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1.
J Am Chem Soc ; 145(36): 19642-19654, 2023 Sep 13.
Artículo en Inglés | MEDLINE | ID: mdl-37651695

RESUMEN

Asymmetric reactions that convert racemic mixtures into enantioenriched amines are of significant importance due to the prevalence of amines in pharmaceuticals, with about 60% of drug candidates containing tertiary amines. Although transition-metal catalyzed allylic substitution processes have been developed to provide access to enantioenriched α-disubstituted allylic amines, enantioselective synthesis of sterically demanding α-tertiary amines with a tetrasubstituted carbon stereocenter remains a major challenge. Herein, we report a chiral diene-ligated rhodium-catalyzed asymmetric substitution of racemic tertiary allylic trichloroacetimidates with aliphatic secondary amines to afford α-trisubstituted-α-tertiary amines. Mechanistic investigation is conducted using synergistic experimental and computational studies. Density functional theory calculations show that the chiral diene-ligated rhodium promotes the ionization of tertiary allylic substrates to form both anti and syn π-allyl intermediates. The anti π-allyl pathway proceeds through a higher energy than the syn π-allyl pathway. The rate of conversion of the less reactive π-allyl intermediate to the more reactive isomer via π-σ-π interconversion was faster than the rate of nucleophilic attack onto the more reactive intermediate. These data imply that the Curtin-Hammett conditions are met in the amination reaction, leading to dynamic kinetic asymmetric transformation. Computational studies also show that hydrogen bonding interactions between ß-oxygen of allylic substrate and amine-NH greatly assist the delivery of amine nucleophile onto more hindered internal carbon of the π-allyl intermediate. The synthetic utility of the current methodology is showcased by efficient preparation of α-trisubstituted-α-tertiary amines featuring pharmaceutically relevant secondary amine cores with good yields and excellent selectivities (branched-linear >99:1, up to 99% enantiomeric excess).

2.
J Am Chem Soc ; 145(40): 21851-21859, 2023 Oct 11.
Artículo en Inglés | MEDLINE | ID: mdl-37747918

RESUMEN

The functional group compatibility of an electrosynthetic method is typically limited by its potential reaction window. Here, we report that alternating current (AC) electrolysis can overcome such potential window-limited functional group compatibility. Using alkene heterodifunctionalization as a model system, we design and demonstrate a series of AC-driven reactions that add two functional groups sequentially and separately under the cathodic and anodic pulses, including chloro- and bromotrilfuoromethylation as well as chlorosulfonylation. We discovered that the oscillating redox environment during AC electrolysis allows the regeneration of the redox-active functional groups after their oxidation or reduction in the preceding step. As a result, even though redox labile functional groups such as pyrrole, quinone, and aryl thioether fall in the reaction potential window, they are tolerated under AC electrolysis conditions, leading to synthetically useful yields. The cyclic voltammetric study has confirmed that the product yield is limited by the extent of starting material regeneration during the redox cycling. Our findings open a new avenue for improving functional group compatibility in electrosynthesis and show the possibility of predicting the product yield under AC electrolysis from voltammogram features.

3.
J Antimicrob Chemother ; 78(9): 2283-2290, 2023 09 05.
Artículo en Inglés | MEDLINE | ID: mdl-37492974

RESUMEN

BACKGROUND: It is not well known how reliably clinicians order reflex urinalysis to microscopy and culture (rUA-cx) for outpatient urinary tract infection (UTI) workup. Antibiotic appropriateness cannot be fully appreciated until the prevalence of UTIs and asymptomatic bacteriuria (ASB) are realized. OBJECTIVE: This quality improvement study has two major aims, first to determine UTI symptom accuracy for rUA-cx ordering and second, to confirm UTI and ASB cases by integrating rUA-cx and cascaded urinalysis results. Antibiotic utilization and diagnostic coding were secondarily linked to UTIs and ASB. METHODS: An electronic best-practice alert informed the ordering of two rUA-cx options: symptomatic- rUA-cx specifically for dysuria, frequency, urgency, costovertebral pain, suprapubic pain or fever versus non-specific-rUA-cx for vague complaints. UTI symptoms were verified by chart review. Confirmed UTI was defined as a significant culture with UTI symptoms and ASB as a significant culture without UTI symptoms. RESULTS: rUA-cx (2065) were prospectively collected over 6 months from female patients at risk for uncomplicated UTIs. Symptomatic-rUA-cx and non-specific-rUA-cx were associated with UTI symptoms for 53% (809/1527) and 20% (107/538), respectively. Overall, 44% (916/2065) of all rUA-cx had UTI symptoms. rUA-cx were overordered by a factor of 9 (2065/225) for every confirmed UTI. The UTI-to-ASB relative ratio was 2.6 (225/86). Regarding UTI-relevant antibiotics, 39% (214/553) were appropriately associated with UTI whereas only 22% (74/339) of inappropriate antibiotics were captured by the ASB definition, underestimating the problem 4-fold. CONCLUSIONS: UTI and ASB remain challenging to categorize despite a meticulous method that applied acceptable criteria.


Asunto(s)
Programas de Optimización del Uso de los Antimicrobianos , Bacteriuria , Infecciones Urinarias , Humanos , Femenino , Pacientes Ambulatorios , Infecciones Urinarias/diagnóstico , Infecciones Urinarias/tratamiento farmacológico , Infecciones Urinarias/epidemiología , Bacteriuria/diagnóstico , Bacteriuria/tratamiento farmacológico , Bacteriuria/epidemiología , Urinálisis/efectos adversos , Antibacterianos/uso terapéutico , Reflejo , Dolor/complicaciones , Dolor/tratamiento farmacológico
4.
Acc Chem Res ; 55(24): 3738-3751, 2022 12 20.
Artículo en Inglés | MEDLINE | ID: mdl-36448710

RESUMEN

The National Research Council's report in 2012 recognized glycosidic bond forming (glycosylation) reactions as critical due to the central importance of carbohydrates to the glycosciences. This report emphasized the need for the development of reproducible and broadly applicable glycosylation technologies to facilitate the stereoselective synthesis of biomedically relevant glycan libraries for tool development and for research applications by nonspecialists. In response to this report with NIH Common Fund support, the publications of new catalytic diastereoselective glycosylation protocols, some with broad generality under mild conditions, have been recently reported by our group and others. These recent discoveries have also advanced the understanding of the glycosylation reaction mechanism involving the coupling of a sugar electrophile bearing a leaving group at its C1-anomeric center with an alcohol nucleophile. This glycosidic bond forming reaction can lead to a mixture of two stereoisomers that differ in the configuration of the anomeric center.In our group, we discovered that readily available phenanthroline, a rigid and planar organic compound with two fused pyridine rings, could be utilized as a nucleophilic catalyst to promote highly diastereoselective glycosylation of an alcohol nucleophile with a sugar bromide electrophile. The phenanthroline catalysis process allows access to a myriad of high yielding and diastereoselective 1,2-cis pyranosides and furanosides. This catalyst-controlled approach has been applied to the synthesis of a potential vaccine adjuvant α-glucan octasaccharide. For pyranosyl bromide electrophiles, an extensive mechanistic investigation illustrated that two phenanthrolinium ion intermediates, a 4C1 chair-liked equatorial-conformer and a B2,5 boat-like axial-conformer, are formed in a ratio of 2:1 (equatorial/axial). To obtain high levels of axial-1,2-cis selectivity, a Curtin-Hammett scenario was proposed wherein interconversion of the 4C1 equatorial-conformer and B2,5 axial-conformer is more rapid than nucleophilic addition. Hydroxyl attack takes place from the axial-face of the more reactive 4C1 chairlike equatorial intermediate to afford an axial-1,2-cis glycoside product. The phenanthroline catalysis system is applicable to a number of furanosyl bromide electrophiles to provide the challenging 1,2-cis substitution products in good yield and diastereoselectivity. NMR experiments and density-functional theory (DFT) calculations support an associative mechanism in which the rate-determining step takes place from an invertive displacement of the faster reacting furanosyl phenanthrolinium ion intermediate with an alcohol nucleophile. Overall, this work stands at the underdeveloped intersection of operationally simple conditions, catalysis, and stereocontrolled glycosidic bond formation, each of which represents an important theme in the preparation of biologically important oligosaccharides and glycopeptides for applications to human health and medicine.


Asunto(s)
Bromuros , Fenantrolinas , Humanos , Glicosilación , Glicósidos , Azúcares , Catálisis , Estereoisomerismo
5.
J Phys Chem A ; 127(25): 5324-5334, 2023 Jun 29.
Artículo en Inglés | MEDLINE | ID: mdl-37316977

RESUMEN

The incorporation of charged groups proximal to a redox active transition metal center can impact the local electric field, altering redox behavior and enhancing catalysis. Vanadyl salen (salen = N,N'-ethylenebis(salicylideneaminato)) complexes functionalized with a crown ether containing a nonredox active metal cation (V-Na, V-K, V-Ba, V-La, V-Ce, and V-Nd) were synthesized. The electrochemical behavior of this series of complexes was investigated by cyclic voltammetry in solvents with varying polarity and dielectric constant (ε) (acetonitrile, ε = 37.5; N,N-dimethylformamide, ε = 36.7; and dichloromethane, ε = 8.93). The vanadium(V/IV) reduction potential shifted anodically with increasing cation charge compared to a complex lacking a proximal cation (ΔE1/2 > 900 mV in acetonitrile and >700 mV in dichloromethane). In contrast, the reduction potential for all vanadyl salen-crown complexes measured in N,N-dimethylformamide was insensitive to the magnitude of the cationic charge, regardless of the electrolyte or counteranion used. Titration studies of N,N-dimethylformamide into acetonitrile resulted in cathodic shifting of the vanadium(V/IV) reduction potential with increasing concentration of N,N-dimethylformamide. Binding constants of N,N-dimethylformamide (log(KDMF)) for the series of crown complexes show increased binding affinity in the order of V-La > V-Ba > V-K > (salen)V(O), indicating an enhancement of Lewis acid/base interaction with increasing cationic charge. The redox behavior of (salen)V(O) and (salen-OMe)V(O) (salen-OMe = N,N'-ethylenebis(3-methoxysalicylideneamine) was also investigated and compared to the crown-containing complexes. For (salen-OMe)V(O), a weak association of triflate salt at the vanadium(IV) oxidation state was observed through cyclic voltammetry titration experiments, and cation dissociation upon oxidation to vanadium(V) was identified. These studies demonstrate the noninnocent role of solvent coordination and cation/anion effects on redox behavior and, by extension, the local electric field.

6.
Angew Chem Int Ed Engl ; 62(32): e202304325, 2023 08 07.
Artículo en Inglés | MEDLINE | ID: mdl-37285191

RESUMEN

Heparan sulfate (HS) contains variably repeating disaccharide units organized into high- and low-sulfated domains. This rich structural diversity enables HS to interact with many proteins and regulate key signaling pathways. Efforts to understand structure-function relationships and harness the therapeutic potential of HS are hindered by the inability to synthesize an extensive library of well-defined HS structures. We herein report a rational and expedient approach to access a library of 27 oligosaccharides from natural aminoglycosides as HS mimetics in 7-12 steps. This strategy significantly reduces the number of steps as compared to the traditional synthesis of HS oligosaccharides from monosaccharide building blocks. Combined with computational insight, we identify a new class of four trisaccharide compounds derived from the aminoglycoside tobramycin that mimic natural HS and have a strong binding to heparanase but a low affinity for off-target platelet factor-4 protein.


Asunto(s)
Aminoglicósidos , Heparitina Sulfato , Aminoglicósidos/farmacología , Heparitina Sulfato/química , Proteínas/metabolismo , Oligosacáridos/química , Disacáridos
7.
Angew Chem Int Ed Engl ; 62(48): e202314843, 2023 Nov 27.
Artículo en Inglés | MEDLINE | ID: mdl-37856668

RESUMEN

Although there are many methods for the asymmetric synthesis of monosubstituted allylic fluorides, construction of enantioenriched 1,2-disubstituted allylic fluorides has not been reported. To address this gap, we report an enantioselective synthesis of 1,2-disubstituted allylic fluorides using chiral diene-ligated rhodium catalyst, Et3 N ⋅ 3HF as a source of fluoride, and Morita Baylis Hillman (MBH) trichloroacetimidates. Kinetic studies show that one enantiomer of racemic MBH substrate reacts faster than the other. Computational studies reveal that both syn and anti π-allyl complexes are formed upon ionization of allylic substrate, and the syn complexes are slightly energetically favorable. This is in contrast to our previous observation for formation of monosubstituted π-allyl intermediates, in which the syn π-allyl conformation is strongly preferred. In addition, the presence of an electron-withdrawing group at C2 position of racemic MBH substrate renders 1,2-disubstituted π-allyl intermediate formation endergonic and reversible. To compare, formation of monosubstituted π-allyl intermediates was exergonic and irreversible. DFT calculations and kinetic studies support a dynamic kinetic asymmetric transformation process wherein the rate of isomerization of the 1,2-disubstituted π-allylrhodium complexes is faster than that of fluoride addition onto the more reactive intermediate. The 1,2-disubstituted allylic fluorides were obtained in good yields, enantioselectivity, and branched selectivity.

8.
J Am Chem Soc ; 144(16): 7441-7456, 2022 04 27.
Artículo en Inglés | MEDLINE | ID: mdl-35413194

RESUMEN

Stereoselective formation of the 1,2-cis furanosidic linkage, a motif of many biologically relevant oligosaccharides and polysaccharides, remains an important synthetic challenge. We herein report a new stereoselective 1,2-cis furanosylation method promoted by phenanthroline catalysts under mild and operationally simple conditions. NMR experiments and density functional theory calculations support an associative mechanism in which the rate-determining step occurs from an inverted displacement of the faster-reacting phenanthrolinium ion intermediate with an alcohol nucleophile. The phenanthroline catalysis system is applicable to a number of furanosyl bromide donors to provide the challenging 1,2-cis substitution products in good yield with high anomeric selectivities. While arabinofuranosyl bromide provides ß-1,2-cis products, xylo- and ribofuranosyl bromides favor α-1,2-cis products.


Asunto(s)
Bromuros , Fenantrolinas , Catálisis , Glicosilación , Estereoisomerismo
9.
ScientificWorldJournal ; 2022: 7872307, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35645630

RESUMEN

Depolymerization of lignin is an important step to obtain a lignin monomer for the synthesis of functional chemicals. In the context of more lignin produced from biomass and pulp industry, converting real lignin with low purity is still required more studies. In this study, the influence of solvent composition and reaction parameters such as binary solvents ratio, time, and temperature, the solvent-to-lignin ratio on the depolymerization of rice straw lignin was investigated carefully. Essential lignin-degraded products including liquid product (LP), char (solid), and gas were obtained, and their yields were directly influenced by reaction conditions. Results show that the maximum lignin conversion rate of 92% and LP yield of 66% was under the condition of 275°C, 30 min, 75 : 1 (mL solvent/1 g lignin), and ethanol 50%. Gas chromatography-mass spectroscopy (GC-MS) analysis was used for the analysis of the depolymerization products and identified 11 compounds which are mainly phenolic compounds such as 2-ethylphenol, 3-ethylphenol, phenol, methyl 2,4,6-trimethylbenzoate. The structure changes of LP and char in various conditions were analyzed using Fourier-transform infrared (FTIR).


Asunto(s)
Lignina , Oryza , Biomasa , Etanol/química , Lignina/química , Solventes/química
10.
Ann Pharm Fr ; 80(5): 711-717, 2022 Sep.
Artículo en Francés | MEDLINE | ID: mdl-35101367

RESUMEN

OBJECTIVES: Evaluate the interest in the MyDéfi application as a tool to help pharmacists identify and manage excessive alcohol consumption, as well as their perception and knowledge of alcohol and their possible role in its management. METHODS: Prospective mixed qualitative and quantitative study, based on face-to-face semi-directive interviews. RESULTS: The 101 pharmacists interviewed in Hauts-de-France region considered that the detection of alcohol consumption was part of their mission, even if it is a difficult subject, and that they had received specific training in alcohology during their university training. Only 12% were aware of early screening and brief intervention on alcohol. Several obstacles were mentioned, such as the lack of training and confidentiality, and difficulties related to patient specificities. Forty-one percent said that the pharmacy was not suitable and almost 72% said that the MyDéfi application could be useful for screening and 91% would recommend the application as one of the best supports, easy to advise with a personalised follow-up. For 32%, the application is accessible to patients (40% think that the main drawback of the application is inaccessibility and 27% its cost). CONCLUSION: Pharmacists consider that excessive alcohol use is a major problem that should mobilise them but many do not feel ready to offer brief interventions. After seeing how the MyDéfi application worked, the majority considered that it could help them in their prevention mission.


Asunto(s)
Aplicaciones Móviles , Farmacéuticos , Consumo de Bebidas Alcohólicas/prevención & control , Etanol , Humanos , Estudios Prospectivos , Teléfono Inteligente
11.
Semin Thromb Hemost ; 47(3): 240-253, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33794549

RESUMEN

Cell surface proteoglycans are important constituents of the glycocalyx and participate in cell-cell and cell-extracellular matrix (ECM) interactions, enzyme activation and inhibition, and multiple signaling routes, thereby regulating cell proliferation, survival, adhesion, migration, and differentiation. Heparanase, the sole mammalian heparan sulfate degrading endoglycosidase, acts as an "activator" of HS proteoglycans, thus regulating tissue hemostasis. Heparanase is a multifaceted enzyme that together with heparan sulfate, primarily syndecan-1, drives signal transduction, immune cell activation, exosome formation, autophagy, and gene transcription via enzymatic and nonenzymatic activities. An important feature is the ability of heparanase to stimulate syndecan-1 shedding, thereby impacting cell behavior both locally and distally from its cell of origin. Heparanase releases a myriad of HS-bound growth factors, cytokines, and chemokines that are sequestered by heparan sulfate in the glycocalyx and ECM. Collectively, the heparan sulfate-heparanase axis plays pivotal roles in creating a permissive environment for cell proliferation, differentiation, and function, often resulting in the pathogenesis of diseases such as cancer, inflammation, endotheliitis, kidney dysfunction, tissue fibrosis, and viral infection.


Asunto(s)
Enfermedad , Glucuronidasa/metabolismo , Heparitina Sulfato/metabolismo , Humanos
12.
Adv Synth Catal ; 363(16): 4054-4066, 2021 Aug 13.
Artículo en Inglés | MEDLINE | ID: mdl-35431716

RESUMEN

Phenanthroline, a rigid and planar compound with two fused pyridine rings, has been used as a powerful ligand for metals and a binding agent for DNA/RNA. We discovered that phenanthroline could be used as a nucleophilic catalyst to efficiently access high yielding and diastereoselective α-1,2-cis glycosides through the coupling of hydroxyl acceptors with α-glycosyl bromide donors. We have conducted an extensive investigation into the reaction mechanism, wherein the two glycosyl phenanthrolinium ion intermediates, a 4C1 chair-liked ß-conformer and a B2,5 boat-like α-conformer, have been detected in a ratio of 2:1 (ß:α) using variable temperature NMR experiments. Furthermore, NMR studies illustrate that a hydrogen bonding is formed between the second nitrogen atom of phenanthroline and the C1-anomeric hydrogen of sugar moiety to stabilize the phenanthrolinium ion intermediates. To obtain high α-1,2-cis stereoselectivity, a Curtin-Hammett scenario was proposed wherein interconversion of the 4C1 chair-like ß-conformer and B2,5 boat-like α-conformer is more rapid than nucleophilic addition. Hydroxyl attack takes place from the α-face of the more reactive 4C1 ß-phenanthrolinium intermediate to give an α-anomeric product. The utility of the phenanthroline catalysis is expanded to sterically hindered hydroxyl nucleophiles and chemoselective coupling of an alkyl hydroxyl group in the presence of a free C1-hemiacetal. In addition, the phenanthroline-based catalyst has a pronounced effect on site-selective couplings of triol motifs and orthogonally activates the anomeric bromide leaving group over the anomeric fluoride and sulfide counterparts.

13.
Inorg Chem ; 60(17): 12801-12812, 2021 Sep 06.
Artículo en Inglés | MEDLINE | ID: mdl-34432458

RESUMEN

Previously, we reported a visible light-activated Cu(I) photocatalyst capable of facilitating C-O bond formation of glycosyl bromides and aliphatic alcohols with a high degree of diastereoselectivity. This catalyst functions equally well in the presence of radical traps, suggesting an entirely inner sphere mechanism atypical for heteroleptic Cu photocatalysis. Further, experimental estimates put the chromophore reducing power at -1.30 V vs Ag/AgCl. This is much more positive than the ∼-2.0 V vs Ag/AgCl onset observed for irreversible reduction of glycosyl bromides in our experiments. Theoretical investigations were undertaken to explain the function of the catalyst. Outer sphere electron transfer from a chromophore to substrate was discounted based on thermodynamics and electron transfer barriers determined by Marcus theory and non-equilibrium solvation calculations. Unactivated and activated chromophores were found to disproportionate to Cu(0) and Cu(II) species. The resulting Cu(0) species undergoes oxidative addition with a glycosyl bromide generating a Cu(II) species. Addition of a nucleophilic alcohol and oxidation of the Cu(II) species to Cu(III) result in rapid reductive elimination forming products and resetting the catalytic cycle.

14.
J Am Chem Soc ; 141(37): 14843-14852, 2019 09 18.
Artículo en Inglés | MEDLINE | ID: mdl-31438667

RESUMEN

Asymmetric allylic fluorination has proven to be a robust and efficient methodology with potential applications for the development of pharmaceuticals and practical synthesis for 18F-radiolabeling. A combined computational (dispersion-corrected DFT) and experimental approach was taken to interrogate the mechanism of the diene-ligated, iridium-catalyzed regio- and enantioselective allylic fluorination. Our group has shown that, in the presence of an iridium(I) catalyst and nucleophilic fluoride source (Et3N·3HF), allylic trichloroacetimidates undergo rapid fluoride substitution to generate allylic fluoride products with excellent levels of branched-to-linear ratios. Mechanistic studies reveal the crucial role of the trichloroacetimidate as a potent leaving group and ligand to enable conversion of racemic allylic trichloroacetimidates to the corresponding enantioenriched allylic fluorides, via a dynamic kinetic asymmetric transformation (DYKAT), in the presence of the chiral bicyclo[3.3.0]octadiene-ligated iridium catalyst.

15.
Angew Chem Int Ed Engl ; 58(21): 6957-6961, 2019 05 20.
Artículo en Inglés | MEDLINE | ID: mdl-30920099

RESUMEN

Carbohydrates are essential moieties of many bioactive molecules in nature. However, efforts to elucidate their modes of action are often impeded by limitations in synthetic access to well-defined oligosaccharides. Most of the current methods rely on the design of specialized coupling partners to control selectivity during the formation of glycosidic bonds. Reported herein is the use of a commercially available phenanthroline to catalyze stereoretentive glycosylation with glycosyl bromides. The method provides efficient access to α-1,2-cis glycosides. This protocol has been performed for the large-scale synthesis of an octasaccharide adjuvant. Density-functional theory calculations, together with kinetic studies, suggest that the reaction proceeds by a double SN 2 mechanism.


Asunto(s)
Bromuros/química , Glicósidos/química , Fenantrolinas/química , Catálisis , Glicosilación , Cinética , Estereoisomerismo
16.
Clin Infect Dis ; 67(11): 1677-1685, 2018 11 13.
Artículo en Inglés | MEDLINE | ID: mdl-29688279

RESUMEN

Background: Increasing antibiotic resistance has made benchmarking appropriate inpatient antibiotic use a worldwide priority supported by expert societies and regulatory bodies; however, standard risk adjustment for fair interfacility comparison has been elusive. We describe a risk-adjusted antibiotic exposure ratio that may help facilitate assessment of antimicrobial use. Methods: This was a retrospective cohort study of 2.7 million admissions evaluating a wide array of potential explanatory variables for correlation with expected antibiotic consumption in a 2-step approach using recursive partitioning and Poisson regression. Observed-to-expected ratios of risk-adjusted antibiotic use were calculated. Three models of varying complexity were compared: (1) a complex ratio consisting of all available antibiotic use risk factors in a hierarchical model; (2) a simplified antimicrobial stewardship program (ASP) ratio using common facility and encounter factors in a single-level model; and (3) a facility ratio using only broad hospital characteristics. Results: Diagnosis-related groups, infection present on admission, patient class, and unit type were the major predictors of expected antibiotic use. Aside from a history of gram-positive resistance in the prior 12 months for anti-methicillin-resistant Staphylococcus aureus drugs, additional clinical and comorbid history information did not improve the model. The simplified ASP ratio demonstrated higher Pearson correlation (R2 = 0.97-0.99) to the complex ratio than the facility ratio (R2 = 0.57-0.85) and provided clinical explanations when discordant. Conclusions: The simplified ASP ratio is derived from a parsimonious model that incorporates disease burden through patient-level risk adjustment and better informs stewardship assessment. This may allow for improved comparison of antibiotic use between healthcare facilities.


Asunto(s)
Antibacterianos/uso terapéutico , Programas de Optimización del Uso de los Antimicrobianos , Benchmarking , Pacientes Internos , Adulto , Anciano , Interpretación Estadística de Datos , Farmacorresistencia Microbiana , Femenino , Hospitales , Humanos , Masculino , Persona de Mediana Edad , Salud Pública , Estudios Retrospectivos , Ajuste de Riesgo , Factores de Riesgo
17.
Biomacromolecules ; 18(10): 3387-3399, 2017 Oct 09.
Artículo en Inglés | MEDLINE | ID: mdl-28846389

RESUMEN

We report herein the first-time exploration of the attachment of well-defined saccharide units onto a synthetic polymer backbone for the inhibition of a glycosidase. More specifically, glycopolymers endowed with heparan sulfate (HS) disaccharides were established to inhibit the glycosidase, heparanase, with an IC50 value in the low nanomolar range (1.05 ± 0.02 nm), a thousand-fold amplification over its monovalent counterpart. The monomeric moieties of these glycopolymers were designed in silico to manipulate the well-established glycotope of heparanase into an inhitope. Studies concluded that (1) the glycopolymers are hydrolytic stable toward heparanase, (2) longer polymer length provides greater inhibition, and (3) increased local saccharide density (monoantennary vs diantennary) is negligible due to hindered active site of heparanase. Furthermore, HS oligosaccharide and polysaccharide controls illustrate the enhanced potency of a multivalent scaffold. Overall, the results on these studies of the multivalent presentation of saccharides on bottlebrush polymers serve as the platform for the design of potent glycosidase inhibitors and have potential to be applied to other HS-degrading proteins.


Asunto(s)
Inhibidores Enzimáticos/síntesis química , Heparitina Sulfato/química , Sitios de Unión , Inhibidores Enzimáticos/farmacología , Glucuronidasa/antagonistas & inhibidores , Polimerizacion , Unión Proteica
18.
Clin Infect Dis ; 61(9): 1446-52, 2015 Nov 01.
Artículo en Inglés | MEDLINE | ID: mdl-26105168

RESUMEN

Given current challenges in antimicrobial resistance and drug development, infectious diseases clinicians must rely on their own ingenuity to effectively treat infections while preserving the current antimicrobial armamentarium. An understanding of pharmacokinetics (PK), pharmacodynamics (PD), antimicrobial susceptibility testing (AST), and how these concepts relate, is essential to this task. In this review, we discuss how and why PK-PD impacts AST and the way infectious diseases are being treated, with a particular focus on vancomycin for methicillin-resistant Staphylococcus aureus, penicillin for Streptococcus pneumoniae, and an update on cephalosporins for Enterobacteriaceae. Finally, we address how new ideas to exploit PK-PD can promote innovative study design and bring about more rapid regulatory review of new antimicrobials.


Asunto(s)
Antibacterianos/farmacología , Antibacterianos/farmacocinética , Enterobacteriaceae/efectos de los fármacos , Staphylococcus aureus Resistente a Meticilina/efectos de los fármacos , Pruebas de Sensibilidad Microbiana/métodos , Streptococcus pneumoniae/efectos de los fármacos , Cefalosporinas/farmacocinética , Cefalosporinas/farmacología , Cefalosporinas/uso terapéutico , Aprobación de Drogas , Descubrimiento de Drogas/métodos , Evaluación Preclínica de Medicamentos/métodos , Infecciones por Enterobacteriaceae/tratamiento farmacológico , Infecciones por Enterobacteriaceae/microbiología , Humanos , Penicilinas/farmacocinética , Penicilinas/farmacología , Penicilinas/uso terapéutico , Infecciones Neumocócicas/tratamiento farmacológico , Infecciones Neumocócicas/microbiología , Infecciones Estafilocócicas/tratamiento farmacológico , Infecciones Estafilocócicas/microbiología , Vancomicina/farmacocinética , Vancomicina/farmacología , Vancomicina/uso terapéutico
19.
J Am Chem Soc ; 137(37): 11912-5, 2015 Sep 23.
Artículo en Inglés | MEDLINE | ID: mdl-26348569

RESUMEN

The Ir-catalyzed enantioselective fluorination of racemic, branched allylic trichloroacetimidates with Et3N·3HF is a mild and efficient route for selective incorporation of fluoride ion into allylic systems. We herein describe the asymmetric fluorination of racemic, secondary allylic electrophiles with Et3N·3HF using a chiral-diene-ligated Ir complex. The methodology enables the formation of acyclic fluorine-containing compounds in good yields with excellent levels of asymmetric induction and overcomes the limitations previously associated with the enantioselective construction of secondary allylic fluorides bearing α-linear substituents.


Asunto(s)
Acetamidas/química , Cloroacetatos/química , Halogenación , Iridio/química , Catálisis , Modelos Moleculares , Conformación Molecular , Estereoisomerismo
20.
Biomacromolecules ; 16(12): 4013-4021, 2015 Dec 14.
Artículo en Inglés | MEDLINE | ID: mdl-26580410

RESUMEN

Preparations of the highly ordered monoantennary, homofunctional diantennary, and heterofunctional diantennary neoglycopolymers of α-d-mannose and ß-d-glucose residues were achieved via ring-opening metathesis polymerization. Isothermal titration calorimetry measurements of these synthetic neoglycopolymers with Concanavalin A (Con A), revealed that heterofunctional diantennary architectures bearing both α-mannose and nonbinding ß-glucose units, poly(Man-Glc), binds to Con A (Ka = 16.1 × 10(6) M(-1)) comparably to homofunctional diantennary neoglycopolymer (Ka = 30 × 10(6) M(-1)) bearing only α-mannose unit, poly(Man-Man). In addition, poly(Man-Glc) neoglycopolymer shows a nearly 5-fold increasing in binding affinity compared to monoantennary neoglycopolymer, poly(Man). Although the exact mechanism for the high binding affinity of poly(Man-Glc) to Con A is unclear, we hypothesize that the α-mannose bound to Con A might facilitate interaction of ß-glucose with the extended binding site of Con A due to the close proximity of ß-glucose to α-mannose residues in the designed polymerizable scaffold.


Asunto(s)
Concanavalina A/química , Glucosa/química , Manosa/química , Sitios de Unión , Calorimetría/métodos , Conformación de Carbohidratos , Cinética , Polimerizacion
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