using an EC skin test. RESULTS: In total, 777 healthy participants and 96 tuberculosis patients were allocated to receive EC skin test at 1.0 µg/0.1 mL or 0.5 µg/0.1 mL. The area under the curve was 0.95 (95% confidence interval [CI], .91-.97) for the EC skin test at 1.0 µg/0.1 mL at 24-72 hours. Compared with the T-SPOT.TB test, the EC skin test demonstrated similar sensitivity (87.5, 95% CI, 77.8-97.2 vs 86.5, 95% CI, 79.5-93.4) and specificity (98.9, 95% CI, 96.0-99.9 vs 96.1, 95% CI, 93.5-97.8). Among BCG vaccinated participants, the EC skin test had high consistency with the T-SPOT.TB test (96.3, 95% CI, 92.0-100.0). No serious adverse events related to the EC skin test were observed. CONCLUSIONS: The EC skin test demonstrated both high specificity and sensitivity at a dose of 1.0 µg/0.1 mL, comparable to the T-SPOT.TB test. The diagnostic accuracy of the EC skin test was not impacted by BCG vaccination. CLINICAL TRIALS REGISTRATION: NCT02389322 and NCT02336542.

Brucella abortus 2308ΔNodVΔNodW double-mutant is highly attenuated and confers protection against wild-type challenge in BALB/c mice.

Brucellosis is an important zoonotic disease of worldwide distribution, which causes animal and human disease. However, the current Brucella abortus (B. abortus) vaccines (S19 and RB51) have several drawbacks, including residual virulence for animals and humans. Moreover, S19 cannot allow serological differentiation between infected and vaccinated animals. We constructed double deletion (ΔNodVΔNodW) mutant from virulent B. abortus 2308 (S2308) by deleting the genes encoding two-component regulatory system (TCS) in chromosome II in S2308.2308ΔNodVΔNodW was significantly reduced survival in murine macrophages (RAW 264.7) and BALB/c mice. Moreover, the inoculated mice showed no splenomegaly. The mutant induced high protective immunity in BALB/c mice against challenge with S2308, and elicited an anti-Brucella-specific immunoglobulin G (IgG) response and induced the secretion of gamma interferon (IFN-γ) and interleukin-4 (IL-4). Moreover, NODV and NODW antigens would allow the serological differentiation between infected and vaccinated animals. These results suggest that 2308ΔNodVΔNodW mutant is a potential live attenuated vaccine candidate and can be used effectively against bovine brucellosis.

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Antibiotic resistance genes (ARGs) have attracted widespread attention as a new global pollutant, mainly due to the abuse of antibiotics. To investigate the diversity of ARGs in three rodent species, we used metagenomic sequencing analysis to analyze the diversity of antibiotic resistance genes of 17 individuals of Apodemus peninsulae and 17 individuals of Myodes rufocanus collected from Mudanfeng, and nine individuals of Apodemus agrarius collected from Sandaoguan. A total of 19 types and 248 subclasses of ARGs were detected in the three rodent species. Seven ARGs showed significant difference and five ARGs showed extremely significant difference between M. rufocanus and A. agrarius. Seven ARGs showed significant difference and four ARGs showed extremely significant difference between A. peninsulae and A. agrarius. Four ARGs showed significant difference and five ARGs showed extremely significant difference between M. rufocanus and A. peninsulae. ARGs showing high abundance in three rodents were macrolides, lincoamides, tetracyclines, and ß-lactams. ARGs were widely distributed in the three rodent species. The significant differences in ARGs among different species might be due to the different distribution areas and their diet differentiation. The study could provide a basis for further studies of ARGs in mice and improve the understanding of the harm of ARGs transmission.

Pharmacokinetics and bioequivalence study of candesartan cilexetil tablet in Chinese volunteers under fasting condition: an open-label, randomized-sequence, 2-period crossover study.

Candesartan is an antihypertensive agent that acts on an angiotensin II receptor. Candesartan cilexetil is a prodrug that is converted into the active form of candesartan during intestinal absorption. This study aimed to assess the pharmacokinetics and bioequivalence of a reference and a test formulation of candesartan cilexetil tablets in healthy Chinese volunteers. A randomized, open-label, single-dose, crossover study was conducted with two treatment periods. Forty-eight healthy Chinese volunteers participated under fasted conditions. Qualified subjects were randomly divided into two groups (1:1 ratio) to receive either the test or reference formulation first. A washout period of 14 days separated the administration of the two formulations. Blood samples were collected at specific time points and analyzed for candesartan concentration using Ultra High-Performance Liquid Chromatography Tandem Mass Spectrometry (UPLC-MS/MS). The maximum concentration (Cmax), the AUC from time zero to the last measured time point (AUC0-t) and the AUC from time zero to infinity (AUC0-∞) fell within the bioequivalence range of 80% to 125%. These results suggest that the test and reference formulations of candesartan cilexetil tablets are bioequivalent, meaning they have similar rates and extents of absorption in healthy Chinese volunteers. No serious adverse events or side effects were reported throughout the study.

The complete mitochondrial genome of the Riparia riparia (Passeriformes: Hirundinidae).

The Sand Martin (Riparia riparia) belongs to Hirundinidae. In this study, the complete mitochondrial genome of R. riparia was sequenced and characterized. The genome was 17,963 bases in length (GenBank accession no. OK537984) including 13 protein-coding genes, two ribosomal RNA (rRNA) genes, 22 transfer RNA (tRNA) genes, and two control regions. The overall base composition of R. riparia mitogenome was 30.5% for A, 31.8% for C, 14.5% for G, and 23.2% for T. Phylogenetic analysis revealed that R. riparia was genetically closest to the species of genus Tachycineta. R. riparia mitogenome could contribute to our understanding of the phylogeny and evolution of this species.

Evolutionary insights into umami, sweet, and bitter taste receptors in amphibians.

Umami and sweet sensations provide animals with important dietary information for detecting and consuming nutrients, whereas bitter sensation helps animals avoid potentially toxic or harmful substances. Enormous progress has been made toward animal sweet/umami taste receptor (Tas1r) and bitter taste receptor (Tas2r). However, information about amphibians is mainly scarce. This study attempted to delineate the repertoire of Tas1r/Tas2r genes by searching for currently available genome sequences in 14 amphibian species. This study identified 16 Tas1r1, 9 Tas1r2, and 9 Tas1r3 genes to be intact and another 17 Tas1r genes to be pseudogenes or absent in the 14 amphibians. According to the functional prediction of Tas1r genes, two species have lost sweet sensation and seven species have lost both umami and sweet sensations. Anurans possessed a large number of intact Tas2rs, ranging from 39 to 178. In contrast, caecilians possessed a contractive bitter taste repertoire, ranging from 4 to 19. Phylogenetic and reconciling analysis revealed that the repertoire of amphibian Tas1rs and Tas2rs was shaped by massive gene duplications and losses. No correlation was found between feeding preferences and the evolution of Tas1rs in amphibians. However, the expansion of Tas2rs may help amphibians adapt to both aquatic and terrestrial habitats. Bitter detection may have played an important role in the evolutionary adaptation of vertebrates in the transition from water to land.

Activation of hypoxia-inducible factor 1 (Hif-1) enhanced bactericidal effects of macrophages to Mycobacterium tuberculosis.

BACKGROUND: Tuberculosis is chronic infection caused by Mycobacterium tuberculosis (M.tb), which infects specifically macrophages. Hif-1, hypoxia-inducible factor-1, was reported to act as master regulator of killing functions in macrophages. AIM: To investigate whether Hif-1 activation would enhance bactericidal effect of macrophages and anti-tuberculosis effect of chemical reagent. METHODS: Hif-1 and LC3B were detected in tissues from pulmonary tuberculosis. U937, human monocytic leukemia cell line, was stimulated with PMA and differentiated into macrophages. Cells were pretreated with Hif-1 chemical inhibitor YC-1, stimulated with CoCl2 (Hif-1 activator), to detect LC3B with Western blot and confocal microscopy. Cells were infected with M. tb H37Rv strain, stimulated with CoCl2, following rifampine treatment. Expression of autophagy markers was detected using Western blot. IL-6 and TNF-α were detected in cell supernatant with ELISA. Acid-fast staining and CFU assay were performed to evaluate intracellular bacterial load. RESULTS AND CONCLUSIONS: Hif-1 and LC3B increased in tissues of pulmonary tuberculosis. Hif-1 activation enhanced autophagy in M. tb infected U937 cells and production of IL-6 and TNF-α. Data from acid-fast staining and CFU indicated that Hif-1 activation enhanced anti-tuberculosis effect of rifampine in macrophages. Conclusively, to activate Hif-1 would strengthen bactericidal effect of macrophages, to further enhance anti-tuberculosis effect of chemical reagent.

Analysis of Peripheral Blood IL-6 and Leukocyte Characteristics in 364 COVID-19 Patients of Wuhan.

SARS-CoV-2, the pathogen of COVID-19, is spreading around the world. Different individuals infected with COVID-19 have different manifestations. It is urgent to determine the risk factors of disease progress of COVID-19. 364 patients diagnosed with COVID-19, who were admitted to Wuhan Pulmonary Hospital from February 3, 2020 to March 16, 2020, were divided into mild, ordinary, severe, and critical groups, according to Chinese novel coronavirus pneumonia diagnosis and treatment plan. Peripheral blood IL-6 and leukocyte characteristics were analyzed, to evaluate the correlation with the severity of COVID-19. The levels of peripheral blood IL-6 were 2.35 ± 0.46 pg/ml (mild), 6.48 ± 1.13 pg/ml (ordinary), 20.30 ± 5.15 pg/ml (severe), and 123.48 ± 44.31 pg/ml (critical). The leukocytes were 5.70 ± 0.41×109/L (mild), 6.21 ± 0.14×109/L (ordinary), 6.37 ± 0.26×109/L (severe), and 10.03 ± 1.43×109/L (critical). The lymphocytes were 1.46 ± 0.19×109/L (mild), 1.89 ± 0.14×109/L (ordinary), 1.26 ± 0.07×109/L (severe), and 1.17 ± 0.23×109/L (critical). The neutrophils were 3.63 ± 0.36×109/L (mild), 3.78 ± 0.11×109/L (ordinary), 4.47 ± 0.25×109/L (severe), and 7.92 ± 1.19×109/L (critical). The monocytes were 0.42 ± 0.05×109/L (mild), 0.44 ± 0.01×109/L (ordinary), 0.46 ± 0.02×109/L (severe), and 0.78 ± 0.25×109/L (critical). Conclusively, increase of peripheral blood IL-6 and decrease of lymphocytes can be used as the indicators of severe COVID-19. The increase of neutrophils and monocytes was noticed in critical cases of COVID-19, suggesting that the increase of neutrophils and monocytes should be considered as risk factors of critical cases of COVID-19. Peripheral blood IL-6 and leukocyte characteristics were also analyzed in different age groups. The increase of serum IL-6, decrease of lymphocytes, and increase of neutrophils were noticed in patients over 60 years old.

Analysis of the Gut Microbiome of Wild and Captive Père David's Deer.

Père David's deer (Elaphurus davidianus or milu) is a highly endangered species originating from China, and many deer are currently being raised in captivity for gradual re-introduction to the wild. Wild and captive deer currently live in the same region but have vastly different diets. In this study, we used 16S rRNA high-throughput sequencing to identify the healthy core microbiome in the gut of wild and captive Père David's deer and investigate how dietary factors influence the gut microbiome by comparing their differences. A core shared gut microbiome was identified in healthy Père David's deer, which was similar to that of other ruminants, mainly comprising the phyla Firmicutes and Bacteroidetes. There were no differences in the richness or diversity of the gut microbiome between the wild and captive deer. However, PCA and ANOSIM demonstrated clear differences in the microbial community structure between the captive and wild deer, which mainly manifested as changes in the relative abundance of 39 bacterial genera. As the majority of these genera were not dominant in the deer gut, no significant difference was detected in functional modules related to the microbiome between the two groups. Therefore, the difference in dietary factors does not appear to affect the healthy core gut microbiome between captive and wild Père David's deer, suggesting strong co-evolution and the possibility of re-establishment in the wild. These data could guide future applications of population management in Père David's deer conservation.

The groundhopper fauna (Orthoptera: Tetrigidae) of Shiwanshan (Guangxi, China) with description of three new species.

This paper deals with 7 subfamilies, 30 genera and 82 species of Tetrigidae from Shiwanshan, Guangxi in China. Among them three new species of the subfamily Metrodorinae are described, namely Mazarredia convexaoides Deng & Zheng sp. nov., Mazarredia shiwanshanensis Deng & Zheng sp. nov. and Bolivaritettix shiwanshanensis Deng & Zheng sp. nov. Also, new synonyms are presented: Miriatroides quadrivertex Zheng & Jiang, 2002 syn.nov. is synonymized with Spadotettix hainanensis Günther, 1939, thus genus Miriatroides Zheng & Jiang, 2002 with the genus Spadotettix Hancock, 1910. Finally, brief comments on faunistic characters of Tetrigidae from Shiwanshan are given.

An open-label, randomized and multi-center clinical trial to evaluate the efficacy of Silibinin in preventing drug-induced liver injury.

UNLABELLED: To assess the clinical efficacy and safety of Silibinin in preventing drug-induced liver injury (DILI) in the general population (high-risk patients with non-drug induced liver injury). METHOD: A prospective, multi-center, randomized, open-label and controlled trial was conducted with 568 patients undergoing primary treatment of pulmonary tuberculosis. The study included 277 patients in experimental group and 291 patients in control group. The patients in the two group were treated with conventional 2HREZ (S)/4HR for tuberculosis (TB), and additional Silibinin capsules (oral administration of 70 mg/time, 3 times/day for 8 weeks in experimental group. Outcomes of liver function, interruption of anti-TB treatment and therapeutic results, as well as adverse reactions were observed and analyzed. RESULTS: At 2, 4 and 8 weeks of treatment, the incidences of liver injury in experimental group were 3.97%, 1.44% and 2.17%, respectively; the incidences in control group were 4.12%, 4.12% and 2.41%, respectively. Statistical analysis showed that there was no difference in the incidence between the two groups at each treatment period (P>0.05). At 8 weeks, the numbers of patients diagnosed of DILI were 18 (7.22%) and 27 (9.28%) in experimental and control groups, respectively (P>0.05). 34.30% and 27.49% of the patients in experimental and control groups had transient abnormal liver function or symptoms, respectively; similar percentages (3.25% and 6.19%) of the patients in two groups have liver function injury and symptoms, and were suspended for anti-TB treatment (P>0.05). The incidence of anorexia and nausea symptoms was lower in experimental group than in control group, and the differences were significant at 4 and 8 weeks (P<0.05). 8 weeks after the treatment, 98.30% of the sputum smear culture were negative in experimental group, which was significantly higher (P<0.01) than that in control group (92.98%). CONCLUSION: Preventive hepatoprotective therapy in the general population may reduce drug discontinuation rate, improve patient's compliance and outcomes of anti-TB treatment.