RESUMO
BACKGROUND: Gepotidacin is a novel, bactericidal, first-in-class triazaacenaphthylene antibiotic that inhibits bacterial DNA replication by a distinct mechanism of action and a unique binding site, providing well balanced inhibition of two type II topoisomerase enzymes. Oral gepotidacin is under investigation to treat uncomplicated urinary tract infections. We aimed to compare the efficacy and safety of oral gepotidacin with that of nitrofurantoin in adolescent and adult female individuals with uncomplicated urinary tract infections. METHODS: EAGLE-2 and EAGLE-3 were phase 3, randomised, multicentre, double-blind, double-dummy, non-inferiority (10% margin) trials, in which patients were enrolled at 219 centres worldwide. Patients assigned female at birth, non-pregnant, aged 12 years or older, weighing 40 kg or more, with two or more symptoms of dysuria, frequency, urgency, or lower abdominal pain, and with evidence of urinary nitrite, pyuria, or both were eligible for inclusion. Patients were randomly assigned (1:1) centrally by interactive response technology to receive oral gepotidacin (1500 mg twice daily for 5 days) or oral nitrofurantoin (100 mg twice daily for 5 days), with randomisation stratified by age category and history of recurrent uncomplicated urinary tract infections. Patients, investigators, and the sponsor study team were masked to treatment assignment. The primary endpoint, therapeutic response (success or failure) at test-of-cure (ie, day 10-13), was evaluated in randomly assigned patients with nitrofurantoin-susceptible qualifying uropathogens (≥105 colony-forming units [CFU] per mL) and who received at least one dose of study treatment. Conforming to regulatory guidance, therapeutic success was defined as combined clinical success (ie, complete symptom resolution) and microbiological success (ie, reduction of qualifying uropathogens to <103 CFU/mL) without other systemic antimicrobial use. Safety analyses included patients who were randomly assigned and who received at least one dose of study treatment. The trials are registered with ClinicalTrials.gov, NCT04020341 (EAGLE-2) and NCT04187144 (EAGLE-3), and are completed. FINDINGS: Studies were undertaken from Oct 17, 2019, to Nov 30, 2022 (EAGLE-2), and from April 23, 2020, to Dec 1, 2022 (EAGLE-3). 1680 patients in EAGLE-2 and 1731 patients in EAGLE-3 were screened for eligibility, of whom 1531 and 1605 were randomly assigned, respectively (767 in the gepotidacin group and 764 in the nitrofurantoin group in EAGLE-2, and 805 in the gepotidacin group and 800 in the nitrofurantoin group in EAGLE-3). After an interim analysis, which was prospectively agreed as a protocol amendment, both studies were stopped for efficacy. Thus, the primary analysis population included only patients who, at the time of the interim analysis data cutoff, had the opportunity to reach the test-of-cure visit or were known to not have attained therapeutic success before the test-of-cure visit. In EAGLE-2, 162 (50·6%) of 320 patients assigned gepotidacin and 135 (47·0%) of 287 patients assigned nitrofurantoin had therapeutic success (adjusted difference 4·3%, 95% CI -3·6 to 12·1). In EAGLE-3, 162 (58·5%) of 277 patients assigned gepotidacin and 115 (43·6%) of 264 patients assigned nitrofurantoin had therapeutic success (adjusted difference 14·6%, 95% CI 6·4 to 22·8). Gepotidacin was non-inferior to nitrofurantoin in both studies and superior to nitrofurantoin in EAGLE-3. The most common adverse event with gepotidacin was diarrhoea (observed in 111 [14%] of 766 patients in EAGLE-2 and in 147 [18%] of 804 patients in EAGLE-3), whereas the most common adverse event with nitrofurantoin was nausea (in 29 [4%] of 760 patients in EAGLE-2 and in 35 [4%] of 798 patients in EAGLE-3). Cases were mostly mild or moderate. No life-threatening or fatal events occurred. INTERPRETATION: Gepotidacin is an efficacious oral antibiotic with acceptable safety and tolerability profiles. As a first-in-class investigational oral antibiotic with activity against common uropathogens, including clinically important drug-resistant phenotypes, gepotidacin has the potential to offer substantial benefit to patients. FUNDING: GSK and the US Office of the Assistant Secretary for Preparedness and Response, Biomedical Advanced Research and Development Authority.
Assuntos
Acenaftenos , Compostos Heterocíclicos com 3 Anéis , Nitrofurantoína , Infecções Urinárias , Adulto , Adolescente , Recém-Nascido , Humanos , Feminino , Nitrofurantoína/uso terapêutico , Resultado do Tratamento , Antibacterianos , Infecções Urinárias/tratamento farmacológico , Pesquisa , Método Duplo-CegoRESUMO
SOURCE CITATION: Wagenlehner F, Perry CR, Hooton TM, et al. Oral gepotidacin versus nitrofurantoin in patients with uncomplicated urinary tract infection (EAGLE-2 and EAGLE-3): two randomised, controlled, double-blind, double-dummy, phase 3, non-inferiority trials. Lancet. 2024;403:741-755. 38342126.
Assuntos
Nitrofurantoína , Infecções Urinárias , Adulto , Feminino , Humanos , Pessoa de Meia-Idade , Acenaftenos , Antibacterianos/uso terapêutico , Antibacterianos/administração & dosagem , Anti-Infecciosos Urinários/uso terapêutico , Método Duplo-Cego , Compostos Heterocíclicos com 3 Anéis/uso terapêutico , Nitrofurantoína/uso terapêutico , Infecções Urinárias/tratamento farmacológico , Ensaios Clínicos Controlados Aleatórios como Assunto , Ensaios Clínicos Fase III como AssuntoRESUMO
Bacillus anthracis is a Gram-positive Centers for Disease Control and Prevention category "A" biothreat pathogen. Without early treatment, inhalation of anthrax spores with progression to inhalational anthrax disease is associated with high fatality rates. Gepotidacin is a novel first-in-class triazaacenaphthylene antibiotic that inhibits bacterial DNA replication by a distinct mechanism of action and is being evaluated for use against biothreat and conventional pathogens. Gepotidacin selectively inhibits bacterial DNA replication via a unique binding mode and has in vitro activity against a collection of B. anthracis isolates including antibacterial-resistant strains, with the MIC90 ranging from 0.5 to 1 µg/mL. In vivo activity of gepotidacin was also evaluated in the New Zealand White rabbit model of inhalational anthrax. The primary endpoint was survival, with survival duration and bacterial clearance as secondary endpoints. The trigger for treatment was the presence of anthrax protective antigen in serum. New Zealand White rabbits were dosed intravenously for 5 days with saline or gepotidacin at 114 mg/kg/d to simulate a dosing regimen of 1,000 mg intravenous (i.v.) three times a day (TID) in humans. Gepotidacin provided a survival benefit compared to saline control, with 91% survival (P-value: 0.0001). All control animals succumbed to anthrax and were found to be blood- and organ culture-positive for B. anthracis. The novel mode of action, in vitro microbiology, preclinical safety, and animal model efficacy data, which were generated in line with Food and Drug Administration Animal Rule, support gepotidacin as a potential treatment for anthrax in an emergency biothreat situation.
Assuntos
Acenaftenos , Vacinas contra Antraz , Antraz , Bacillus anthracis , Compostos Heterocíclicos com 3 Anéis , Infecções Respiratórias , Coelhos , Humanos , Animais , Antraz/microbiologia , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Modelos Animais de Doenças , Vacinas contra Antraz/uso terapêuticoRESUMO
The ongoing spread of antimicrobial resistance has made the treatment of uncomplicated urinary tract infections (UTIs) and urogenital gonorrhoea increasingly difficult. New oral treatment options are urgently needed. Gepotidacin (previously GSK2140944) is a novel, bactericidal, oral, 'first-in-class' triazaacenaphthylene antibiotic that inhibits bacterial DNA replication by blocking two essential topoisomerase enzymes. Mutations in both enzymes would likely be necessary for resistance to occur, thus raising hopes that the drug will be able to maintain long-term effectiveness. Data from Phase II clinical trials of gepotidacin in UTIs and urogenital gonorrhoea appear promising, and Phase III trials are underway. In this review we summarize the development of gepotidacin and discuss its potential role in clinical practice. If approved, gepotidacin will be the first new oral antibiotic for UTIs in more than 20 years.
Assuntos
Gonorreia , Infecções Urinárias , Humanos , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Gonorreia/tratamento farmacológico , Gonorreia/microbiologia , Acenaftenos/uso terapêutico , Acenaftenos/farmacologia , Infecções Urinárias/tratamento farmacológicoRESUMO
Polycyclic aromatic hydrocarbons (PAHs) are harmful to human health due to their carcinogenic, teratogenic, and mutagenic effects. A thermophilic Hydrogenibacillus sp. strain N12 capable of degrading a variety of PAHs and derivatives was previously isolated. In this study, an aromatic ring-hydroxylating oxygenase, NarA2B2, was identified from strain N12, with substrate specificity including naphthalene, phenanthrene, dibenzothiophene, fluorene, acenaphthene, carbazole, biphenyl, and pyrene. NarA2B2 was proposed to add one or two atoms of molecular oxygen to the substrate and catalyze biphenyl at C-2, 2 or C-3, 4 positions with different characteristics than before. The key catalytic amino acids, H222, H227, and D379, were identified as playing a pivotal role in the formation of the 2-his-1-carboxylate facial triad. Furthermore, we conducted molecular docking and molecular dynamics simulations, notably, D219 enhanced the stability of the iron center by forming two stable hydrogen bonds with H222, while the mutation of F216, T223, and H302 modulated the catalytic activity by altering the pocket's size and shape. Compared to the wild-type (WT) enzyme, the degradation ratios of acenaphthene by F216A, T223A, and H302A had an improvement of 23.08%, 26.87%, and 29.52%, the degradation ratios of naphthalene by T223A and H302A had an improvement of 51.30% and 65.17%, while the degradation ratio of biphenyl by V236A had an improvement of 77.94%. The purified NarA2B2 was oxygen-sensitive when it was incubated with L-ascorbic acid in an anaerobic environment, and its catalytic activity was restored in vitro. These results contribute to a better understanding of the molecular mechanism responsible for PAHs' degradation in thermophilic microorganisms.IMPORTANCE(i) A novel aromatic ring-hydroxylating oxygenase named NarA2B2, capable of degrading multiple polycyclic aromatic hydrocarbons and derivatives, was identified from the thermophilic microorganism Hydrogenibacillus sp. N12. (ii) The degradation characteristics of NarA2B2 were characterized by adding one or two atoms of molecular oxygen to the substrate. Unlike the previous study, NarA2B2 catalyzed biphenyl at C-2, 2 or C-3, 4 positions. (iii) Catalytic sites of NarA2B2 were conserved, and key amino acids F216, D219, H222, T223, H227, V236, F243, Y300, H302, W316, F369, and D379 played pivotal roles in catalysis, as confirmed by protein structure prediction, molecular docking, molecular dynamics simulations, and point mutation.
Assuntos
Oxigenases , Hidrocarbonetos Policíclicos Aromáticos , Humanos , Oxigenases/metabolismo , Acenaftenos , Simulação de Acoplamento Molecular , Hidrocarbonetos Policíclicos Aromáticos/metabolismo , Aminoácidos , Oxigênio , Biodegradação AmbientalRESUMO
BACKGROUND: Gepotidacin is a novel, first-in-class triazaacenaphthylene antibiotic that inhibits bacterial DNA replication by a distinct mechanism of action and is active against most strains of Neisseria gonorrhoeae (N. gonorrhoeae). Phase II data suggested higher exposures were needed for efficacy and to suppress resistance development. A translational approach using in vitro pharmacokinetic/pharmacodynamic (PK/PD) and clinical data was used to select a gepotidacin dose for a phase III study. In this narrative review of previously shown data, we summarise how a translational approach based on in vitro PK/PD and population PK modelling and simulation data was undertaken to select a dosing regimen for the ongoing phase III gepotidacin study in participants with uncomplicated urogenital gonorrhoea. METHODS: For dose selection, prior in vitro minimum inhibitory concentrations (MICs) and PK/PD data were available. PK modelling was conducted to determine a dose that would limit plasma concentrations to less than 14 µg/mL (as concentrations above this are associated with QT prolongation and effects associated with acetylcholinesterase inhibition) while maintaining ≥90% probability of target attainment (PTA) for efficacy and resistance suppression against N. gonorrhoeae isolates with gepotidacin MICs ≤1 µg/mL. RESULTS: Two 3000 mg gepotidacin doses, administered 10-12 hours apart, resulted in PTA of ≥97.5% and ≥91.7% for gepotidacin MICs ≤1 µg/mL for the ratio of the area under the free drug plasma concentration-time curve over 24 hours to the MIC (fAUC0-24/MIC) efficacy, and resistance suppression targets of 40 and 46, respectively, but limited the occurrence of maximum plasma concentrations ≥14 µg/mL. CONCLUSIONS: Two gepotidacin 3000 mg oral doses 10-12 hours apart provide ~2-fold higher systemic exposures, increase efficacy for higher gepotidacin MIC N. gonorrhoeae isolates, reduce resistance potential and limit plasma concentrations of potential safety concern, compared with higher doses.
Assuntos
Gonorreia , Humanos , Gonorreia/tratamento farmacológico , Gonorreia/microbiologia , Acetilcolinesterase/farmacologia , Acetilcolinesterase/uso terapêutico , Antibacterianos/uso terapêutico , Acenaftenos/farmacologia , Acenaftenos/uso terapêutico , Neisseria gonorrhoeae , Testes de Sensibilidade Microbiana , Ensaios Clínicos Fase III como AssuntoRESUMO
Tuning solubility and mechanical activation alters the stereoselectivity of the [2 + 2] photochemical cycloaddition of acenaphthylene. Photomechanochemical conditions produce the syn cyclobutane, whereas the solid-state reaction in the absence of mechanical activation provides the anti. When the photochemical dimerization occurs in a solubilizing organic solvent, there is no selectivity. Dimerization in H2O, in which acenaphthylene is insoluble, provides the anti product. DFT calculations reveal that insoluble and solid-state reactions proceed via a covalently bonded excimer, which drives anti selectivity. Alternatively, the noncovalently bound syn conformer is more mechanosusceptible than the anti, meaning it experiences greater destabilization, thereby producing the syn product under photomechanochemical conditions. Cyclobutanes are important components of biologically active natural products and organic materials, and we demonstrate stereoselective methods for obtaining syn or anti cyclobutanes under mild conditions and without organic solvents. With this work, we validate photomechanochemistry as a viable new direction for the preparation of complex organic scaffolds.
Assuntos
Acenaftenos , Ciclobutanos , Teoria da Densidade Funcional , DimerizaçãoRESUMO
A series of heteroleptic bipyridine Pd(II) complexes based on 1,2-bis[(2,6-diisopropylphenyl)imino]acenaphthene (dpp-Bian) or 1,2-bis[(2,4,6-trimethylphenyl)imino]acenaphthene (tmp-Bian) were prepared. All complexes were fully characterized by spectrochemical methods, and their crystal structures were confirmed by X-ray diffraction analysis. The 72 h stability of heteroleptic bipyridine Pd(II) complexes with Bian ligands under physiological conditions was investigated using 1H NMR spectroscopy. The anticancer activity of all complexes was assessed in a panel of cancer cell lines in comparison with uncoordinated ligands and clinically used drugs cisplatin and doxorubicin. The ability of the complexes to bind DNA was investigated using several methods, including EtBr replacement assay, density functional theory calculations, circular dichroism spectroscopy, DNA gel electrophoresis, and TUNEL assay. The electrochemical activity of all complexes and the uncoordinated ligands was studied using cyclic voltammetry, and reactive oxygen species production in cancer cells was investigated using confocal microscopy. Heteroleptic bipyridine PdII-Bian complexes were cytotoxic in a low micromolar concentration range and showed some selectivity toward cancer cells in comparison with noncancerous MRC-5 lung fibroblasts.
Assuntos
Compostos Heterocíclicos , Paládio , Paládio/farmacologia , Acenaftenos/química , Acenaftenos/farmacologia , Ligantes , DNA , OxirreduçãoRESUMO
Acenaphthene is a polycyclic aromatic hydrocarbon (PAH) that is a widely distributed environmental pollutant that accumulates in organisms and leads to health risks in humans. Although acenaphthene is reported to be toxic to aquatic organisms, its effects of acenaphthene on the livers of these organisms have not been evaluated. Here, zebrafish were used as an experimental model. Zebrafish larvae were exposed to 4.5, 5.5, and 6.5 mg/L acenaphthene for 72 h while adult zebrafish were exposed to 1.5, 2, and 2.5 mg/L acenaphthene for 28 days. We investigated the mechanism by which acenaphthene causes liver toxicity in zebrafish. The results showed that acenaphthene affected the early development of zebrafish and led to mitochondrial damage by promoting the production of reactive oxygen species (ROS) resulting in oxidative stress. The expression of genes related to inflammation and apoptosis was analyzed, observing up-regulation of the pro-inflammatory factors IL-8, TNF-α, and IL-6. The pro-apoptotic genes p53, Caspase-3, and Bax and the Bax/Bcl-2 ratio were up-regulated, while the anti-apoptotic gene Bcl-2 was down-regulated. In addition, we investigated the effects of acenaphthene on liver metabolism. When exposed to acenaphthene, the glycogen content of the liver decreased, while lipid accumulation increased together with alterations in related indicators of liver metabolism. In conclusion, acenaphthene induced oxidative stress through ROS production, leading to mitochondrial damage and activation of pathways associated with inflammation and apoptosis, resulting in hepatotoxicity. This affects normal liver metabolism. Our results revealed the mechanism of hepatotoxicity in zebrafish acenaphthene, and provided new evidence for a more comprehensive understanding of the hepatotoxicity of acenaphthene.
Assuntos
Doença Hepática Induzida por Substâncias e Drogas , Peixe-Zebra , Animais , Humanos , Peixe-Zebra/metabolismo , Espécies Reativas de Oxigênio/metabolismo , Acenaftenos , Proteína X Associada a bcl-2/metabolismo , Estresse Oxidativo , Fígado , Inflamação/metabolismo , Doença Hepática Induzida por Substâncias e Drogas/metabolismo , ApoptoseRESUMO
Polycyclic aromatic hydrocarbons are a class of chemicals that occur naturally. They generally demonstrate a high degree of critical toxicity towards humans. Acenaphthene and naphthalene contain compounds that are commonly found in the environment as compared to other PAHs. Consequently, a reliable method of detecting PAHs is crucial for the monitoring of water quality. A colorimetric method based on sodium nitrite-functionalized gold nanoparticles was developed in this study for acenaphthene and naphthalene detection. Different functionalized parameters are determined for the optimization of assay conditions. A linear relationship was found in the analyte concentration range of 0.1-10 ppm with the limit of detection for acenaphthene and naphthalene being 0.046 ppm and 0.0015 ppm, respectively, under the optimized assay conditions. The method's recovery rate for actual samples falls within the range of 98.4-103.0%. In selective and anti-interference tests, the presence of cations and anions has minimal impact on the detection of the analyte. The colorimetric detection method proposed in this study effectively determines the presence of the analyte in real water samples and has a high recovery rate.
Assuntos
Nanopartículas Metálicas , Hidrocarbonetos Policíclicos Aromáticos , Humanos , Acenaftenos , Ouro , Colorimetria , Naftalenos , Hidrocarbonetos Policíclicos Aromáticos/químicaRESUMO
The research aims to evaluate the seasonal differences in the distribution, source, and risks of water-contaminated PAHs. The PAHs were extracted by the liquid-liquid method and analyzed with GC-MS, and a total of eight PAHs were detected. There was a percentage increase in the average concentration of the PAHs from the wet to the dry season in the range of 20 (Anthracene)-350 (Pyrene)%. Total PAHs (∑PAHs) range from 0.31 to 1.23 mg/l in the wet period and from 0.42 to 1.96 mg/l in the dry period. The distribution of the average PAHs in mg/l showed that Fluoranthene ≤ Pyrene < Acenaphthene < Fluorene < Phenanthrene < Acenaphthylene < Anthracene < Naphthalene in wet period and while Fluoranthene < Acenaphthene < Pyrene < Fluorene < Phenanthrene < Acenaphthylene < Anthracene < Naphthalene in the dry period. The children were exposed to non-carcinogenic risk through non-dietary ingestion due to the accumulative effect (HI) of the PAHs in the dry period. Furthermore, the naphthalene was responsible for ecological and carcinogenic risk in the wet period, while the fluorene, phenanthrene, and anthracene were responsible for ecological and carcinogenic risk in the dry period. However, while adults and children are both susceptible to carcinogenic risk through the oral channel during the dry period, only children are susceptible to non-carcinogenic risk through this pathway. The multivariate statistical analysis revealed the influence of physicochemical parameters on the detected PAHs and also showed the PAHs' sources to be mainly combustion, pyrolysis, and vehicular emission.
Assuntos
Fenantrenos , Hidrocarbonetos Policíclicos Aromáticos , Adulto , Criança , Humanos , Hidrocarbonetos Policíclicos Aromáticos/análise , Acenaftenos/análise , Estações do Ano , Água/análise , Fluorenos/análise , Pirenos , Naftalenos/análise , Antracenos/análise , Medição de Risco , Monitoramento AmbientalRESUMO
Polycyclic aromatic hydrocarbons (PAHs) and their oxygenated derivates (O-PAHs) are identified in soils and groundwater of industrialized sites and contribute to the risk for Humans and the Environment. Nevertheless, data are scarce in literature concerning their retention and transfer in soils and no soil - water partition coefficients are available for these compounds. Sorption of two PAHs, fluorene and acenaphthene and two O-PAHs, 9H-fluorenone and dibenzofuran onto two soils with different organic carbon contents was evaluated and compared by determining their sorption isotherms. Effect of ionic strength and liquid to solid ratio, on fluorene and fluorenone sorption was also evaluated. Sorption equilibrium is achieved within less than 24 hr of mixing and linear sorption models best fit the isotherm data. Acenaphthene and dibenzofuran are similarly sorbed onto the soil. KD of fluorene is higher than the one of fluorenone, showing a smaller affinity of fluorenone towards the solid phase. This means that O-PAH could form larger contamination plumes in groundwater than PAHs. Decreasing the L/S ratio from 100 to 50 and 30, increases the sorption of fluorenone onto the soil by 56% and 67% respectively, while the sorption of fluorene is slightly increased. Increasing the ionic strength of the aqueous phase also modifies the sorption of fluorenone, contrary to the sorption of fluorene which is slightly affected.
Assuntos
Água Subterrânea , Hidrocarbonetos Policíclicos Aromáticos , Poluentes do Solo , Acenaftenos , Adsorção , Carbono , Dibenzofuranos , Fluorenos , Humanos , Hidrocarbonetos Policíclicos Aromáticos/análise , Solo , Poluentes do Solo/análise , ÁguaRESUMO
Cycloaddition reactionsâepitomized by the Diels-Alder reactionâoffer an arguably unmatched springboard for achieving chemical complexity, often with excellent selectivity, in a modular single step. We report the synthesis of aza-acenaphthenes in a single step by an unprecedented formal peri-(3 + 2) cycloaddition of simple quinolines with alkynes. A commercially available iridium complex exerts a dual role of photosensitizer and photoredox catalyst, fostering a cyclization/rearomatization cascade. The initial energy-transfer phase leads to the acenaphthene skeleton, while the ensuing redox shuttling step leads to aromatization. We applied this technology to 8-substituted quinolines and phenanthrolines, which smoothly reacted with both terminal and internal alkynes with excellent levels of regio- and diastereoselectivity. Density functional theory calculations revealed the intertwined EnT/SET nature of the process and offered guiding design principles for the synthesis of new aza-acenaphthenes.
Assuntos
Acenaftenos , Quinolinas , Alcinos , Ciclização , Reação de CicloadiçãoRESUMO
Gepotidacin is a novel, first-in-class triazaacenaphthylene antibiotic that may provide a new treatment option for antibiotic-resistant pathogens. Two pharmacokinetic evaluations of oral gepotidacin are presented: a relative bioavailability study that guided formulation development, followed by an adult and adolescent study of the final formulation. In the relative bioavailability study, after gepotidacin administration to 26 healthy adults as free-base roller-compacted (RC) tablets, free-base high-shear wet granulation (HSWG) tablets, and mesylate salt reference capsules, the RC tablet exposure ratios and 90% confidence intervals (CIs) were within the 0.80-to-1.25 confidence bounds; however, the HSWG tablet maximum observed concentration (Cmax) was higher than the reference (ratio, 1.15; 90% CI, 1.0113, 1.3047). In the healthy adult (n = 16) and adolescent (n = 17) study, a gepotidacin mesylate salt tablet was evaluated as a 1,500-mg single dose or 2 doses administered 6 or 12 h apart (6,000 mg total), or placebo was administered. The single-dose mean Cmax was â¼27% higher in adolescents than in adults, and area under the concentration-time curve (AUC) values were comparable in both populations. After 2 doses were administered, the mean Cmax values were similar for both age groups, and the mean AUC was â¼35% higher in adolescents than in adults. Concentrations increased proportionally with dose. Safety-risk profiles were similar for both age groups. Across studies, the most common adverse events were gastrointestinal. Overall, the pharmacokinetics of the final gepotidacin mesylate salt tablet have been well characterized, enrollment of adolescents into the pivotal trials is supported, and dosing intervals were determined that should provide adequate exposures for microbiological efficacy. (This study has been registered at ClinicalTrials.gov under identifiers NCT02853435 and NCT04079790.).
Assuntos
Acenaftenos , Inibidores da Topoisomerase , Acenaftenos/farmacocinética , Administração Oral , Adolescente , Adulto , Área Sob a Curva , Disponibilidade Biológica , Estudos Cross-Over , Compostos Heterocíclicos com 3 Anéis/farmacocinética , Humanos , ComprimidosRESUMO
Gepotidacin (formerly GSK2140944) is a first-in-class triazaacenaphthylene antibacterial currently in phase III clinical trials. When tested against Gram-negative (n = 333) and Gram-positive (n = 225) anaerobes by agar dilution, gepotidacin inhibited 90% of isolates at concentrations of 4 and 2 µg/mL, respectively. Given gepotidacin's in vitro activity against the anaerobic isolates tested, further study is warranted to better understand the utility of gepotidacin in the treatment of infections caused by clinically relevant anaerobic organisms.
Assuntos
Acenaftenos , Compostos Heterocíclicos com 3 Anéis , Acenaftenos/farmacologia , Antibacterianos/farmacologia , Bactérias Gram-Positivas , Compostos Heterocíclicos com 3 Anéis/farmacologia , Testes de Sensibilidade MicrobianaRESUMO
Antibiotics are the current standard-of-care treatment for uncomplicated urinary tract infections (uUTIs). However, increasing rates of bacterial antibiotic resistance necessitate novel therapeutic options. Gepotidacin is a first-in-class triazaacenaphthylene antibiotic that selectively inhibits bacterial DNA replication by interaction with the bacterial subunits of DNA gyrase (GyrA) and topoisomerase IV (ParC). Gepotidacin is currently in clinical development for the treatment of uUTIs and other infections. In this article, we review data for gepotidacin from nonclinical studies, including in vitro activity, in vivo animal efficacy, and pharmacokinetic (PK) and pharmacokinetic/pharmacodynamic (PK/PD) models that informed dose selection for phase III clinical evaluation of gepotidacin. Based on this translational package of data, a gepotidacin 1,500-mg oral dose twice daily for 5 days was selected for two ongoing, randomized, multicenter, parallel-group, double-blind, double-dummy, active-comparator phase III clinical studies evaluating the safety and efficacy of gepotidacin in adolescent and adult female participants with uUTIs (ClinicalTrials.gov identifiers NCT04020341 and NCT04187144).
Assuntos
Acenaftenos , Infecções Urinárias , Acenaftenos/farmacologia , Adolescente , Animais , Antibacterianos/farmacologia , Ensaios Clínicos Fase III como Assunto , Feminino , Compostos Heterocíclicos com 3 Anéis/farmacologia , Humanos , Testes de Sensibilidade Microbiana , Estudos Multicêntricos como Assunto , Ensaios Clínicos Controlados Aleatórios como Assunto , Infecções Urinárias/tratamento farmacológicoRESUMO
AIMS: To develop physiologically based pharmacokinetic (PBPK) and population pharmacokinetic (PopPK) models to predict effective doses of gepotidacin in paediatrics for the treatment of pneumonic plague (Yersinia pestis). METHODS: A gepotidacin PBPK model was constructed using a population-based absorption, distribution, metabolism and excretion simulator, Simcyp®, with physicochemical and in vitro data, optimized with clinical data from a dose-escalation intravenous (IV) study and a human mass balance study. A PopPK model was developed with pooled PK data from phase 1 studies with IV gepotidacin in healthy adults. RESULTS: For both the PopPK and PBPK models, body weight was found to be a key covariate affecting gepotidacin clearance. With PBPK, ~90% of the predicted PK for paediatrics fell between the 5th and 95th percentiles of adult values except for subjects weighing ≤5 kg. PopPK-simulated paediatric means for Cmax and AUC(0-τ) were similar to adult exposures across various weight brackets. The proposed dosing regimens were weight-based for subjects ≤40 kg and fixed-dose for subjects >40 kg. Comparison of observed and predicted exposures in adults indicated that both PBPK and PopPK models achieved similar AUC and Cmax for a given dose, but the Cmax predictions with PopPK were slightly higher than with PBPK. The two models differed on dose predictions in children <3 months old. The PopPK model may be suboptimal for low age groups due to the absence of maturation characterization of drug-metabolizing enzymes involved with clearance in adults. CONCLUSIONS: Both PBPK and PopPK approaches can reasonably predict gepotidacin exposures in children.
Assuntos
Peste , Acenaftenos , Administração Intravenosa , Criança , Simulação por Computador , Compostos Heterocíclicos com 3 Anéis , Humanos , Lactente , Modelos Biológicos , Peste/tratamento farmacológicoRESUMO
RATIONALE: Various solvent supports have been developed to overcome solvent instability during liquid-phase microextraction. The hydrophobic polyurethane sponge (PS) possesses numerous cross-linked internal microchannels and terminal micropores that can facilitate steady solvent storage capacity, high extraction efficiency, extractant loading, and recycling convenience. METHODS: In this study, an easy, convenient, and efficient PS-supported liquid-phase microextraction (PS-LPME) coupled with gas chromatography-mass spectrometry (GC-MS) method was developed for the trace analysis of different organic compounds in aqueous solutions. Different extraction solvents, PS dosages, stirring speeds, and extraction times were first investigated by extracting eight polycyclic aromatic hydrocarbons (PAHs: naphthalene, acenaphthylene, acenaphthene, fluorene, phenanthrene, anthracene, fluoranthene, and pyrene), and then applied for the analysis of triazines, amides, chloroacetamides, and organophosphorus compounds. RESULTS: High enrichment factors (approximately 208-439) were observed for the monitored PAHs. Good linearities, with determination coefficients (r2 ) greater than 0.9992, were achieved in the concentration range of 0.01-50 µg L-1 . Low limits of detection and quantification were found in the ranges of 0.3-3 ng L-1 and 1-10 ng L-1 , respectively. At three spiked concentrations (0.1, 1, and 10 µg L-1 ), good recoveries were obtained in the range of 91.6-118.5% with intra- and inter-day relative standard deviations of less than 6.4% and 11.7%, respectively. CONCLUSIONS: The developed PS-LPME method coupled with GC-MS was successfully applied in the analysis of different organic compounds in aqueous solutions and has shown great convenience and satisfactory enrichment performance in microextraction analysis.
Assuntos
Fenantrenos , Hidrocarbonetos Policíclicos Aromáticos , Poluentes Químicos da Água , Acenaftenos/análise , Amidas , Antracenos/análise , Fluorenos/análise , Limite de Detecção , Compostos Organofosforados , Fenantrenos/análise , Hidrocarbonetos Policíclicos Aromáticos/análise , Poliuretanos , Pirenos , Solventes/química , Triazinas/análise , Água/química , Poluentes Químicos da Água/análiseRESUMO
Self-assembly of (Bu4N)4[ß-Mo8O26], AgNO3, and 2-bis[(2,6-diisopropylphenyl)-imino]acenaphthene (dpp-bian) in DMF solution resulted in the (Bu4N)2[ß-{Ag(dpp-bian)}2Mo8O26] (1) complex. The complex was characterized by single crystal X-ray diffraction (SCXRD), X-ray powder diffraction (XRPD), diffuse reflectance (DR), infrared spectroscopy (IR), and elemental analysis. Comprehensive SCXRD studies of the crystal structure show the presence of Ag+ in an uncommon coordination environment without a clear preference for Ag-N over Ag-O bonding. Quantum chemical calculations were performed to qualify the nature of the Ag-N/Ag-O interactions and to assign the electronic transitions observed in the UV-Vis absorption spectra. The electrochemical behavior of the complex combines POM and redox ligand signatures. Complex 1 demonstrates catalytic activity in the electrochemical reduction of CO2.
Assuntos
Acenaftenos , Dióxido de Carbono , Acenaftenos/química , Ligantes , Estrutura Molecular , Eletroquímica , Modelos MolecularesRESUMO
Smoked cheeses are particularly popular among consumers for their flavor and aroma. Of interest, therefore, is the health aspect related to the likelihood of polycyclic aromatic hydrocarbons (PAHs), which are known carcinogens found in smoked products. Thus, the purpose of this study was to evaluate the occurrence of 15 polycyclic aromatic hydrocarbons (PAHs) in smoked and non-smoked cheeses purchased in Poland to monitor their safety. The level of selected PAHs in cheese samples was determined using the HPLC-DAD-FLD method. Most of the cheeses tested met the maximum level of benzo[a]pyrene (2 µg/kg) and the sum of benz[a]anthracene, chrysene, benzo[b]fluoranthene and benzo[a]pyrene (12 µg/kg) established for these products. However, all the cheeses studied in this work had relatively low amounts of the sum of these compounds compared to the information available in the cheese literature, ranging from Assuntos
Queijo
, Fenantrenos
, Hidrocarbonetos Policíclicos Aromáticos
, Hidrocarbonetos Policíclicos Aromáticos/análise
, Crisenos
, Fumaça
, Cromatografia Líquida de Alta Pressão
, Benzo(a)pireno/análise
, Polônia
, Acenaftenos
, Fluorenos
, Carcinógenos
, Antracenos