Risk factors for irinotecan-induced liver injury: a retrospective multicentre cross-sectional study in China.

OBJECTIVES: The hepatotoxicity of irinotecan has been widely implicated in the treatment of multiple solid tumours. However, there are few studies on the influencing factors of irinotecan-induced hepatotoxicity. Herein, we investigated the risk factors for irinotecan-induced liver injury among 421 patients receiving irinotecan-based regimens (IBRs). DESIGN: Retrospective multi-centre cross-sectional study. SETTING: This study surveyed four hospitals in China. PARTICIPANTS: After excluding participants with missing variables, we retrospectively collected the demographic, clinical and therapeutic data of 421 patients who received IBRs in four hospitals between January 2020 and December 2021 and divided the patients into two groups: those without liver injury and those with liver injury. RESULTS: The 421 enrolled patients were grouped (liver injury group: n=92; control group: n=329) according to their hepatic biochemical monitoring parameters. In our study, the multivariate logistic regression results showed that three to four cycles of chemotherapy (OR (95% CI): 2.179 (1.272 to 3.733); p=0.005) and liver metastasis (OR (95% CI): 1.748 (1.079 to 2.833); p=0.023) were independent risk factors for irinotecan-induced liver injury. The Cox proportional hazards model demonstrated that alcohol consumption history (OR (95% CI): 2.032 (1.183 to 3.491); p=0.010) and a cumulative dose of irinotecan ≥1000 mg (OR (95% CI): 0.362 (0.165 to 0.792); p=0.011) were significantly correlated with the onset time of irinotecan-induced liver injury. CONCLUSIONS: These findings suggest that patients with liver metastasis or who received three to four cycles of chemotherapy should undergo rigorous liver function monitoring to prevent or reduce the incidence of irinotecan-induced liver injury. Moreover, patients with a history of alcohol consumption should also be closely monitored.

Risk factors for oxaliplatin-induced hypersensitivity reaction in patients with colorectal cancer.

OBJECTIVE: Hypersensitivity reactions with oxaliplatin (OXA) have attracted much attention. This study aimed to analyze the risk factors for OXA-induced hypersensitivity reaction in Chinese colorectal cancer patients through a single-center retrospective investigation. METHODS: The information from 459 colorectal cancer patients treated with OXA in a hospital was collected retrospectively to explore the risk factors for OXA-induced hypersensitivity reaction. RESULTS: Among the 459 patients, 47 (10.24% incidence) cases developed hypersensitivity reactions, with a 3.70% incidence of grade III/IV reaction. The main symptoms included itching, flushing, dyspnea, and rash, which mainly involved skin and adnexa, respiratory system, and nervous system. Dexamethasone pretreatment presented no significant effects on the hypersensitivity reaction (P = 0.282). Multivariate analysis indicated that the previous allergic history (odds ratio (OR) 2.553, 95% confidence interval (CI) 1.139-5.721, P = 0.023) and OXA-free interval (OR 3.605, 95% CI 1.909-6.809, P = 0.000) were independent risk factors for OXA-induced hypersensitivity reaction. CONCLUSIONS: The incidence of OXA-induced hypersensitivity reaction in colorectal cancer patients was similar to those reported in other countries. Clinical medical staff should pay close attention to high-risk factors, such as allergic history and patients having OXA-free intervals in order to avoid or alleviate hypersensitivity reactions.

Clinical Features of Oxaliplatin-induced Hypersensitivity Reactions in Chinese Patients: A Retrospective Multicenter Analysis.

OBJECTIVE: The characteristics of oxaliplatin-induced hypersensitivity reactions (HSRs) in Chinese patients were investigated to provide a reference for patients treated with oxaliplatin. METHODS: The study reviewed the records of patients who developed oxaliplatin-induced HSRs in 17 hospitals from May 2016 to May 2017. We collected and analyzed the basic information, history of oxaliplatin administration and premedication treatments, chemotherapy cycles, HSR symptoms, and the management and outcomes of these patients. RESULTS: Oxaliplatin-induced HSRs were recorded in 137 patients who had been treated with oxaliplatin-containing regimens. Five different chemotherapy regimens were applied. The median infusion cycle when oxaliplatin-induced HSRs occurred was 7, and HSRs occurred during or shortly after oxaliplatin infusion. Most of the patients experienced grade 1 or grade 2 HSRs with mild symptoms of pruritis (49.64%), flushing (46.72%), chest discomfort (26.28%), and urticaria (25.55%). The majority of the patients completely recovered from HSRs following treatment with antihistamines and dexamethasone. Seven patients completed chemotherapy with oxaliplatin after the symptoms resolved with proper management. CONCLUSION: The results indicate that oxaliplatin-induced HSRs remain an important issue in safely and successfully fulfilling oxaliplatin-containing chemotherapy. Further studies are needed to analyze the risk factors and establish prophylaxis for such reactions.

Dahurelmusin A, a Hybrid Peptide-Polyketide from Elymus dahuricus Infected by the Epichloë bromicola Endophyte.

One novel hybrid peptide-polyketide, dahurelmusin A (1), was isolated from Elymus dahuricus infected by the Epichloë bromicola endophyte. Comprehensive spectroscopic analysis revealed that 1 is the first example of hybrid peptide-polyketide possessing an unprecedented 5-hydroxy-2,2,4,6-tetramethyl-3-oxooctanoic acid moiety. The single-crystal X-ray diffraction analyses allowed the absolute configuration assignment of this compound. Compound 1 also exhibited significant insecticidal activities against Rhopalosiphum padi and Brevicoryne brassicae with LC50 values of 0.092 and 0.251 mM, respectively.

Highly oxygenated triterpenoids from the roots of Schisandra chinensis and their anti-inflammatory activities.

A new highly oxygenated triterpenoid, schinchinenlactone D (1), and three known compounds (2-4) were isolated from the roots of Schisandra chinensis. Their structures were determined by combining the spectroscopic analysis with the theoretical computations. The anti-inflammatory activities of compounds 1-4 were evaluated, and compound 3 exhibits the most significant activity in the inhibition of NO production with an IC50 value of 10.6 µM.

Effect of HbA1C detection on the diagnostic screening for glucose metabolic disorders in polycystic ovary syndrome.

PURPOSE: This study aimed to assess the effect of hemoglobin A1C (HbA1C) detection on the diagnostic screening for glucose metabolic disorders in women with polycystic ovary syndrome (PCOS). MATERIALS AND METHODS: A total of 161 patients with PCOS (mean age = 23.68 +/- 4.23 years) were subjected to an oral glucose tolerance test (OGTT). The receiver operating characteristic (ROC) curve was plotted to evaluate the fasting plasma glucose (FPG), and HbA1C was used to probe the sensitivity and specificity of abnormal glucose tolerance. RESULTS: Based on the traditional standards of blood sugar, the prevalence of type 2 diabetes was 5.6%, and the pre-diabetes prevalence was 7.5%. Based on the HbA1C standards, 4.3% of patients were diagnosed with type 2 diabetes, and 10.6% of the diabetic patients can be considered as high-risk populations. Based on the combined standards of OGTT and HbA1C, the prevalence of type 2 diabetes was 6.2%, and the pre-diabetes prevalence was 12.4%. OGTT is considered the gold standard for identifying abnormal glucose tolerance, and HbA1C detection is considered to be stronger than FPG. The areas under the ROC curves of HbA1C and FPG were 0.968 and 0.672, respectively (p < 0.01). The American Diabetes Association (ADA) recommends the cut-off value of HbA1c > or = 5.7% and FPG > or = 5.6 mmol/l for identifying abnormal glucose tolerance. The sensitivity and specificity were 76.7% and 89.5% for HBA1C, as well as 40.5% and 94.3% for FPG, respectively. The positive and negative likelihood ratios were 7.3 and 0.26 for HbA1C, as well as 7.1 and 0.63 for FPG, respectively. CONCLUSION: HbA1C detection can be used as a method for diagnosis and screening.

Eleven new highly oxygenated triterpenoids from the leaves and stems of Schisandra chinensis.

Eleven new triterpenoids, schinchinenins A­H (1­8) and schinchinenlactones A­C (9­11) together with three known triterpenoids, henrischinins A­C (12­14), were isolated from the leaves and stems of Schisandra chinensis by bioassay-guided fractionation. Schinchinenin A (1) is the first example of a highly oxygenated triterpenoid characterized by a 5/5/7/6/5-fused pentacyclic ring and a 3-one-2-oxabicyclo[3.2.1]-octane moiety. Schinchinenins E and F (5 and 6) are highly oxygenated triterpenoids that contain a hydroperoxyl moiety, which is rare in compounds from the Schisandra genus. The structures and stereochemistry of 1­11 were elucidated using spectroscopic analysis, single-crystal X-ray diffraction, computational optical rotation, chemical transformation, and CD exciton chirality methods. The activities of compounds 1, 2, 7, and 12­14 against HSV-2 and adenovirus were evaluated for the first time, and of these compounds, 13 was the most active inhibitor of HSV-2, with a selectivity index value as high as 29.95.