RESUMO
The current treatments available for anxiety and depression are only palliative. Full remission has remained elusive, characterizing unmet medical needs. In the scope of an academic drug discovery program, we describe here the design, synthesis, in vitro metabolism prediction and pharmacological characterization of a new piperazine compound, 1-(4-methoxyphenyl)-4-((1-phenyl-1H-pyrazol-4-yl)methyl)piperazine (LQFM005), and of its main putative metabolite, 4-(4-((4-(4-methoxyphenyl)piperazin-1-yl)methyl)- 1H-pyrazol-1-yl)phenol (LQFM235). The production of the metabolite was initially performed by in vitro biotransformation of LQFM005 using Aspergillus candidus and then by chemical synthesis. Oral administration of either 12 or 24 µmol/kg LQFM005 to mice did not affect spontaneous locomotor activity but increased the time spent in the center of the open field. Both LQFM005 and LQFM235 (24 µmol/kg) increased the time spent by the mice in the open arms of the elevated plus maze (EPM), a good indication of anxiolytic-like effect, and decreased the immobility time in the forced swimming test (FST), suggesting an antidepressant-like effect. The previous administration of WAY-100635 (a 5-HT1A antagonist) abolished the effects of LQFM005 in both EPM and FST. Binding experiments showed that LQFM005 and its metabolite bind to the 5-HT1A receptor with a moderate affinity (Ki around 5-9 µM). The two compounds are relatively safe, as indicated by cytotoxic assessment using the 3T3 fibroblast cell line and estimated LD50 around 600 mg/kg. In conclusion, oral administration of the newly synthesized phenylpiperazines produced anxiolytic- and antidepressant-like effects in behavioral tests, putatively in part through the activation of 5-HT1A receptors.
Assuntos
Ansiolíticos/farmacologia , Antidepressivos/farmacologia , Ansiedade/tratamento farmacológico , Depressão/tratamento farmacológico , Piperazinas/farmacologia , Animais , Comportamento Animal/efeitos dos fármacos , Locomoção , Masculino , Camundongos , Piperazinas/antagonistas & inibidores , Piperazinas/metabolismo , Piridinas/antagonistas & inibidores , NataçãoRESUMO
Many chemotherapeutic drugs produce double-strand breaks (DSB) on cancer cell DNA, thereby inducing cell death. However, the DNA damage response (DDR) enables cancer cells to overcome DNA damage and escape cell death, often leading to therapeutic resistance and unsuccessful outcomes. It is therefore important to develop inhibitors that target DDR proteins to render cancer cells hypersensitive to DNA damage. Here, we investigated the applicability of PFI-3, a recently developed bromodomain inhibitor specifically targeting the SWI/SNF chromatin remodeler that functions to promote DSB repair, in cancer treatment. We verified that PFI-3 effectively blocks chromatin binding of its target bromodomains and dissociates the corresponding SWI/SNF proteins from chromatin. We then found that, while having little toxicity as a single agent, PFI-3 synergistically sensitizes several human cancer cell lines to DNA damage induced by chemotherapeutic drugs such as doxorubicin. This PFI-3 activity occurs only for the cancer cells that require SWI/SNF for DNA repair. Our mechanism studies show that PFI-3 exerts the DNA damage-sensitizing effect by directly blocking SWI/SNF's chromatin binding, which leads to defects in DSB repair and aberrations in damage checkpoints, eventually resulting in increase of cell death primarily via necrosis and senescence. This work therefore demonstrates the activity of PFI-3 to sensitize cancer cells to DNA damage and its mechanism of action via SWI/SNF targeting, providing an experimental rationale for developing PFI-3 as a sensitizing agent in cancer chemotherapy. IMPLICATIONS: This study, revealing the activity of PFI-3 to sensitize cancer cells to chemotherapeutic drugs, provides an experimental rationale for developing this bromodomain inhibitor as a sensitizing agent in cancer chemotherapy.
Assuntos
Compostos Azabicíclicos/antagonistas & inibidores , Compostos Azabicíclicos/uso terapêutico , Proteínas Cromossômicas não Histona/genética , Dano ao DNA/genética , Domínios Proteicos/genética , Piridinas/antagonistas & inibidores , Piridinas/uso terapêutico , Fatores de Transcrição/genética , Compostos Azabicíclicos/farmacologia , Humanos , Piridinas/farmacologiaRESUMO
This study was designed to investigate the protective effect of resveratrol (RES) on premature ovarian failure (POF) and the proliferation of female germline stem cells (FGSCs) at the tissue and cell levels. POF mice were lavaged with RES, and POF ovaries were co-cultured with RES and/or GANT61 in vitro. FGSCs were pretreated with Busulfan and RES and/or GANT61 and co-cultured with M1 macrophages, which were pretreated with RES. The weights of mice and their ovaries, as well as their follicle number, were measured. Ovarian function, antioxidative stress, inflammation, and FGSCs survival were evaluated. RES significantly increased the weights of POF mice and their ovaries as well as the number of follicles, while it decreased the atresia rate of follicles. Higher levels of Mvh, Oct4, SOD2, GPx, and CAT were detected after treatment with RES in vivo and in vitro. RES treatment resulted in significantly lower TNF-α and IL-6 concentrations and an obviously higher IL-10 concentration in the ovaries. In FGSCs, higher Mvh, Oct4, and SOD2 concentrations and lower TNF-α, IL-6, and MDA concentrations were measured in the RES group. Blockage of the Hh signaling pathway reversed the protective effect of RES on FGSCs. In conclusion, RES effectively improved the ovarian function of the POF model and the productive capacity of FGSCs via relieving oxidative stress and inflammation and a mechanism involving the Hh signaling pathway, suggesting that RES is a potential agent against POF and can aid in the survival of FGSCs.
Assuntos
Antioxidantes/farmacologia , Regulação da Expressão Gênica/efeitos dos fármacos , Células-Tronco de Oogônios/efeitos dos fármacos , Folículo Ovariano/efeitos dos fármacos , Insuficiência Ovariana Primária/tratamento farmacológico , Resveratrol/farmacologia , Animais , Peso Corporal/efeitos dos fármacos , Bussulfano/toxicidade , Catalase/genética , Catalase/metabolismo , Sobrevivência Celular/efeitos dos fármacos , Técnicas de Cocultura , RNA Helicases DEAD-box/genética , RNA Helicases DEAD-box/metabolismo , Feminino , Glutationa Peroxidase/genética , Glutationa Peroxidase/metabolismo , Humanos , Interleucina-6/genética , Interleucina-6/metabolismo , Macrófagos/citologia , Macrófagos/efeitos dos fármacos , Macrófagos/metabolismo , Camundongos , Fator 3 de Transcrição de Octâmero/genética , Fator 3 de Transcrição de Octâmero/metabolismo , Células-Tronco de Oogônios/metabolismo , Células-Tronco de Oogônios/patologia , Tamanho do Órgão/efeitos dos fármacos , Folículo Ovariano/metabolismo , Folículo Ovariano/patologia , Cultura Primária de Células , Insuficiência Ovariana Primária/induzido quimicamente , Insuficiência Ovariana Primária/genética , Insuficiência Ovariana Primária/patologia , Piridinas/antagonistas & inibidores , Piridinas/farmacologia , Pirimidinas/antagonistas & inibidores , Pirimidinas/farmacologia , Transdução de Sinais , Superóxido Dismutase/genética , Superóxido Dismutase/metabolismo , Fator de Necrose Tumoral alfa/genética , Fator de Necrose Tumoral alfa/metabolismo , Glutationa Peroxidase GPX1RESUMO
Cockroach neurosecretory cells, dorsal unpaired median (DUM) neurons, express two distinct α-bungarotoxin-insensitive nicotinic acetylcholine receptor subtypes, nAChR1 and nAChR2 which are differently sensitive to the neonicotinoid insecticides and intracellular calcium pathways. The aim of this study is to determine whether sulfoxaflor acts as an agonist of nAChR1 and nAChR2 subtypes. We demonstrated that 1â¯mM sulfoxaflor induced high current amplitudes, compared to acetylcholine, suggesting that it was a full agonist of DUM neuron nAChR subtypes. Sulfoxaflor evoked currents were not inhibited by the nicotinic acetylcholine receptor antagonist d-tubocurarine (dTC) which reduced nAChR1. But, sulfoxaflor evoked currents were reduced in the presence of 5 µM mecamylamine which is known to reduce nAChR2 subtype. Interestingly, when 1 µM imidacloprid was added in the extracellular solution, sulfoxaflor-induced currents were significantly suppressed. Moreover, when extracellular calcium concentration was increased, bath application of 1 µM imidacloprid partially reduced sulfoxaflor activated currents when nAChR1 was inhibited with 20 µM dTC and completely suppressed sulfoxaflor currents when nAChR2 was inhibited with 5 µM mecamylamine. Our data demonstrated therefore that sulfoxaflor activates both nAChR1 and nAChR2 subtypes.
Assuntos
Bungarotoxinas/farmacologia , Colinérgicos/farmacologia , Baratas , Neonicotinoides/farmacologia , Agonistas Nicotínicos/farmacologia , Nitrocompostos/farmacologia , Piridinas/farmacologia , Receptores Nicotínicos/efeitos dos fármacos , Compostos de Enxofre/farmacologia , Acetilcolina/farmacologia , Animais , Cálcio/farmacologia , Mecamilamina/farmacologia , Antagonistas Nicotínicos/farmacologia , Técnicas de Patch-Clamp , Piridinas/antagonistas & inibidores , Compostos de Enxofre/antagonistas & inibidores , Tubocurarina/toxicidadeAssuntos
Anticoagulantes , Antitrombinas , Inibidores do Fator Xa , Hemorragia/induzido quimicamente , Tromboembolia Venosa/tratamento farmacológico , Anticoagulantes/administração & dosagem , Anticoagulantes/efeitos adversos , Anticoagulantes/uso terapêutico , Antitrombinas/administração & dosagem , Antitrombinas/efeitos adversos , Antitrombinas/uso terapêutico , Dabigatrana/administração & dosagem , Dabigatrana/efeitos adversos , Dabigatrana/antagonistas & inibidores , Dabigatrana/uso terapêutico , Inibidores do Fator Xa/administração & dosagem , Inibidores do Fator Xa/efeitos adversos , Inibidores do Fator Xa/uso terapêutico , Hemorragia/tratamento farmacológico , Humanos , Neoplasias/complicações , Assistência Perioperatória , Pirazóis/administração & dosagem , Pirazóis/efeitos adversos , Pirazóis/antagonistas & inibidores , Pirazóis/uso terapêutico , Piridinas/administração & dosagem , Piridinas/efeitos adversos , Piridinas/antagonistas & inibidores , Piridinas/uso terapêutico , Piridonas/administração & dosagem , Piridonas/efeitos adversos , Piridonas/antagonistas & inibidores , Piridonas/uso terapêutico , Rivaroxabana/administração & dosagem , Rivaroxabana/efeitos adversos , Rivaroxabana/antagonistas & inibidores , Rivaroxabana/uso terapêutico , Tiazóis/administração & dosagem , Tiazóis/efeitos adversos , Tiazóis/antagonistas & inibidores , Tiazóis/uso terapêutico , Tromboembolia Venosa/etiologia , Tromboembolia Venosa/prevenção & controle , Trombose Venosa/tratamento farmacológico , Trombose Venosa/etiologia , Trombose Venosa/prevenção & controleRESUMO
Epithelial folding transforms simple sheets of cells into complex three-dimensional tissues and organs during animal development. Epithelial folding has mainly been attributed to mechanical forces generated by an apically localized actomyosin network, however, contributions of forces generated at basal and lateral cell surfaces remain largely unknown. Here we show that a local decrease of basal tension and an increased lateral tension, but not apical constriction, drive the formation of two neighboring folds in developing Drosophila wing imaginal discs. Spatially defined reduction of extracellular matrix density results in local decrease of basal tension in the first fold; fluctuations in F-actin lead to increased lateral tension in the second fold. Simulations using a 3D vertex model show that the two distinct mechanisms can drive epithelial folding. Our combination of lateral and basal tension measurements with a mechanical tissue model reveals how simple modulations of surface and edge tension drive complex three-dimensional morphological changes.
Assuntos
Drosophila/crescimento & desenvolvimento , Células Epiteliais/citologia , Epitélio/anatomia & histologia , Epitélio/embriologia , Morfogênese , Estresse Mecânico , Actinas/metabolismo , Actomiosina , Amidas/antagonistas & inibidores , Animais , Fenômenos Biomecânicos , Padronização Corporal/genética , Divisão Celular , Proliferação de Células , Forma Celular , Tamanho Celular , Drosophila/anatomia & histologia , Drosophila/embriologia , Drosophila/genética , Proteínas de Drosophila/genética , Proteínas de Drosophila/metabolismo , Células Epiteliais/efeitos dos fármacos , Epitélio/efeitos dos fármacos , Matriz Extracelular , Discos Imaginais/crescimento & desenvolvimento , Larva/citologia , Larva/metabolismo , Terapia a Laser , Modelos Anatômicos , Modelos Biológicos , Piridinas/antagonistas & inibidoresRESUMO
The HIV-1 transactivator of transcription (Tat) is a neurotoxin involved in the pathogenesis of HIV-1 associated neurocognitive disorders (HAND). The neurotoxic effects of Tat are mediated directly via AMPA/NMDA receptor activity and indirectly through neuroinflammatory signaling in glia. Emerging strategies in the development of neuroprotective agents involve the modulation of the endocannabinoid system. A major endocannabinoid, anandamide (N-arachidonoylethanolamine, AEA), is metabolized by fatty acid amide hydrolase (FAAH). Here we demonstrate using a murine prefrontal cortex primary culture model that the inhibition of FAAH, using PF3845, attenuates Tat-mediated increases in intracellular calcium, neuronal death, and dendritic degeneration via cannabinoid receptors (CB1R and CB2R). Live cell imaging was used to assess Tat-mediated increases in [Ca2+]i, which was significantly reduced by PF3845. A time-lapse assay revealed that Tat potentiates cell death while PF3845 blocks this effect. Additionally PF3845 blocked the Tat-mediated increase in activated caspase-3 (apoptotic marker) positive neurons. Dendritic degeneration was characterized by analyzing stained dendritic processes using Imaris and Tat was found to significantly decrease the size of processes while PF3845 inhibited this effect. Incubation with CB1R and CB2R antagonists (SR141716A and AM630) revealed that PF3845-mediated calcium effects were dependent on CB1R, while reduced neuronal death and degeneration was CB2R-mediated. PF3845 application led to increased levels of AEA, suggesting the observed effects are likely a result of increased endocannabinoid signaling at CB1R/CB2R. Our findings suggest that modulation of the endogenous cannabinoid system through inhibition of FAAH may be beneficial in treatment of HAND.
Assuntos
Síndrome da Imunodeficiência Adquirida/complicações , Síndrome da Imunodeficiência Adquirida/patologia , Amidoidrolases/antagonistas & inibidores , HIV-1/patogenicidade , Degeneração Neural/prevenção & controle , Fármacos Neuroprotetores/farmacologia , Produtos do Gene tat do Vírus da Imunodeficiência Humana/antagonistas & inibidores , Produtos do Gene tat do Vírus da Imunodeficiência Humana/toxicidade , Síndrome da Imunodeficiência Adquirida/enzimologia , Animais , Ácidos Araquidônicos , Cálcio/metabolismo , Agonistas de Receptores de Canabinoides/farmacologia , Antagonistas de Receptores de Canabinoides/farmacologia , Caspase 3/metabolismo , Morte Celular/efeitos dos fármacos , Endocanabinoides/farmacologia , Indóis/farmacologia , Camundongos , Degeneração Neural/patologia , Piperidinas/antagonistas & inibidores , Piperidinas/farmacologia , Alcamidas Poli-Insaturadas , Córtex Pré-Frontal/enzimologia , Córtex Pré-Frontal/metabolismo , Cultura Primária de Células , Piridinas/antagonistas & inibidores , Piridinas/farmacologia , Rimonabanto/farmacologiaRESUMO
BACKGROUND: The pathogenesis of Helicobacter pylori (H. pylori) infection-induced duodenal ulcer remains to be elucidated. Duodenal mucosal bicarbonate secretion is the most important protective factor against acid-induced mucosal injury. We previously revealed that H. pylori infection downregulated the expression and functional activity of duodenal mucosal cystic fibrosis transmembrane conductance regulator (CFTR) and solute linked carrier 26 gene family A6 (SLC26A6) which are the two key duodenal mucosal epithelial cellular bicarbonate transporters to mediate duodenal bicarbonate secretion. In this study, we investigated the mechanism of H. pylori infection-induced duodenal CFTR and SLC26A6 expression downregulation. RESULTS: We found that H. pylori infection induced the increase of serum transforming growth factor ß (TGFß) level and duodenal mucosal TGFß expression and the decrease of duodenal mucosal CFTR and SLC26A6 expressions in C57 BL/6 mice. The results from the experiments of human duodenal epithelial cells (SCBN) showed that H. pylori increased TGFß production and decreased CFTR and SLC26A6 expressions in SCBN cells. TGFß inhibitor SB431542 reversed the H. pylori-induced CFTR and SLC26A6 expression decreases. The further results showed that TGFß directly decreased CFTR and SLC26A6 expressions in SCBN cells. TGFß induced the phosphorylation of p38 mitogen-activated protein kinase (MAPK) and P38 MAPK inhibitor SB203580 reversed the TGFß-induced CFTR and SLC26A6 expression decreases. CONCLUSIONS: H. pylori infection downregulates duodenal epithelial cellular CFTR and SLC26A6 expressions through TGFß-mediated P38 MAPK signaling pathway, which contributes to further elucidating the pathogenesis of H. pylori-associated duodenal ulcer.
Assuntos
Antiporters/metabolismo , Regulador de Condutância Transmembrana em Fibrose Cística/metabolismo , Regulação para Baixo , Duodeno/metabolismo , Infecções por Helicobacter , Helicobacter pylori/patogenicidade , Transportadores de Sulfato/metabolismo , Fator de Crescimento Transformador beta/metabolismo , Animais , Antiporters/genética , Bicarbonatos/metabolismo , Regulador de Condutância Transmembrana em Fibrose Cística/genética , Duodeno/microbiologia , Células Epiteliais/metabolismo , Células Epiteliais/microbiologia , Infecções por Helicobacter/microbiologia , Imidazóis/antagonistas & inibidores , Mucosa Intestinal/metabolismo , Mucosa Intestinal/microbiologia , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Piridinas/antagonistas & inibidores , Transportadores de Sulfato/genética , Fator de Crescimento Transformador beta/genética , Proteínas Quinases p38 Ativadas por Mitógeno/efeitos dos fármacos , Proteínas Quinases p38 Ativadas por Mitógeno/genéticaAssuntos
Anticoagulantes/efeitos adversos , Antídotos/uso terapêutico , Hemorragia , Idoso , Anticorpos Monoclonais Humanizados/uso terapêutico , Dabigatrana/efeitos adversos , Dabigatrana/antagonistas & inibidores , Feminino , Hemorragia/induzido quimicamente , Hemorragia/tratamento farmacológico , Hemorragia/prevenção & controle , Humanos , Masculino , Pirazóis/efeitos adversos , Pirazóis/antagonistas & inibidores , Piridinas/efeitos adversos , Piridinas/antagonistas & inibidores , Piridonas/efeitos adversos , Piridonas/antagonistas & inibidores , Risco , Rivaroxabana/efeitos adversos , Rivaroxabana/antagonistas & inibidores , Tiazóis/efeitos adversos , Tiazóis/antagonistas & inibidoresRESUMO
A novel bacteriological agar, named Furukawa Agar, has been specifically designed to inhibit the growth of filamentous fungi during microbiological examination of bacteria from organic compost, thereby allowing complete analysis of the resulting bacterial organisms, without the overgrowth with filamentous fungi.
Assuntos
Ágar/farmacologia , Bactérias/crescimento & desenvolvimento , Compostagem , Meios de Cultura/farmacologia , Fungos/efeitos dos fármacos , Manejo de Espécimes/métodos , Ágar/química , Antifúngicos/farmacologia , Bactérias/isolamento & purificação , Técnicas Bacteriológicas/métodos , Técnicas de Cultura de Células , Meios de Cultura/química , Fungos/crescimento & desenvolvimento , Nitrilas/antagonistas & inibidores , Nitrilas/química , Piridinas/antagonistas & inibidores , Piridinas/química , Triazóis/antagonistas & inibidores , Triazóis/químicaRESUMO
For more than half a century, warfarin, a vitamin K antagonist, has been the anticoagulant of choice. However, direct oral anticoagulants are rapidly gaining in popularity, which poses the need for efficacious reversal agents. This review article summarizes the strategies and agents used to reverse oral anticoagulants.
Assuntos
Anticoagulantes/administração & dosagem , Dabigatrana/antagonistas & inibidores , Pirazóis/antagonistas & inibidores , Piridinas/antagonistas & inibidores , Piridonas/antagonistas & inibidores , Rivaroxabana/antagonistas & inibidores , Tiazóis/antagonistas & inibidores , Varfarina/antagonistas & inibidores , Administração Oral , Ensaios Clínicos Fase III como Assunto , HumanosRESUMO
AIMS: Acetamiprid (ACE) is an insecticide of the neonicotinoid family, the most widely used in the world. Herein, we assessed the effect of ACE on either the humoral or cellular immune responses of rodents. We also evaluated the role of curcumin in the restoration of altered immune responses after ACE treatment. METHODS: Five groups of five Swiss Albino mice were immunized intraperitoneally with the recombinant form of CFP32, a virulence factor of Mycobacterium tuberculosis. One group received ACE (5mg/kg) during 61days, a second one received ACE associated with curcumin (100mg/kg). Three control groups were included; one untreated, the second received corn oil and the third received curcumin alone. The humoral immune response was assessed by ELISA testing the anti-rCFP32 antibody concentrations in the serum. The cellular immune response was assessed by analyzing the cellular proliferation of the splenocytes stimulated in vitro by a mitogen or rCFP32. RESULTS: The ACE-treated mice showed a significant immunosuppression of the specific humoral response with a restorative effect of curcumin when administered with ACE. Similarly, ACE significantly decreased the level of splenocyte proliferation after either a non specific or a specific activation. Curcumin partially restores the antigen specific cellular immune response. Moreover, when administered alone, curcumin significantly inhibits the proliferative responses to the mitogen confirming its anti-mitogenic effect. Histological analysis showed alteration of spleens of mice exposed to ACE. SIGNIFICANCE: Altogether, our data indicated that ACE could potentially be harmful to the immune system.
Assuntos
Imunidade Celular/efeitos dos fármacos , Imunidade Humoral/efeitos dos fármacos , Piridinas/administração & dosagem , Piridinas/toxicidade , Animais , Anticorpos/sangue , Proteínas de Bactérias/imunologia , Proliferação de Células/efeitos dos fármacos , Curcumina/farmacologia , Interações Medicamentosas , Imunossupressores/farmacologia , Ativação Linfocitária/efeitos dos fármacos , Masculino , Camundongos , Neonicotinoides , Piridinas/antagonistas & inibidores , Baço/efeitos dos fármacosRESUMO
AIMS: To determine proinflammatory mechanisms of Treponema pallidum outer membrane protein Tp92 in the early syphilis infection in human macrophages and HMEC-1 cells. METHODS: Recombinant Tp92 protein was used to stimulate target human macrophages and HMEC-1 cells. PDTC (Pyrrolidinedithiocarbamic acid), SB202190 and Z-YVAD-FMK were used to block the MyD88/NF-κB, MAPKs/p38 and NLRP3/Caspase-1 pathway, respectively. TNF-α, IL-1ß, IL-6, IL-8,NLRP3, casepase-1 were detected by ELISA or Western blot. Lactate dehydrogenase (LDH) activity was measured. RESULTS: Tp92 protein could significantly induced the secretion of proinflammatory cytokines TNF-α, IL-1ß, IL-6 and IL-8 in HMEC-1 cells, but not in macrophages except IL-8. When MyD88/NF-κB pathway was blocked, differences in the secretion of TNF-α, IL-6 and IL-1ß levels and LDH enzyme activity between Tp92 group and Tp92 + PDTC group were not significant (P > 0.05) in HMEC-1 cells and macrophages except IL-8(P < 0.05). When MAPKs/p38 pathway was blocked, differences in the secretion of TNF-α, IL-1ß, IL-6 and IL-8 and LDH enzyme activity both Tp92 group and Tp92 + SB2010190 group were not significant (P > 0.05) in HMEC-1 cells and macrophages. In contrast, when NLRP3/Caspase-1 pathway was blocked with Z-YVAD-FMK, TNF-α, IL-6 and IL-1ß levels, LDH enzyme activity, and Caspase-1 and NLRP3 protein levels were significantly declined (P < 0.05) in HMEC-1 cells except IL-8(P > 0.05). The LDH enzyme activity in macrophages was decreased before and after Z-YVAD-FMK blocking (P < 0.05),however, differences in the secretion of TNF-α, IL-1ß, IL-6 and IL-8 between Tp92 group and Tp92+Z-YVAD-FMK group in macrophages were not significant (P > 0.05). CONCLUSIONS: Tp92 protein may promote proinflammatory cytokines TNF-α, IL-1ß, IL-6 secretion of HMEC-1 cells, but not in macrophages, and increase the LDH enzyme activity of HMEC-1 cells and macrophages through NLRP3/Caspase-1 pathway. However, Tp92 protein may promote IL-8 secretion of HMEC-1 cells and macrophages through MyD88/NF-κB pathway.
Assuntos
Antígenos de Superfície/farmacologia , Proteínas de Bactérias/farmacologia , Linhagem Celular/efeitos dos fármacos , Citocinas/metabolismo , Macrófagos/efeitos dos fármacos , Macrófagos/metabolismo , Proteínas de Membrana/farmacologia , Treponema pallidum/metabolismo , Clorometilcetonas de Aminoácidos/antagonistas & inibidores , Antígenos de Superfície/genética , Proteínas de Bactérias/genética , Caspase 1/efeitos dos fármacos , Caspase 1/metabolismo , Clonagem Molecular , Citocinas/efeitos dos fármacos , Humanos , Imidazóis/antagonistas & inibidores , Interleucina-1beta/metabolismo , Interleucina-6/metabolismo , Interleucina-8/metabolismo , L-Lactato Desidrogenase/efeitos dos fármacos , L-Lactato Desidrogenase/metabolismo , Proteínas de Membrana/genética , Quinases de Proteína Quinase Ativadas por Mitógeno/efeitos dos fármacos , Quinases de Proteína Quinase Ativadas por Mitógeno/metabolismo , Fator 88 de Diferenciação Mieloide/efeitos dos fármacos , Fator 88 de Diferenciação Mieloide/metabolismo , NF-kappa B/efeitos dos fármacos , NF-kappa B/metabolismo , Proteína 3 que Contém Domínio de Pirina da Família NLR/efeitos dos fármacos , Proteína 3 que Contém Domínio de Pirina da Família NLR/metabolismo , Piridinas/antagonistas & inibidores , Pirrolidinas/antagonistas & inibidores , Proteínas Recombinantes/genética , Proteínas Recombinantes/farmacologia , Transdução de Sinais/efeitos dos fármacos , Células THP-1 , Tiocarbamatos/antagonistas & inibidores , Treponema pallidum/genética , Fator de Necrose Tumoral alfa/metabolismoRESUMO
Direct oral anticoagulants (DOACs) are effective in preventing and treating venous thromboembolism, and preventing stroke in atrial fibrillation. Until recently, there has been no specific reversal agent for DOACs. Now, a specific antidote for the direct thrombin inhibitor, dabigatran has been approved for use, and antidotes for factor Xa inhibitors (rivaroxaban, apixaban and edoxaban) are being developed. We review the evidence for currently used and emerging reversal strategies, and discuss possible clinical implications, including increased prescription of DOACs, use of DOACs in clinical situations previously felt to pose too great a risk of bleeding, and use of reversal agents beyond currently approved indications.
Assuntos
Antitrombinas , Dabigatrana/antagonistas & inibidores , Inibidores do Fator Xa , Pirazóis/antagonistas & inibidores , Piridinas/antagonistas & inibidores , Piridonas/antagonistas & inibidores , Rivaroxabana/antagonistas & inibidores , Tiazóis/antagonistas & inibidores , Anticorpos Monoclonais Humanizados/farmacologia , Anticoagulantes , Arginina/análogos & derivados , Arginina/farmacologia , Fator Xa/farmacologia , Hemorragia/induzido quimicamente , Hemorragia/prevenção & controle , Humanos , Piperazinas/farmacologia , Proteínas Recombinantes/farmacologia , Tromboembolia Venosa/tratamento farmacológicoRESUMO
Direct oral anticoagulants (DOACs) are increasingly used for prevention and treatment of venous thromboembolism and for prevention of stroke in patients with nonvalvular atrial fibrillation. In phase III clinical trials that included more than 100,000 patients, the DOACs were at least as effective as vitamin K antagonists (VKAs) and were associated with less serious bleeding, particularly less intracranial bleeding. Real-world evidence supports these outcomes. Despite this, some physicians and patients are concerned about serious bleeding or emergencies unless specific reversal agents for the DOACs are available. However, in clinical trials performed without reversal agents, the outcome of major bleeds was similar or better in patients receiving DOACs than in those taking VKAs. Because of their short half-lives, supportive measures are sufficient to manage most bleeds in patients receiving DOACs. Anticoagulant reversal should only be considered with life-threatening bleeds, with bleeds that fail to respond to usual measures and in patients requiring urgent surgery. Idarucizumab is licensed for dabigatran reversal and andexanet alfa is likely to be soon licensed for reversal of rivaroxaban, apixaban, and edoxaban. To ensure responsible use of these agents, every hospital needs a bleeding management algorithm that identifies patients eligible for reversal and outlines appropriate dosing regimens.
Assuntos
Anticoagulantes/efeitos adversos , Hemorragia/induzido quimicamente , Tromboembolia Venosa/tratamento farmacológico , Administração Oral , Anticorpos Monoclonais Humanizados/uso terapêutico , Anticoagulantes/administração & dosagem , Fibrilação Atrial/complicações , Ensaios Clínicos Fase III como Assunto , Dabigatrana/efeitos adversos , Dabigatrana/antagonistas & inibidores , Fator Xa/uso terapêutico , Previsões , Hemorragia/prevenção & controle , Hemorragia/terapia , Humanos , Pirazóis/antagonistas & inibidores , Piridinas/antagonistas & inibidores , Piridonas/antagonistas & inibidores , Proteínas Recombinantes/uso terapêutico , Rivaroxabana/antagonistas & inibidores , Acidente Vascular Cerebral/etiologia , Acidente Vascular Cerebral/prevenção & controle , Tiazóis/antagonistas & inibidores , Tromboembolia Venosa/prevenção & controleRESUMO
As expected with all antithrombotic agents, there is a risk of bleeding complications in patients receiving direct oral anticoagulants (DOACs) because of the DOAC itself, acute trauma, invasive procedures, or underlying comorbidities. For many bleeding events, a prudent course of action will be to withdraw the DOAC, then "wait and support" the patient, with the expectation that the bleeding event should resolve with time. Likewise, DOAC therapy may be interrupted ahead of a planned procedure, the stopping time being dependent on the agent involved and the patient's renal function. However, urgent reversal of anticoagulation is required in patients with serious or life-threatening bleeding or in those requiring urgent surgery or procedures. Novel specific reversal agents, either under development or recently approved, will need to be incorporated into local anticoagulation reversal protocols. For dabigatran-treated patients, idarucizumab recently has been approved for clinical use in cases of life-threatening or uncontrolled bleeding or when patients require emergency surgery or urgent procedures, both associated with a high risk of bleeding. As clinical experience with individual specific reversal agents grows, their roles in managing major bleeding events in DOAC-treated patients will become better defined. Future research, as well as ongoing use of idarucizumab, should help establish when it is appropriate to re-dose with idarucizumab, coadminister with prothrombin complex concentrates, or re-initiate DOAC after idarucizumab use. Ongoing trials should help identify the appropriate doses and expected durations of effect for andexanet alfa and ciraparantag, which are likely to vary depending on the individual oral anticoagulants.
Assuntos
Anticorpos Monoclonais Humanizados/uso terapêutico , Anticoagulantes/efeitos adversos , Arginina/análogos & derivados , Inibidores do Fator Xa/efeitos adversos , Fator Xa/uso terapêutico , Hemorragia/prevenção & controle , Piperazinas/uso terapêutico , Proteínas Recombinantes/uso terapêutico , Anticorpos Monoclonais Humanizados/administração & dosagem , Anticorpos Monoclonais Humanizados/efeitos adversos , Arginina/administração & dosagem , Arginina/efeitos adversos , Arginina/uso terapêutico , Protocolos Clínicos , Dabigatrana/efeitos adversos , Dabigatrana/antagonistas & inibidores , Tratamento de Emergência , Fator Xa/administração & dosagem , Fator Xa/efeitos adversos , Hemorragia/induzido quimicamente , Hospitais , Humanos , Seleção de Pacientes , Piperazinas/administração & dosagem , Piperazinas/efeitos adversos , Guias de Prática Clínica como Assunto , Pirazóis/efeitos adversos , Pirazóis/antagonistas & inibidores , Piridinas/efeitos adversos , Piridinas/antagonistas & inibidores , Piridonas/efeitos adversos , Piridonas/antagonistas & inibidores , Proteínas Recombinantes/administração & dosagem , Proteínas Recombinantes/efeitos adversos , Rivaroxabana/efeitos adversos , Rivaroxabana/antagonistas & inibidores , Procedimentos Cirúrgicos Operatórios , Tiazóis/efeitos adversos , Tiazóis/antagonistas & inibidoresRESUMO
Direct oral anticoagulants (DOACs) are rapidly replacing vitamin K antagonists (VKAs) for treatment of venous thromboembolism (VTE). The DOACs include dabigatran, which inhibits thrombin, and rivaroxaban, apixaban, and edoxaban, which inhibit factor Xa. When compared with conventional VTE treatment consisting of a parenteral anticoagulant followed by a VKA, the DOACs were equally effective for prevention of recurrence, but were associated with less bleeding. With similar efficacy, better safety, and the convenience of fixed dosing without the need for routine coagulation monitoring, guidelines now recommend DOACs over VKAs for VTE treatment in patients without active cancer. Nonetheless, measures are needed to optimize the safety of DOACs. Focusing on these measures, this paper summarizes the results of phase III trials evaluating DOACs for VTE treatment; identifies which VTE patients are or are not candidates for DOACs; provides guidance on how to choose among DOACs; lists the licensed dosing information for DOACs; discusses the optimal treatment duration for VTE; describes periprocedural management of DOACs in patients requiring surgery or intervention; and finally, reviews the management of bleeding, including the role for specific reversal agents.
Assuntos
Anticoagulantes/efeitos adversos , Tromboembolia Venosa/tratamento farmacológico , Administração Oral , Anticoagulantes/administração & dosagem , Anticoagulantes/uso terapêutico , Coagulação Sanguínea/efeitos dos fármacos , Ensaios Clínicos Fase III como Assunto , Coagulantes/farmacologia , Dabigatrana/administração & dosagem , Dabigatrana/antagonistas & inibidores , Dabigatrana/uso terapêutico , Humanos , Segurança do Paciente , Pirazóis/administração & dosagem , Pirazóis/antagonistas & inibidores , Pirazóis/uso terapêutico , Piridinas/administração & dosagem , Piridinas/antagonistas & inibidores , Piridinas/uso terapêutico , Piridonas/administração & dosagem , Piridonas/antagonistas & inibidores , Piridonas/uso terapêutico , Rivaroxabana/administração & dosagem , Rivaroxabana/antagonistas & inibidores , Rivaroxabana/uso terapêutico , Tiazóis/administração & dosagem , Tiazóis/antagonistas & inibidores , Tiazóis/uso terapêuticoRESUMO
New oral anticoagulants (NOACs) have been developed in recent years and are increasingly used in clinical practice. Dabigatran is a direct thrombin (factor II) inhibitor while rivaroxaban, apixaban and edoxaban are direct inhibitors of factor Xa. The European Medicines Agency (EMA) currently approves these NOACs for different clinical uses. NOACs do not require routine monitoring of coagulation although an assessment of anticoagulation activity in these patients may be required in different conditions. NOACs show a similar or lower incidence of bleeding compared with conventional therapies in phase III trials. In case of bleeding, non-specific reversal strategies are available while specific reversal agents are the subject of ongoing trials. The role of this review is to summarize the current knowledge on NOCAs focusing on bleeding management in the perioperative period.
Assuntos
Anticoagulantes/efeitos adversos , Hemorragia/terapia , Administração Oral , Anticoagulantes/administração & dosagem , Ensaios Clínicos Fase III como Assunto , Dabigatrana/administração & dosagem , Dabigatrana/efeitos adversos , Hemorragia/induzido quimicamente , Humanos , Pirazóis/administração & dosagem , Pirazóis/efeitos adversos , Pirazóis/antagonistas & inibidores , Piridinas/administração & dosagem , Piridinas/efeitos adversos , Piridinas/antagonistas & inibidores , Piridonas/administração & dosagem , Piridonas/efeitos adversos , Piridonas/antagonistas & inibidores , Rivaroxabana/administração & dosagem , Rivaroxabana/efeitos adversos , Tiazóis/administração & dosagem , Tiazóis/efeitos adversos , Tiazóis/antagonistas & inibidoresAssuntos
Anticorpos Monoclonais Humanizados/uso terapêutico , Antitrombinas/efeitos adversos , Dabigatrana/efeitos adversos , Inibidores do Fator Xa/efeitos adversos , Fator Xa/uso terapêutico , Hemorragia/tratamento farmacológico , Pirazóis/efeitos adversos , Piridinas/efeitos adversos , Piridonas/efeitos adversos , Proteínas Recombinantes/uso terapêutico , Rivaroxabana/efeitos adversos , Tiazóis/efeitos adversos , Administração Oral , Anticorpos Monoclonais Humanizados/farmacologia , Antitrombinas/uso terapêutico , Perda Sanguínea Cirúrgica/prevenção & controle , Hemorragia Cerebral/induzido quimicamente , Hemorragia Cerebral/terapia , Ensaios Clínicos como Assunto , Dabigatrana/antagonistas & inibidores , Dabigatrana/imunologia , Dabigatrana/uso terapêutico , Aprovação de Drogas , Emergências , Fator Xa/farmacologia , Inibidores do Fator Xa/uso terapêutico , Hemorragia/induzido quimicamente , Humanos , Pirazóis/antagonistas & inibidores , Pirazóis/uso terapêutico , Piridinas/antagonistas & inibidores , Piridinas/uso terapêutico , Piridonas/antagonistas & inibidores , Piridonas/uso terapêutico , Proteínas Recombinantes/farmacologia , Rivaroxabana/antagonistas & inibidores , Rivaroxabana/uso terapêutico , Tiazóis/antagonistas & inibidores , Tiazóis/uso terapêutico , Estados Unidos , United States Food and Drug AdministrationRESUMO
Novel oral anticoagulants (NOACs) have emerged as a good alternative to warfarin in the prevention of stroke for patients with atrial fibrillation. NOAC use is increasing rapidly; therefore, greater understanding of their use in the perioperative period is important for optimal care. Studies and reviews that reported on the use of NOACs were identified, with particular focus on the perioperative period. PubMed was searched for relevant articles published between January 2000 and August 2015. The inevitable rise in the use of NOACs such as rivaroxaban (Xarelto™), apixaban (Eliquis™), edoxaban (Lixiana™) and dabigatran (Pradaxa™) may present a simplified approach to perioperative anticoagulant management due to fewer drug interactions, rapidity of onset of action and relatively short half-lives. Coagulation status, however, cannot reliably be monitored and no antidotes are currently available. When planning for discontinuation of NOACs, special consideration of renal function is required. Advice regarding the management of bleeding complications is provided for consideration in emergency surgery. In extreme circumstances, haemodialysis may be considered for bleeding with the use of dabigatran. NOACs will increasingly affect operative planning in plastic surgery. In order to reduce the incidence of complications associated with anticoagulation, the management of NOACs in the perioperative period requires knowledge of the time of last dose, renal function and the bleeding risk of the planned procedure. Consideration of these factors will allow appropriate interpretation of the current guidelines.