Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 17 de 17
Filter
Add more filters

Publication year range
1.
J Membr Biol ; 257(3-4): 207-214, 2024 Aug.
Article in English | MEDLINE | ID: mdl-38630294

ABSTRACT

The signal peptidase complex (SPC) mediates processing of signal peptides of secretory precursors. But, recent studies show that the eukaryotic SPC also cleaves internal transmembrane segments of some membrane proteins, and its non-catalytic subunit, Spc1/SPCS1 plays a critical role in this process. To assess the impact of Spc1 on membrane proteostasis, we carried out quantitative proteomics of yeast cells with and without Spc1. Our data show that the abundance of the membrane proteome in yeast cells lacking Spc1 is in general reduced compared to that in wild-type cells, implicating its role in controlling the cellular levels of membrane proteins.


Subject(s)
Membrane Proteins , Proteome , Saccharomyces cerevisiae Proteins , Saccharomyces cerevisiae , Saccharomyces cerevisiae/metabolism , Saccharomyces cerevisiae/genetics , Proteome/metabolism , Saccharomyces cerevisiae Proteins/metabolism , Saccharomyces cerevisiae Proteins/genetics , Membrane Proteins/metabolism , Membrane Proteins/genetics , Proteomics/methods , Cell Membrane/metabolism , Aspartic Acid Endopeptidases/metabolism , Aspartic Acid Endopeptidases/genetics , Serine Endopeptidases
2.
J Cell Sci ; 134(13)2021 07 01.
Article in English | MEDLINE | ID: mdl-34125229

ABSTRACT

Signal peptidase (SPase) cleaves the signal sequences (SSs) of secretory precursors. It contains an evolutionarily conserved membrane protein subunit, Spc1, that is dispensable for the catalytic activity of SPase and whose role remains unknown. In this study, we investigated the function of yeast Spc1. First, we set up an in vivo SPase cleavage assay using variants of the secretory protein carboxypeptidase Y (CPY) with SSs modified in the N-terminal and hydrophobic core regions. When comparing the SS cleavage efficiencies of these variants in cells with or without Spc1, we found that signal-anchored sequences became more susceptible to cleavage by SPase without Spc1. Furthermore, SPase-mediated processing of model membrane proteins was enhanced in the absence of Spc1 and was reduced upon overexpression of Spc1. Spc1 co-immunoprecipitated with proteins carrying uncleaved signal-anchored or transmembrane (TM) segments. Taken together, these results suggest that Spc1 protects TM segments from SPase action, thereby sharpening SPase substrate selection and acting as a negative regulator of the SPase-mediated processing of membrane proteins.


Subject(s)
Peptide Hydrolases , Saccharomyces cerevisiae Proteins , Serine Endopeptidases , Membrane Proteins/genetics , Protein Sorting Signals , Saccharomyces cerevisiae , Serine Endopeptidases/metabolism
3.
J Transl Med ; 20(1): 59, 2022 01 31.
Article in English | MEDLINE | ID: mdl-35101070

ABSTRACT

OBJECTIVE: This study discusses the effects of focus training on heart rate variability (HRV) in post-stroke fatigue (PoSF) patients. METHODS: Self-generate physiological coherence system (SPCS) was used for the focus training of PoSF patients for 12 weeks. Then, fatigue severity scale (FSS), Hamilton depression scale (HAMD), HRV and satisfaction scale (SASC-19) before and after the training were assessed. RESULTS: Compared with the control group, FSS score, HAMD score, RMSSD, PNN50% were significantly lower in the research group at the end of the intervention (P < 0.05); SDNN, SDANN, LF, HF, LF/HF intervention satisfaction rate increased significantly in the research group at the end of the intervention (P < 0.05). CONCLUSION: The use of SPCS software during the focus training of PoSF patients reduced the fatigue and depression, meanwhile improved the HRV of the patients. Therefore, these patients were greatly satisfied with the intervention.


Subject(s)
Autonomic Nervous System , Stroke , Fatigue/etiology , Fatigue/therapy , Heart Rate/physiology , Humans , Stroke/complications
4.
J Antimicrob Chemother ; 69(7): 1987-92, 2014 Jul.
Article in English | MEDLINE | ID: mdl-24633204

ABSTRACT

OBJECTIVES: Colistin is the first revived antibiotic to undergo substantial 'redevelopment' in academic settings. This study investigated the variation and accuracy of information in the summary of product characteristics (SPC) of intravenous colistin products approved in the European Union. METHODS: The dosing, indication and pharmacokinetic information in the SPCs of approved intravenous colistin products in 21 European countries were compared. RESULTS: In general, some SPCs have been updated over recent years though vital aspects of dosing recommendations, indications and pharmacokinetic information show a rather broad variation. The importance of a loading dose and of a daily dose >6 million international units in critically ill patients with good renal function is not considered in all SPCs. The pharmacokinetic section and dosing recommendations for special patient populations require careful review and updating, in order to take account of newly published data. CONCLUSIONS: This study highlights the challenges of integrating new rapidly evolving scientific knowledge into approved SPCs in Europe.


Subject(s)
Anti-Bacterial Agents/administration & dosage , Bacterial Infections/drug therapy , Colistin/administration & dosage , Product Labeling/standards , Administration, Intravenous , Anti-Bacterial Agents/pharmacokinetics , Colistin/pharmacokinetics , European Union , Humans
5.
Se Pu ; 42(2): 131-141, 2024 Feb.
Article in Zh | MEDLINE | ID: mdl-38374593

ABSTRACT

Given continuous development in society and the economy, obesity has become a global epidemic, arousing great concern. In addition to genetic and dietary factors, exposure to environmental chemicals is associated with the occurrence and development of obesity. Current research has indicated that some chemicals with endocrine-disrupting effects can affect lipid metabolism in vivo, causing elevated lipid storage. These chemicals are called "environmental obesogens". Synthetic phenolic compounds (SPCs) are widely used in industrial and daily products, such as plastic products, disinfectants, pesticides, food additives, and so on. The exposure routes of SPCs to the human body may include food and water consumption, direct skin contact, etc. Their unintended exposure could cause harmful effects on human health. As a type of endocrine disruptor, SPCs interfere with adipogenesis and lipid metabolism, exhibiting the characteristics of environmental obesogens. Because SPCs have similar phenolic structures, gathering information on their influences on lipid metabolism would be helpful to understand their structure-related effects. In this review, three commonly used research methods for screening environmental obesogens, including in vitro testing for molecular interactions, cell adipogenic differentiation models, and in vivo studies on lipid metabolism, are summarized, and the advantages and disadvantages of these methods are compared and discussed. Based on both in vitro and in vivo data, three types of SPCs, including bisphenol A (BPA) and its analogues, alkylphenols (APs), and synthetic phenolic antioxidants (SPAs), are systematically discussed in terms of their ability to disrupt adipogenesis and lipid metabolism by focusing on adipose and hepatic tissues, among others. Common findings on the effects of these SPCs on adipocyte differentiation, lipid storage, hepatic lipid accumulation, and liver steatosis are described. The underlying toxicological mechanisms are also discussed from the aspects of nuclear receptor transactivation, inflammation and oxidative stress regulation, intestinal microenvironment alteration, epigenetic modification, and some other signaling pathways. Future research to increase public knowledge on the obesogenic effects of emerging chemicals of concern is encouraged.


Subject(s)
Endocrine Disruptors , Lipid Metabolism , Humans , Environmental Exposure , Obesity/etiology , Obesity/genetics , Adipogenesis , Endocrine Disruptors/pharmacology , Benzhydryl Compounds , Lipids
6.
J Vasc Access ; : 11297298231218468, 2024 Jan 02.
Article in English | MEDLINE | ID: mdl-38166435

ABSTRACT

BACKGROUND: Short peripheral catheters (SPCs) are used to provide intravenous therapies in hospitalized patients. Recently, the category of SPC has become more complex, with the introduction in clinical practice of "integrated" SPCs (ISPCs), renewed regarding the material (polyurethane rather than polytetrafluoroethylene) and design (large wing; pre-assembled extension; preassembled needle-free connector (NFC)). METHODS: This systematic review and meta-analysis aimed to analyze randomized controlled trials (RCTs) and quasi-randomized studies in hospitalized patients, analyzing the risk of overall catheter failure as well as the risk of each type of complication (occlusion, infiltration, thrombophlebitis, and dislodgement) for ISPCs compared to non-integrated SPCs. These systematic review and meta-analysis were registered on PROSPERO (CRD42022322970). DATA SOURCES: We searched PUBMED®, EMBASE®, and the Cochrane Controlled Clinical Trials register from April to November 2022. RESULTS: INCLUDED STUDIES: The research identified 1260 articles. After the abstract review, 13 studies were included for full manuscript review and, after that, six papers (4727 patients) were included in the meta-analysis. DESCRIPTION OF THE EFFECT: We found a significantly reduced risk of catheter failure (pooling all complications) for ISPCs compared to SPCs (p = 0.002 RR 0.65; 95% CI 0.63-0.9). A significant reduction in the risks of occlusion (p = 0.007 RR 0.72; 95% CI 0.56-0.92) was observed. As regards the risk of infiltration, thrombophlebitis, and dislodgement, the analysis showed a trend in favor of ISPCs, though not statistically significant (respectively p = 0.2 RR 0.84; 95% CI 0.64-1.1; p = 0.25 RR 0.91; 95% CI 0.78-1.07; p = 0.06 RR 0.72; 95% CI 0.52-1.01). CONCLUSIONS: ISPCs significantly reduce the risks of catheter failure (overall complications) and occlusion. More RCTs are needed to understand if the preassembled ISPC is better than the composted closed system (non-integrated SPC + extension line + NFC).

7.
Laryngoscope ; 133(9): 2192-2197, 2023 09.
Article in English | MEDLINE | ID: mdl-36440626

ABSTRACT

OBJECTIVES: To examine the clinical usefulness of transoral ultrasonography (US) in determining the invasion depth of superficial pharyngeal carcinoma (SPC). Determining the invasion depth of SPC is crucial for transoral surgery including determining treatment strategy. This study aimed to examine the usefulness of transoral US in determining the invasion depth of SPC. METHODS: Forty-six patients with 51 lesions who underwent both magnifying endoscopy with narrow-band imaging (ME-NBI) and transoral US were included. The primary outcomes were the sensitivity, specificity, positive (PPV), and negative predictive values (NPV) of ME-NBI and transoral US findings for pathological tumor depth in SPCs. RESULTS: The accuracy (82.4%), sensitivity (85.2%), PPV (82.1%), and NPV (82.6%) rates of US for subepithelial propria (SEP) were higher than those of ME-NBI and macroscopic classification, indicating that transoral US is superior to ME-NBI in determining the invasion depth. All cases where the SEP was clearly invaded (SEP deep) could be diagnosed as SEP by transoral US. CONCLUSIONS: Transoral US may be useful in determining the invasion depth of SPCs. LEVEL OF EVIDENCE: 3 Laryngoscope, 133:2192-2197, 2023.


Subject(s)
Carcinoma, Squamous Cell , Pharyngeal Neoplasms , Humans , Retrospective Studies , Neoplasm Invasiveness/pathology , Endoscopy , Pharyngeal Neoplasms/diagnostic imaging , Pharyngeal Neoplasms/surgery , Carcinoma, Squamous Cell/pathology , Ultrasonography , Narrow Band Imaging
8.
Bioact Mater ; 16: 433-450, 2022 Oct.
Article in English | MEDLINE | ID: mdl-35415291

ABSTRACT

Small-diameter vascular grafts fabricated from synthetic biodegradable polymers exhibit beneficial mechanical properties but often face poor regenerative potential. Different tissue engineering approaches have been employed to improve tissue regeneration in vascular grafts, but there remains a requirement for a new generation of synthetic grafts that can orchestrate the host response to achieve robust vascular regeneration. Vascular stem/progenitor cells (SPCs) are mostly found in quiescent niches but can be activated in response to injury and participate in endothelium and smooth muscle regeneration during neo-artery formation. Here, we developed a functional vascular graft by surface immobilization of stem cell antigen-1 (Sca-1) antibody on an electrospun poly(ε-caprolactone) graft (PCL-Sca-1 Ab). PCL-Sca-1 Ab promoted capture and retainment of Sca-1+ SPCs in vitro. In rat abdominal aorta replacement models, PCL-Sca-1 Ab stimulated in vivo recruitment of Sca-1+ SPCs, and drove SPCs differentiation towards vascular cell lineages. The origin of infiltrated Sca-1+ SPCs was further investigated using a bone marrow transplantation mouse model, which revealed that Sca-1+ SPCs originating from the resident tissues and bone marrow contributed to rapid vascular regeneration of vascular grafts. Our data indicated that PCL-Sca-1 Ab vascular grafts may serve as a useful strategy to develop next generation cell-free vascular grafts.

9.
Cell Rep ; 39(12): 110981, 2022 06 21.
Article in English | MEDLINE | ID: mdl-35732119

ABSTRACT

Vascular bypass surgery continues to use autologous grafts and often suffers from a shortage of donor grafts. Decellularized xenografts derived from porcine veins provide a promising candidate because of their abundant availability and low immunogenicity. Unfortunately, transplantation outcomes are far from satisfactory because of insufficient regeneration and adverse pathologic remodeling. Herein, a nitrate-functionalized prosthesis has been incorporated into a decellularized porcine vein graft to fabricate a bio-hybrid vascular graft with local delivery of nitric oxide (NO). Exogenous NO efficiently promotes vascular regeneration and attenuates intimal hyperplasia and vascular calcification in both rabbit and mouse models. The underlying mechanism was investigated using a Sca1 2A-CreER; Rosa-RFP genetic-lineage-tracing mouse model that reveals that Sca1+ stem/progenitor cells (SPCs) are major contributors to vascular regeneration and remodeling, and NO plays a critical role in regulating SPC fate. These results support the translational potential of this off-the-shelf vascular graft.


Subject(s)
Spinocerebellar Ataxias , Vascular Grafting , Animals , Disease Models, Animal , Humans , Hyperplasia/etiology , Mice , Nitric Oxide , Rabbits , Stem Cells , Swine , Vascular Grafting/adverse effects
10.
Article in English | MEDLINE | ID: mdl-34501584

ABSTRACT

Due to the high effectiveness of cancer screening and therapies, the diagnosis of second primary cancers (SPCs) has increased in women with endometrial cancer (EC). However, previous studies providing adequate evidence to support screening for SPCs in endometrial cancer are lacking. This study aimed to develop effective risk prediction models of second primary endometrial cancer (SPEC) in women with obesity (body mass index (BMI) > 25) and included datasets on the incidence of SPEC and the other risks of SPEC in 4480 primary cancer survivors from a hospital-based cancer registry database. We found that obesity plays a key role in SPEC. We used 10 independent variables as predicting variables, which correlated to obesity, and so should be monitored for the early detection of SPEC in endometrial cancer. Our proposed scheme is promising for SPEC prediction and demonstrates the important influence of obesity and clinical data representation in all cases following primary treatments. Our results suggest that obesity is still a crucial risk factor for SPEC in endometrial cancer.


Subject(s)
Endometrial Neoplasms , Neoplasms, Second Primary , Body Mass Index , Endometrial Neoplasms/epidemiology , Female , Hospitals , Humans , Obesity/complications , Obesity/epidemiology , Registries , Risk Factors
11.
Virus Res ; 296: 198338, 2021 04 15.
Article in English | MEDLINE | ID: mdl-33577859

ABSTRACT

Zika is a major teratogenic virus that can be transmitted from pregnant women to the fetus via the transplacental route. At present, no specific vaccines or treatments are available. Large-scale functional genomics approaches for the analysis of host cell function in infection greatly improve the understanding of molecular infection processes and advance the discovery of antiviral targets. We conducted a pooled CRISPR/Cas9 screen to explore trophoblast function upon Zika infection. The identified Zika virus host factors enrich in the ER membrane complex and the signal peptide processing pathway. Finally, we demonstrate that signal peptidase complex subunit 1 (SPCS1) is crucial for virus replication in trophoblasts.


Subject(s)
Zika Virus Infection , Zika Virus , Female , Humans , Membrane Proteins/metabolism , Placenta/metabolism , Pregnancy , Serine Endopeptidases , Trophoblasts/metabolism , Virus Replication/physiology
12.
Cells ; 9(5)2020 04 30.
Article in English | MEDLINE | ID: mdl-32365922

ABSTRACT

Duchenne muscular dystrophy (DMD) is a genetic disorder associated with a progressive deficiency of dystrophin that leads to skeletal muscle degeneration. In this study, we tested the hypothesis that a co-transplantation of two stem/progenitor cell populations, namely bone marrow-derived mesenchymal stem cells (BM-MSCs) and skeletal muscle-derived stem/progenitor cells (SM-SPCs), directly into the dystrophic muscle can improve the skeletal muscle function of DMD patients. Three patients diagnosed with DMD, confirmed by the dystrophin gene mutation, were enrolled into a study approved by the local Bioethics Committee (no. 79/2015). Stem/progenitor cells collected from bone marrow and skeletal muscles of related healthy donors, based on HLA matched antigens, were expanded in a closed MC3 cell culture system. A simultaneous co­transplantation of BM-MSCs and SM-SPCs was performed directly into the biceps brachii (two patients) and gastrocnemius (one patient). During a six­month follow­up, the patients were examined with electromyography (EMG) and monitored for blood kinase creatine level. Muscle biopsies were examined with histology and assessed for dystrophin at the mRNA and protein level. A panel of 27 cytokines was analysed with multiplex ELISA. We did not observe any adverse effects after the intramuscular administration of cells. The efficacy of BM­MSC and SM­SPC application was confirmed through an EMG assessment by an increase in motor unit parameters, especially in terms of duration, amplitude range, area, and size index. The beneficial effect of cellular therapy was confirmed by a decrease in creatine kinase levels and a normalised profile of pro-inflammatory cytokines. BM-MSCs may support the pro-regenerative potential of SM-SPCs thanks to their trophic, paracrine, and immunomodulatory activity. Both applied cell populations may fuse with degenerating skeletal muscle fibres in situ, facilitating skeletal muscle recovery. However, further studies are required to optimise the dose and timing of stem/progenitor cell delivery.


Subject(s)
Mesenchymal Stem Cell Transplantation , Mesenchymal Stem Cells/cytology , Muscle Development , Muscle, Skeletal/physiopathology , Muscular Dystrophy, Duchenne/physiopathology , Tissue Donors , Adolescent , Adult , Biopsy , Cell Fusion , Child , Cytokines/blood , Dystrophin/genetics , Dystrophin/metabolism , Electromyography , Humans , Intercellular Signaling Peptides and Proteins/blood , Mesenchymal Stem Cells/metabolism , Middle Aged , Motor Neurons/pathology , Muscle, Skeletal/pathology , Muscular Dystrophy, Duchenne/blood , Muscular Dystrophy, Duchenne/pathology , Phenotype , RNA, Messenger/genetics , RNA, Messenger/metabolism , Treatment Outcome , Young Adult
13.
Front Genet ; 10: 848, 2019.
Article in English | MEDLINE | ID: mdl-31620166

ABSTRACT

Due to the high effectiveness of cancer screening and therapies, the diagnosis of second primary cancers (SPCs) has increased in women with breast cancer. The present study was conducted to develop a novel machine learning-based classification scheme for predicting the risk factors of SPCs in breast cancer survivors. The proposed scheme was based on the XGBoost classifier with the following four comparable strategies: transformation, resampling, clustering, and ensemble learning, to improve the training balanced accuracy. Results suggested that the best prediction accuracy for an empirical case is the XGBoost associated with the strategies of resampling and clustering. The experimental results showed that age, sequence of radiotherapy and surgery, surgical margins of the primary site, human epidermal growth factor, high-dose clinical target volume, and estrogen receptors are relatively more important risk factors associated with SPCs in patients with breast cancer. These risk factors should be monitored for the early detection of breast cancer. In conclusion, the proposed scheme can support the important influence of personality and clinical symptom representations in all phases of the primary treatment trajectory. Our results further suggested that adaptive machine learning techniques require the incorporation of significant variables for optimal predictions.

14.
Front Chem ; 6: 69, 2018.
Article in English | MEDLINE | ID: mdl-29616215

ABSTRACT

The dual-functional Ca12Al14O33: Tb3+ and Ca12Al14O33: Sm3+ materials were prepared by the Self-Propagating Combustion Synthesis (SPCS) technology. The structure, morphology and light absorption property were investigated by XRD, FT-IR, UV-Vis DRS and SEM etc. The doping of Tb3+ and Sm3+ ions had not changed cubic structure of Ca12Al14O33 but leaded to the slight lattice dilatation and the red-shifts of absorption peaks/edges. The excitation and emission spectra indicated that Ca12Al14O33: Tb3+ and Ca12Al14O33: Sm3+ are superior green and red luminescent materials, respectively, and it displayed the distinctly refined structure characteristics which had importantly reference value for the energy level investigation of Tb3+ and Sm3+ ions. Meanwhile, Ca12Al14O33: Tb3+ and Ca12Al14O33: Sm3+ also exhibited the improved photocatalytic degradation for removing dye MB compared with bare Ca12Al14O33.

15.
Drugs Today (Barc) ; 54(8): 499-505, 2018 Aug.
Article in English | MEDLINE | ID: mdl-30209444

ABSTRACT

The joint 24th Medicines for Europe and 21st International Generic and Biosimilars Association (IGBA) Annual Conference brought together key industry leaders and more than 200 participants in Budapest, Hungary, to discuss both challenges and opportunities for the global generic, biosimilar and value added medicines industries. Challenges relating to sustainability were debated with key experts, who shared perspectives on topics such as medicines shortages, use of data, Brexit, international regulatory cooperation, the E.U. Falsified Medicines Directive (FMD) and the potential impact of antimicrobial resistance. European industry leaders outlined the period of intense preparations needed to ensure compliance by the early 2019 milestones for the FMD and Brexit. The conference also anticipated exciting opportunities for the industry and broadly welcomed the European Commission's legislative proposal for a (long-awaited and much discussed) E.U. Supplementary Protection Certificate manufacturing waiver. Medicines for Europe and IGBA are committed to supporting and strengthening such policy initiatives aimed at boosting European competitiveness, increasing investments in R+D for biosimilar medicines, and most importantly, delivering faster access to medicines for patients. The importance of not forgetting that the ultimate aim of the industry was to facilitate patient access to necessary medicines was stressed throughout the conference. As the conference took place in Hungary, László György (State Secretary for Economic Strategy and Regulation at the Ministry of Innovation and Technology) spoke about the role of technology innovation and access to medicines in the country and the role of his ministry. He indicated that the primary goal of the newly established ministry was to maintain and improve decent living conditions in the light of aging populations and enhance the competitiveness of the pharmaceutical industry, "which plays a decisive role in the Hungarian economy."


Subject(s)
Biosimilar Pharmaceuticals/therapeutic use , Commerce , Drug Industry , Drugs, Generic/therapeutic use , Biosimilar Pharmaceuticals/economics , Biosimilar Pharmaceuticals/supply & distribution , Commerce/economics , Commerce/legislation & jurisprudence , Commerce/trends , Drug Costs , Drug Industry/economics , Drug Industry/legislation & jurisprudence , Drug Industry/trends , Drug and Narcotic Control , Drugs, Generic/economics , Drugs, Generic/supply & distribution , Humans
16.
Bioresour Technol ; 142: 498-503, 2013 Aug.
Article in English | MEDLINE | ID: mdl-23759433

ABSTRACT

A key limitation in the overall hydrolysis process is the restricted access that the hydrolytic enzymes have due to the macro-and-micro structure of cellulose and its association with hemicellulose and lignin. Previous work has shown that several non-hydrolytic proteins can disrupt cellulose structure and boost the activity of hydrolytic enzymes when purer forms of cellulose are used. In the work reported here, Swollenin primarily disrupted the hemicellulosic fraction of pretreated corn stover, resulting in the solubilisation of monomeric and oligomeric sugars. Although Swollenin showed little synergism when combined with the cellulase monocomponents exoglucanase (CEL7A) and endoglucanase (CEL5A), it showed pronounced synergism with xylanase monocomponents Xylanase GH10 and Xylanase GH11, resulting in the release of significantly more xylose (>300%). It appears that Swollenin plays a role in amorphogenesis and that its primary action is enhancing access to the hemicellulose fraction that limits or masks accessibility to the cellulose component of lignocellulosic substrates.


Subject(s)
Biomass , Cellulase/metabolism , Fungal Proteins/metabolism , Xylosidases/metabolism , Chromatography, High Pressure Liquid , Electrophoresis/methods , Hydrolysis , Morphogenesis
17.
Dig Liver Dis ; 45 Suppl 5: S343-8, 2013 Sep 30.
Article in English | MEDLINE | ID: mdl-24091114

ABSTRACT

With the licensing of the direct acting antivirals telaprevir and boceprevir the topic of drug-drug interactions has come to the forefront. These first generation hepatitis C virus protease inhibitors are metabolized by and inhibit the key drug metabolizing enzyme CYP3A4, which means that knowledge of drug-drug interactions has become an essential component of the evaluation of a patient starting triple therapy. The number of potential co-medications means that many drugs will be used in hepatitis C virus patients where there are no pharmacokinetic study data. Here we have to use the data that are available and seek to extrapolate to unstudied drugs using key principles of clinical pharmacology (disposition characteristics, concentration-effect relationships, therapeutic window) in order to give some guidance for management of patients. This is a rapidly moving area in hepatitis C therapy, both in terms of understanding the drug interaction profile of telaprevir and boceprevir, interaction mechanisms that sometimes appear counterintuitive and that may involve enzymes other than CYP3A4 or transporters, but then seeking to understand the interaction potential of the next wave of drugs that will soon be with us.


Subject(s)
Antiviral Agents , Drug Interactions , Hepatitis C, Chronic/drug therapy , Oligopeptides , Proline/analogs & derivatives , Antiviral Agents/metabolism , Antiviral Agents/pharmacokinetics , Antiviral Agents/therapeutic use , Contraindications , Cytochrome P-450 CYP3A/metabolism , Databases, Pharmaceutical , Humans , Internet , Oligopeptides/metabolism , Oligopeptides/pharmacokinetics , Oligopeptides/therapeutic use , Proline/metabolism , Proline/pharmacokinetics , Proline/therapeutic use
SELECTION OF CITATIONS
SEARCH DETAIL