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1.
Proc Natl Acad Sci U S A ; 121(23): e2403131121, 2024 Jun 04.
Artículo en Inglés | MEDLINE | ID: mdl-38805267

RESUMEN

The renal elimination pathway is increasingly harnessed to reduce nonspecific accumulation of engineered nanoparticles within the body and expedite their clinical applications. While the size of nanoparticles is recognized as crucial for their passive filtration through the glomerulus due to its limited pore size, the influence of nanoparticle charge on their transport and interactions within the kidneys remains largely elusive. Herein, we report that the proximal tubule and peritubular capillary, rather than the glomerulus, serve as primary charge barriers to the transport of charged nanoparticles within the kidney. Employing a series of ultrasmall, renal-clearable gold nanoparticles (AuNPs) with precisely engineered surface charge characteristics as multimodal imaging agents, we have tracked their distribution and retention across various kidney components following intravenous administration. Our results reveal that retention in the proximal tubules is governed not by the nanoparticle's zeta-potential, but by direct Coulombic interactions between the positively charged surface ligands of the AuNPs and the negatively charged microvilli of proximal tubules. However, further enhancing these interactions leads to increased binding of the positively charged AuNPs to the peritubular capillaries during the initial phase of elimination, subsequently facilitating their slow passage through the glomeruli and interaction with tubular components in a charge-selective manner. By identifying these two critical charge-dependent barriers in the renal transport of nanoparticles, our findings offer a fundamental insight for the design of renal nanomedicines tailored for selective targeting within the kidney, laying down a foundation for developing targeting renal nanomedicines for future kidney disease management in the clinics.


Asunto(s)
Oro , Nanopartículas del Metal , Oro/química , Nanopartículas del Metal/química , Animales , Ratones , Túbulos Renales Proximales/metabolismo , Eliminación Renal , Riñón/metabolismo , Masculino
2.
Proc Natl Acad Sci U S A ; 120(18): e2221097120, 2023 05 02.
Artículo en Inglés | MEDLINE | ID: mdl-37094155

RESUMEN

Western dietary patterns have been unfavorably linked with mental health. However, the long-term effects of habitual fried food consumption on anxiety and depression and underlying mechanisms remain unclear. Our population-based study with 140,728 people revealed that frequent fried food consumption, especially fried potato consumption, is strongly associated with 12% and 7% higher risk of anxiety and depression, respectively. The associations were more pronounced among male and younger consumers. Consistently, long-term exposure to acrylamide, a representative food processing contaminant in fried products, exacerbates scototaxis and thigmotaxis, and further impairs exploration ability and sociality of adult zebrafish, showing anxiety- and depressive-like behaviors. Moreover, treatment with acrylamide significantly down-regulates the gene expression of tjp2a related to the permeability of blood-brain barrier. Multiomics analysis showed that chronic exposure to acrylamide induces cerebral lipid metabolism disturbance and neuroinflammation. PPAR signaling pathway mediates acrylamide-induced lipid metabolism disorder in the brain of zebrafish. Especially, chronic exposure to acrylamide dysregulates sphingolipid and phospholipid metabolism, which plays important roles in the development of anxiety and depression symptoms. In addition, acrylamide promotes lipid peroxidation and oxidation stress, which participate in cerebral neuroinflammation. Acrylamide dramatically increases the markers of lipid peroxidation, including (±)5-HETE, 11(S)-HETE, 5-oxoETE, and up-regulates the expression of proinflammatory lipid mediators such as (±)12-HETE and 14(S)-HDHA, indicating elevated cerebral inflammatory status after chronic exposure to acrylamide. Together, these results both epidemiologically and mechanistically provide strong evidence to unravel the mechanism of acrylamide-triggered anxiety and depression, and highlight the significance of reducing fried food consumption for mental health.


Asunto(s)
Metabolismo de los Lípidos , Pez Cebra , Masculino , Animales , Depresión , Enfermedades Neuroinflamatorias , Acrilamida , Ansiedad , Contaminación de Alimentos/análisis
3.
Angew Chem Int Ed Engl ; 62(45): e202308909, 2023 11 06.
Artículo en Inglés | MEDLINE | ID: mdl-37688526

RESUMEN

The elevated glutathione (GSH) level in solid tumors has been used as a major hallmark for GSH-responsive nanoparticles to enhance targeting efficiency and specificity. Meanwhile, GSH is mainly synthesized inside the hepatocytes of the liver in the body and constantly released into the blood through hepatic GSH efflux to regulate redox potential of the entire body. However, it remains largely unknown how this hepatic GSH efflux affects the tumor targeting of GSH-responsive nanoparticles. Herein, we report that depletion of hepatic GSH enhanced the tumor targeting of GSH-responsive indocyanine green-conjugated Au25 nanoclusters coated with 18 GSH ligand (ICG-Au25 SG18 ). The dissociation of ICG from Au25 SG18 by the hepatic GSH through thiol-exchange reaction and the subsequent hepatobiliary clearance of the detached ICG were slowed down by GSH depletion, which in turn prolonged the blood circulation of intact ICG-Au25 SG18 and enhanced its tumor targeting. Our work highlights glutathione-mediated crosstalk between the liver and tumor, in addition to well-known Kupffer cell-mediated uptake, in the tumor targeting of engineered nanoparticles, which could be modulated to enhance targeting efficiency and specificity of cancer nanomedicines while reducing their nonspecific accumulation.


Asunto(s)
Nanopartículas del Metal , Nanopartículas , Neoplasias , Humanos , Verde de Indocianina , Oro , Hígado , Glutatión , Línea Celular Tumoral
4.
Ther Drug Monit ; 44(3): 377-383, 2022 06 01.
Artículo en Inglés | MEDLINE | ID: mdl-35094001

RESUMEN

BACKGROUND: The clinical guidelines suggest that the dosing of cyclosporine (CsA), during combination therapy with paritaprevir/ritonavir-ombitasvir and dasabuvir (PrOD), would be only one-fifth of the pre-PrOD total daily dose to be administered once daily. However, this dosing may not be applicable to all patients depending on their clinical condition. This study focuses on the pharmacokinetic dynamics of PrOD with CsA in Asian organ transplant recipients with severe liver fibrosis or cirrhosis who undergo concurrent treatment with PrOD treatment and CsA. The efficacy and safety of PrOD treatment was also evaluated. METHODS: Data from 7 patients obtained between January 2017 and September 2017 were retrospectively analyzed. Determinations of the blood concentrations of CsA were made, whether used as a single treatment or in combination therapy with PrOD. RESULTS: The combination regimen compared with CsA administered alone resulted in a 4.53-fold and 5.52-fold increase in the area under the concentration-time curve from time 0-12 hours (AUC0-12 h) of CsA on days 1 and 15, respectively. In addition, the maximal concentration, time to maximum concentration, and terminal phase elimination half-life (t1/2) of CsA were increased during the combined treatment of PrOD and CsA. The authors proposed reducing the CsA dosage during PrOD treatment to one-seventh of that of the pre-PrOD treatment of the total daily dose to maintain target CsA levels. All patients achieved sustained virologic responses at week 12. There were no episodes of serious adverse events or graft rejections observed. CONCLUSIONS: Although the combination with PrOD significantly affects the pharmacokinetics of CsA, it is effective and safe with regular monitoring of the CsA blood concentrations and appropriate CsA dose adjustment.


Asunto(s)
Hepatitis C , Compuestos Macrocíclicos , Trasplante de Órganos , 2-Naftilamina , Anilidas/uso terapéutico , Antivirales/efectos adversos , Carbamatos , Ciclopropanos , Ciclosporina/farmacología , Ciclosporina/uso terapéutico , Interacciones Farmacológicas , Quimioterapia Combinada , Hepacivirus , Hepatitis C/tratamiento farmacológico , Humanos , Lactamas Macrocíclicas , Cirrosis Hepática/tratamiento farmacológico , Compuestos Macrocíclicos/uso terapéutico , Prolina/análogos & derivados , Estudios Retrospectivos , Ribavirina/uso terapéutico , Ritonavir , Sulfonamidas , Uracilo/análogos & derivados , Valina
5.
Psychol Res ; 86(7): 2059-2066, 2022 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-35048198

RESUMEN

Relative to audition, vision is considered much less trustworthy in sensorimotor timing such as synchronizing finger movements with a temporally regular sequence. Visuomotor timing requires maintaining attention over time, whereas the sustained visual attention may not be well held in conventional visuomotor timing task settings where flashing visual stimuli consisted of a briefly presented flash and a long blank period. In the present study, the potential attentional lapses in time due to the disappearance of the flash were carefully controlled in Experiment 1 by changing the color of the flash instead of its disappearance, or in Experiment 2 by adding an additional continuously presented fixation point serving as an external attentional cue when the flash disappeared. Improvement of visuomotor timing performance was found in both experiments. The finding suggests a role of enhanced sustained visual attention in improving visuomotor timing, by which vision could also be a trustworthy modality for processing temporal information in sensorimotor interactions.


Asunto(s)
Percepción Auditiva , Percepción Visual , Humanos
6.
Bioconjug Chem ; 31(5): 1522-1528, 2020 05 20.
Artículo en Inglés | MEDLINE | ID: mdl-32353229

RESUMEN

The coming era of precision nanomedicine demands engineered nanoparticles that can be readily translated into the clinic, like that of molecular agents, without being hindered by intrinsic size heterogeneity and long-term body retention. Herein we report that conjugation of indocyanine green (ICG), an FDA-approved near-infrared (NIR) dye, onto an atomically precise glutathione-coated Au25 (GS-Au25) nanocluster led to a molecular-like photothermal nanoparticle (ICG4-GS-Au25) with significantly enhanced ICG photostability and tumor targeting. Under weak NIR light irradiation conditions, free ICG failed to suppress tumor growth but the original tumors were completely eradicated with ICG4-GS-Au25. In the meantime, "off-target" ICG4-GS-Au25 was effectively cleared out from the body like small-molecule drugs after glutathione-mediated biotransformation in the liver. These findings highlight the merits of molecular-like nanomedicines, offering a new pathway to meet FDA's criteria for the clinical translation of nanomedicines.


Asunto(s)
Oro/química , Oro/farmacología , Verde de Indocianina/química , Nanopartículas del Metal/química , Nanomedicina/métodos , Terapia Fototérmica/métodos , Línea Celular Tumoral , Proliferación Celular/efectos de los fármacos , Proliferación Celular/efectos de la radiación , Glutatión/química , Oro/uso terapéutico , Humanos
7.
Bioconjug Chem ; 31(2): 241-247, 2020 02 19.
Artículo en Inglés | MEDLINE | ID: mdl-31697893

RESUMEN

Subtle changes in size can induce distinct responses of the body to hard nanomaterials; however, it is largely unknown whether just a few ethylene oxide unit differences in soft poly(ethylene glycol) (PEG) molecules could significantly alter the renal clearance of small molecules. By systematically investigating in vivo transport of the representative renal clearable organic dyes, IRDye800CW after being conjugated with a series of PEG molecules with molecular weight (MW) below 10 kDa, we found a MW-dependent scaling law: PEG45 (MW = 2100 Da) is an optimized MW to generate the most efficient renal clearance for IRDye800CW by expediting the glomerular filtration of organic dyes and reducing their nonspecific interactions with background tissue. Moreover, the uniqueness of PEG45 can be generalized to other organic dyes such as ZW800-1 and fluorescein. This finding highlights the importance of low-MW PEGylation in tailoring in vivo transport of organic fluorophores, which would broaden their biomedical applications.


Asunto(s)
Colorantes/metabolismo , Riñón/metabolismo , Polietilenglicoles/metabolismo , Animales , Transporte Biológico , Colorantes/análisis , Ratones Endogámicos BALB C , Peso Molecular , Imagen Óptica , Polietilenglicoles/análisis
8.
Nanotechnology ; 31(32): 325505, 2020 Aug 07.
Artículo en Inglés | MEDLINE | ID: mdl-32299070

RESUMEN

Heterojunctions are an important strategy for designing high performance electrical sensor materials and related devices. Herein, a new type of metal-semiconductor hybrid nanoparticle has been successfully used to remarkably sensitize the surface of ZnO nanowires for detecting NO2 with high responses over a broad temperature window ranging from room temperature to 600 °C. These hybrid nanoparticles are comprised of iron oxide nanowires with well dispersed single crystalline Au nanoparticles. The hybrid nanoparticle decorated ZnO nanowires have achieved a giant response, as high as 74 500 toward NO2 gas, about 42 times that of Au decorated ZnO nanowire sensors. This dramatic enhancement may be attributed to the efficient charge transfer across the Au-Fe2O3 Schottky and Fe2O3-ZnO semiconductor heterojunction interfaces. Due to the incorporation of thermally-stable Fe2O3 nanoparticles as the support of Au nanoparticles, the working temperature of nanowire sensors was successfully extended to higher temperatures, with an increase of 200 °C, from 400 °C to 600 °C. Such a combination of semiconductor heterojunction and semiconductor-metal Schottky contact presents a new strategy for designing high performance electrical sensors with high sensitivity, stability, selectivity, and wide operation temperature window, which are potentially suitable for advanced energy systems such as automotive engines and power plants.

9.
Psychol Res ; 84(7): 2046-2056, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31190091

RESUMEN

Timing is essential for various behaviors and relative to vision, audition is considered to be specialized for temporal processing. The present study conducted a sensorimotor timing task that required tapping in synchrony with a temporally regular sequence and a perceptual timing task that required detecting a timing deviation among a temporally regular sequence. The sequence was composed of auditory tones, visual flashes, or a visual bouncing ball. In the sensorimotor task, sensorimotor timing performance (synchronization stability) of the bouncing ball was much greater than that of flashes and was comparable to that of tones. In the perceptual task, where perceptual timing performance of the bouncing ball was greater than that of flashes, it was poorer than that of tones. These results suggest the facilitation of both perceptual and sensorimotor processing of temporal information by the bouncing ball. Given such facilitation of temporal processing, however, audition is still superior over vision in perceptual detection of timing.


Asunto(s)
Percepción Auditiva/fisiología , Desempeño Psicomotor/fisiología , Percepción del Tiempo/fisiología , Percepción Visual/fisiología , Adulto , Femenino , Humanos , Masculino , Adulto Joven
10.
Psychol Res ; 84(2): 343-351, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-29955958

RESUMEN

Researchers have puzzled over the phenomenon in sensorimotor timing that people tend to tap ahead of time. When synchronizing movements (e.g., finger taps) with an external sequence (e.g., a metronome), humans typically tap tens of milliseconds before event onsets, producing the elusive negative asynchrony. Here, we present 24 metronome-tapping data sets from 8 experiments with different experimental settings, showing that less negative asynchrony is associated with lower tapping variability. Further analyses reveal that this negative mean-SD correlation of asynchrony is likely to be observed for sequence types appropriate for synchronization, as indicated by the statistically negative lag 1 autocorrelation of inter-response intervals. The reported findings indicate an association between negative asynchrony and timing variability.


Asunto(s)
Movimiento/fisiología , Desempeño Psicomotor/fisiología , Tiempo de Reacción/fisiología , Percepción del Tiempo/fisiología , Adolescente , Femenino , Dedos/fisiología , Humanos , Masculino , Factores de Tiempo , Adulto Joven
11.
Angew Chem Int Ed Engl ; 59(45): 19894-19898, 2020 11 02.
Artículo en Inglés | MEDLINE | ID: mdl-32705738

RESUMEN

Salivary elimination is an important pathway for the body to excrete small molecules with digestive enzymes. However, very few engineered nanoparticles can be excreted through salivary glands, which often host bacteria or viruses during infection and involve in disease transmission. Herein, we report that renal clearable glutathione coated AgNPs (GS-AgNPs) can selectively accumulate in the submandibular salivary gland, followed by being excreted in its excretory duct. By conducting head-to-head comparison on in vivo transport and interactions of both GS-AgNPs and glutathione coated gold nanoparticles (GS-AuNPs) with the same sizes, we found that low-density GS-AgNPs showed much higher vascular permeability than GS-AuNPs and can rapidly penetrate into submandibular salivary glands, be efficiently taken up by striated and excretory duct cells, and eventually secreted into saliva.


Asunto(s)
Nanopartículas del Metal/química , Eliminación Salival , Plata/química , Animales , Humanos , Ratones , Glándula Submandibular/metabolismo , Distribución Tisular
12.
Angew Chem Int Ed Engl ; 58(25): 8479-8483, 2019 06 17.
Artículo en Inglés | MEDLINE | ID: mdl-31006932

RESUMEN

Precise control of in vivo transport of anticancer drugs in normal and cancerous tissues with engineered nanoparticles is key to the future success of cancer nanomedicines in clinics. This requires a fundamental understanding of how engineered nanoparticles impact the targeting-clearance and permeation-retention paradoxes in the anticancer-drug delivery. Herein, we systematically investigated how renal-clearable gold nanoparticles (AuNPs) affect the permeation, distribution, and retention of the anticancer drug doxorubicin in both cancerous and normal tissues. Renal-clearable AuNPs retain the advantages of the free drug, including rapid tumor targeting and high tumor vascular permeability. The renal-clearable AuNPs also accelerated body clearance of off-target drug via renal elimination. These results clearly indicate that diverse in vivo transport behaviors of engineered nanoparticles can be used to reconcile long-standing paradoxes in the anticancer drug delivery.


Asunto(s)
Antibióticos Antineoplásicos/metabolismo , Doxorrubicina/metabolismo , Oro/metabolismo , Riñón/metabolismo , Nanopartículas del Metal/química , Animales , Antibióticos Antineoplásicos/química , Antibióticos Antineoplásicos/farmacología , Proliferación Celular/efectos de los fármacos , Doxorrubicina/química , Doxorrubicina/farmacología , Sistemas de Liberación de Medicamentos , Oro/química , Humanos , Riñón/química , Células MCF-7 , Neoplasias Mamarias Experimentales/diagnóstico por imagen , Neoplasias Mamarias Experimentales/tratamiento farmacológico , Ratones , Estructura Molecular , Imagen Óptica , Tamaño de la Partícula , Propiedades de Superficie
13.
Genesis ; 56(11-12): e23261, 2018 12.
Artículo en Inglés | MEDLINE | ID: mdl-30375740

RESUMEN

MAB21L2(R51C) is one of the five documented MAB21L2 mutations in human patients with bilateral eye malformations identified via whole exome sequencing. In addition to the eye abnormality, patients with MAB21L2 R51C/+ mutation also have skeletal dysplasia and intellectual disability. To evaluate the pathology of this mutant allele systematically in understanding the functional role of MAB21L2 in human development, we introduce the R51C mutation into the mouse genome by CRISPR/Cas9 system to generate a mouse model for detailed characterization. The Mab21l2 R51C/+ mice have eyeless phenotype and skeletal abnormalities. Micro-computed tomography (micro-CT) analysis showed the Mab21l2 R51C/+ mice have no eye balls but with two abnormal tissues underneath the brain. Histological analysis revealed that the early eye development in the mutant embryos is interrupted. In addition, Mab21l2 R51C/+ mice also have joint fusion phenotype; the humerus is fused with radius, whereas femur is fused with tibia. Limbs in the mutant animals are distinctly shorter than the wild type; and deltoid tuberosities in humeri are absent in these Mab21l2 R51C/+ mice. In summary, we showed that our Mab21l2 R51C/+ mutant mice have recapitulated the pathological features in eye and bone of human patients. Further analyses of the mutant phenotype with molecular markers will provide insight on how MAB21L2 guides the optic differentiation and skeletogenesis, revealing specific underlying pathogenic mechanism of the MAB21L2(R51C) mutation.


Asunto(s)
Anomalías del Ojo/genética , Proteínas del Ojo/genética , Péptidos y Proteínas de Señalización Intracelular/genética , Anomalías Musculoesqueléticas/genética , Fenotipo , Animales , Modelos Animales de Enfermedad , Ratones , Mutación Missense , Síndrome
14.
Bioconjug Chem ; 29(6): 1841-1846, 2018 06 20.
Artículo en Inglés | MEDLINE | ID: mdl-29775044

RESUMEN

Fundamental understanding of how the hydrophobicity impacts cellular interactions of engineered nanoparticles is critical to their future success in healthcare. Herein, we report that inserting hydrophobic octanethiol onto the surface of zwitterionic luminescent glutathione coated gold nanoparticles (GS-AuNPs) of 2 nm enhanced their affinity to the cellular membrane and increased cellular uptake kinetics by more than one order of magnitude, rather than inducing the accumulation of the AuNPs in the bilayer core or enhancing their passive diffusion. These studies highlight the diversity and heterogeneity in the hydrophobicity-induced nano-bio interactions at the cellular level and offer a new pathway to expediting cellular uptake of engineered nanoparticles. In addition, the amphiphilic luminescent AuNPs with high affinity to cell membrane and rapid endocytosis potentially serve as dual-modality imaging probes to correlate fluorescence and electron microscopies at the cellular level.


Asunto(s)
Glutatión/metabolismo , Oro/metabolismo , Sustancias Luminiscentes/metabolismo , Nanopartículas/metabolismo , Compuestos de Sulfhidrilo/metabolismo , Membrana Celular/metabolismo , Difusión , Endocitosis , Glutatión/química , Oro/química , Células HeLa , Humanos , Interacciones Hidrofóbicas e Hidrofílicas , Luminiscencia , Sustancias Luminiscentes/química , Nanopartículas/química , Imagen Óptica , Tamaño de la Partícula , Compuestos de Sulfhidrilo/química , Propiedades de Superficie
15.
Phytother Res ; 31(8): 1119-1127, 2017 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-28504367

RESUMEN

The autophagy-lysosome pathway (ALP) is a primary means by which damaged organelles and long-lived proteins are removed from cells and their components recycled. Impairment of the ALP has been found to be linked to the pathogenesis of Parkinson's disease (PD), a chronic neurodegenerative disorder characterized by the accumulation of protein aggregates and loss of dopaminergic neurons in the midbrain. In recent years, some active compounds derived from plants have been found to regulate the ALP and to exert neuroprotective effects in experimental models of PD, raising the possibility that autophagy enhancement may be an effective therapeutic strategy in PD treatment. In this review, we summarize recent findings of natural products that enhance ALP and thereby protect against PD. Research articles were retrieved from PubMed using relevant keywords in combination. Papers related to the topic were identified, and then the reliability of the experiments was assessed in terms of methodology. The results suggest that targeting the ALP with natural products is a promising strategy for PD treatment. However, risk of bias exists in some studies due to the defective methodology. Rigorous experimental design following the guidelines of autophagy assays, molecular target identification and in vivo efficacy evaluation is critical for the development of ALP enhancers for PD treatment in future studies. Copyright © 2017 John Wiley & Sons, Ltd.


Asunto(s)
Autofagia/efectos de los fármacos , Productos Biológicos/farmacología , Lisosomas/efectos de los fármacos , Fármacos Neuroprotectores/farmacología , Enfermedad de Parkinson/tratamiento farmacológico , Animales , Neuronas Dopaminérgicas/patología , Humanos
16.
Int J Mol Sci ; 18(2)2017 Jan 28.
Artículo en Inglés | MEDLINE | ID: mdl-28134846

RESUMEN

Hippocampal neurogenesis plays a critical role in the formation of new neurons during learning and memory development. Attenuation of neurogenesis in the brain is one of the primary causes of dementia in Alzheimer's disease (AD), and, conversely, modulating the process of hippocampal neurogenesis benefit patients with AD. Traditional Chinese medicine (TCM), particularly herbal medicine, has been in use for thousands of years in Asia and many regions of the world for the treatment of cancer, cardiovascular diseases and neurodegenerative diseases. In this review, we summarize the role of neurotrophic factors, signal transducing factors, epigenetic modulators and neurotransmitters in neurogenesis, and we also discuss the functions of several Chinese herbs and their active molecules in activating multiple pathways involved in neurogenesis. TCM herbs target pathways such as Notch, Wnt, Sonic Hedgehog and receptor tyrosine kinase pathway, leading to activation of a signaling cascade that ultimately enhances the transcription of several important genes necessary for neurogenesis. Given these pathway activating effects, the use of TCM herbs could be an effective therapeutic strategy for the treatment of AD.


Asunto(s)
Enfermedad de Alzheimer/tratamiento farmacológico , Neurogénesis , Animales , Humanos , Medicina Tradicional China , Transducción de Señal
17.
Pharmacoepidemiol Drug Saf ; 25(6): 661-7, 2016 06.
Artículo en Inglés | MEDLINE | ID: mdl-26799240

RESUMEN

PURPOSE: During the past two decades, many novel immunosuppressive drugs have been approved for transplant recipients. Trends in the use of maintenance immunosuppressants after liver transplantation in Asia are unclear. Thus, we aimed to analyze the prescription trends in maintenance immunosuppressive drugs among liver transplant recipients in Taiwan and compare the results with the trends reported from western countries. METHODS: We conducted a retrospective nationwide population-based study utilizing the National Health Insurance Research Database (NHIRD) to analyze the prescribing patterns of immunosuppressants used in Taiwanese liver transplant recipients from 2000 to 2009. RESULTS: A total of 1686 liver transplant patients and their prescriptions of immunosuppressants were analyzed. The 5-year survival rate of liver transplant recipients was 79.6%. In 2009, the major immunosuppressive therapy among liver transplant recipients was a dual-drug regimen with tacrolimus and mycophenolic acid (57.3%). Among the calcineurin inhibitors (CNI), the use of cyclosporine decreased from 58.9% to 12.5%, while the use of tacrolimus notably increased from 23.3% to 77.5%. The use of azathioprine decreased from 21.3% to 0.4%, while the use of mycophenolic acid increased from 56.1% to 76.5%. Among the mammalian target of rapamycin (mTOR) inhibitors, sirolimus was approved in 2002, and its use increased to 8.7% in 2009. In the first 3 months after liver transplantation, a total of 17 different regimens were used in 2009, compared with seven regimens in 2000. CONCLUSIONS: Although the CNI-based combination obviously remains the major regimen, our results reveal a trend toward individualized immunosuppressive regimens among Taiwanese liver transplant recipients. Copyright © 2016 John Wiley & Sons, Ltd.


Asunto(s)
Inhibidores de la Calcineurina/administración & dosificación , Inmunosupresores/administración & dosificación , Trasplante de Hígado/métodos , Pautas de la Práctica en Medicina/estadística & datos numéricos , Adulto , Bases de Datos Factuales , Quimioterapia Combinada , Femenino , Estudios de Seguimiento , Humanos , Inmunosupresores/farmacología , Masculino , Persona de Mediana Edad , Medicina de Precisión , Estudios Retrospectivos , Tasa de Supervivencia , Taiwán , Factores de Tiempo , Adulto Joven
18.
Pharmacoepidemiol Drug Saf ; 23(12): 1312-9, 2014 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-25335855

RESUMEN

PURPOSE: Significantly increasing heart transplantations have been performed in Taiwan in the past decades, but the trends of maintenance immunosuppression for heart transplant recipients have not been well known. In this study, we aimed to explore the trends of maintenance immunosuppressive therapy and common complications for heart transplant recipients. METHODS: We retrospectively analyzed ambulatory prescriptions in 488 heart transplant recipients for the period 2000-2009. Patient complications after heart transplantation were also identified. RESULTS: The annual number of new heart transplant recipients ranged from 18 to 68. The 5-year survival rate was 77.9%. The total number of regimens was 10 in 2000, and increased to 28 in 2009. Most prescriptions were immunosuppressive combinations (95.5%-89.5%). The majority of immunosuppressive regimens were a triple regimen: cyclosporine, mycophenolic acid and corticosteroid in 2009. Cyclosporine was a predominant calcineurin inhibitor with a decreasing trend from 73.9% to 59.1%, whereas the use of tacrolimus significantly increased from 11.9% to 38.4%. Mycophenolic acid was the most frequently used antimetabolite (60.1%-80.3%), while the use of azathioprine was reduced (21.6%-2.3%). From 2008, the launch of everolimus initiated a new era in the utilization of mammalian target of rapamycin inhibitors for maintenance immunosuppression. CONCLUSIONS: Cyclosporine remained the most frequently used calcineurin inhibitors, and tacrolimus increased gradually. Mycophenolic acid was the most popular antimetabolite rather than azathioprine. The rapidly increased everolimus combined regimen may change the patterns of maintenance immunosuppression. The increasing number of combination therapies indicates an active role of everolimus and a tendency of complex tailored individual therapies.


Asunto(s)
Rechazo de Injerto/tratamiento farmacológico , Trasplante de Corazón , Inmunosupresores/uso terapéutico , Pautas de la Práctica en Medicina/tendencias , Receptores de Trasplantes/estadística & datos numéricos , Quimioterapia Combinada , Historia del Siglo XXI , Humanos , Estudios Retrospectivos , Taiwán , Factores de Tiempo
19.
Front Oncol ; 14: 1362160, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38725630

RESUMEN

Sarcomatoid carcinoma (SC) is a rare, complex, aggressive tumor that spreads rapidly, is highly malignant, and has metastasized. Surgical resection is the primary treatment, and it usually occurs in the lungs and kidneys but rarely in the neck. Patients with advanced sarcomatoid carcinoma (SC) of the head and neck (HN) have a poor progonsis. In recent years, immune checkpoint inhibitors (ICIs) have been established as treatments for many solid tumors; however, the effectiveness of ICIs in treating SC of HN is still little recognized. We report a case study of a middle-aged woman with primary sarcomatoid carcinoma of the neck. She developed sarcomatoid carcinoma of the contralateral neck 7 months after the first surgical treatment. Subsequently, disease recurrence and metastasis occurred 8 months after the second surgery. The patient did not receive any treatment after both surgeries. The tumor showed high programmed death-ligand 1 (PD-L1) expression, with a combined positive score (CPS): 95. The patient's response to treatment was assessed as partial remission (PR) after 2 cycles of anlotinib combined with sintilimab. The patient has survived for over 2 years and remains in PR status, despite experiencing grade 2 hypothyroidism as an adverse event during treatment. The case highlights the efficacy and safety of anlotinib and sintilimab as a first-line treatment.

20.
Nat Rev Nephrol ; 20(6): 354-370, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38409369

RESUMEN

Kidney disease affects more than 10% of the global population and is associated with considerable morbidity and mortality, highlighting a need for new therapeutic options. Engineered nanoparticles for the treatment of kidney diseases (renal nanomedicines) represent one such option, enabling the delivery of targeted therapeutics to specific regions of the kidney. Although they are underdeveloped compared with nanomedicines for diseases such as cancer, findings from preclinical studies suggest that renal nanomedicines may hold promise. However, the physiological principles that govern the in vivo transport and interactions of renal nanomedicines differ from those of cancer nanomedicines, and thus a comprehensive understanding of these principles is needed to design nanomedicines that effectively and specifically target the kidney while ensuring biosafety in their future clinical translation. Herein, we summarize the current understanding of factors that influence the glomerular filtration, tubular uptake, tubular secretion and extrusion of nanoparticles, including size and charge dependency, and the role of specific transporters and processes such as endocytosis. We also describe how the transport and uptake of nanoparticles is altered by kidney disease and discuss strategic approaches by which nanoparticles may be harnessed for the detection and treatment of a variety of kidney diseases.


Asunto(s)
Enfermedades Renales , Nanomedicina , Nanopartículas , Humanos , Nanomedicina/métodos , Riñón/metabolismo , Riñón/fisiología , Animales , Sistemas de Liberación de Medicamentos , Tasa de Filtración Glomerular
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