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PURPOSE/BACKGROUND: In clozapine therapeutic drug monitoring (TDM) studies, Chinese reached the same concentrations using half the dosage Caucasians use. Defining clozapine poor metabolizers (PMs) requires stratification by ethnicity, smoking, and sex. METHODS/PROCEDURES: After sex and smoking stratification in 129 Chinese inpatients (mean, 8.8 TDM samples per patient), we explored the association between the total concentration-dose (C/D) ratio and CYP1A2 (*1C, *1F, and *7) and CYP2C19 alleles (*2 and *3). A systematic literature review identified 22 clozapine TDM prior studies (13 in Caucasians and 7 in East Asians). FINDINGS/RESULTS: In our Chinese sample, the mean total clozapine C/D ratio (ng/mL per mg/d) was 1.96 for 22 male smokers, 2.07 for 5 female smokers, 2.47 for 36 male nonsmokers, and 2.95 for 66 female nonsmokers. CYP1A2 *1C had no significant effects, and CYP1A2 *1F had small effects. Five clozapine PMs (4%) needed low clozapine doses of 75 to 115 mg/d to get therapeutic concentrations. Using the same methodology in a published Italian sample, we found 5 PMs (3.3% of 152). In the systematic review, the clozapine C/D ratio (ng/mL per mg/d) was higher when comparing: (1) weighted mean values of 1.57 in 876 East Asians versus 1.07 in 1147 Caucasians and (2) ranks of 8 East Asians versus 13 Caucasian samples (P < 0.001). IMPLICATIONS/CONCLUSIONS: Future TDM studies need to further explore the frequency of clozapine PMs after sex and smoking stratification in East Asian and Caucasian patients. Compared with Caucasians, East Asians appear to have a clinically relevant decrease in clozapine clearance.
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Antipsicóticos/metabolismo , Povo Asiático/genética , Clozapina/metabolismo , População Branca/genética , Citocromo P-450 CYP1A2/genética , Citocromo P-450 CYP2C19 , Monitoramento de Medicamentos/métodos , Feminino , Humanos , Masculino , Projetos Piloto , Prevalência , Fatores Sexuais , Fumar/metabolismoRESUMO
Nanoparticles (NPs) with feature sizes ranging between 1 nm and 100 nm have increasingly gained momentum for their versatile functionality as the pharmaceutical agents in many branches of biomedical research and clinical experiments. However, NPs' inherent material toxicity and the concomitant adverse effects of their function, such as photo-physical properties, often remain a major concern over the issues of environmental safety and human health, and require a thorough assessment before a wide-spread usage can be complied. This research herein investigates the intrinsic and photothermal toxicity of Cs0.33WO3 NPs solution in zebrafish larvae through a direct immersion method. Experimentally, the survival, hatching and malformation rates of zebrafish embryo/larvae as functions of the NP feature sizes, concentration and duration of photothermal dose were examined and analyzed. This study verified that the Cs0.33WO3 NPs has an intrinsic toxicity on a scale of a fraction of 1 mg/ml, and the phototoxicity effect of the NIR-irradiated NPs, when irradiated for 30 min, can affect the embryogenesis of zebrafish larvae and causes 60% and 50% in the survival and delayed hatching rates, respectively, as well as a severe malformation.
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Childhood-onset schizophrenia (COS) is an unusual severe neurodevelopmental disorder of unknown etiology. In this study, we aimed to survey the missense variants in new cases of COS and also identify possible pathology biomarkers for COS. We found one list of mutated genes such as TTN, MUC12, and MUC2, which are the candidates to be involved in the etiology of COS. Next, we used WGSNA to predict COS disease-related genes and identified differential DNA methylation among COS disease groups, COS dangerous groups, and normal groups and found eight methylation sites that can be used as the diagnostic biomarkers. A total of six key genes are obtained through the intersection analysis between weighted correlation network analysis (WGCNA) mode, methylation-related genes, and differentially expressed genes (DGenes). These genes may play important roles in the progression of COS and serve as the potential biomarkers for future diagnosis. Our results might help to design the molecule or gene-targeted drugs for COS.
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Anti-B cell maturation antigen (BCMA) chimeric antigen receptor (CAR) T-cell therapy is effective and well-tolerated for refractory or relapsed multiple myeloma (RRMM). The purpose of the present study was to analyze efficacy in RRMM patients with renal impairment treated by anti-BCMA CAR-T cell therapy. A total of 59 RRMM patients were selected, and divided into impaired renal function (IRF) group [baseline estimated glomerular filtration rate (eGFR) < 90 mL/min/1.73 m2 (n=18)] and normal renal function (NRF) group (baseline eGFR ≥ 90 mL/min/1.73 m2, n=41). For patients with IRF, eGFR at the 6th month post-CAR-T cells infusion was significantly higher than the baseline (P<0.05). The multivariate analysis showed that light chain type and beta-2 micro-globulin (beta-2M) were associated factors with the decrease of serum creatinine. Median progression-free survival (PFS) in the NRF group and IRF group was 266 days and 181 days respectively. Overall survival (OS) in the NRF group and IRF group was 877 days and 238 days respectively. There was no significant difference in the objective response rate (ORR) between the IRF group and the NRF group. It is suggested that CAR-T cells therapy could improve the renal function during the treatment of RRMM. The renal function could be more significantly improved in RRMM patients with light chain type than with other types.
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Antígeno de Maturação de Linfócitos B/genética , Imunoterapia Adotiva , Nefropatias/terapia , Mieloma Múltiplo/terapia , Adulto , Antígeno de Maturação de Linfócitos B/antagonistas & inibidores , Terapia Baseada em Transplante de Células e Tecidos/tendências , Feminino , Regulação Neoplásica da Expressão Gênica/efeitos dos fármacos , Humanos , Rim/efeitos dos fármacos , Rim/patologia , Nefropatias/complicações , Nefropatias/genética , Nefropatias/patologia , Masculino , Pessoa de Meia-Idade , Mieloma Múltiplo/complicações , Mieloma Múltiplo/genética , Mieloma Múltiplo/patologia , Receptores de Antígenos Quiméricos/genética , Receptores de Antígenos Quiméricos/uso terapêuticoRESUMO
The aims are to evaluate the efficacy and safety of aripiprazole for tic disorders (TDs) in children and adolescents. We searched PubMed, Embase, PsychINFO, Cochrane database as well as Chinese databases of CNKI, VIP, CBM and Wanfang from the database inception to October 2016, and 17 full-text studies (N=1305) were included in our article. The meta-analysis of 10 studies (N=817) showed that there was no significant difference in the reduction of total YGTSS score between aripiprazole and other drugs, and meta-analysis of 7 studies (n=324) which used tic symptom control â§30% as outcome measure showed that there was no significant difference between aripiprazole and other treatments. The most common AEs of aripiprazole were the drowsiness, nausea/vomiting and increased appetite, and meta analysis which used the TESS scale as the outcome measurement showed that there was a significant difference between aripiprazole and haloperidol. In conclusion, these data provide moderate quality evidence that aripiprazole could be an effective and safe treatment option for TDs, and results from further trials are urgently needed to extend this evidence base.
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Antipsicóticos/uso terapêutico , Aripiprazol/uso terapêutico , Transtornos de Tique/tratamento farmacológico , Transtornos de Tique/psicologia , Adolescente , Criança , Humanos , Comportamento Problema/psicologia , Estudos Prospectivos , Ensaios Clínicos Controlados Aleatórios como Assunto/métodos , Transtornos de Tique/diagnóstico , Resultado do TratamentoRESUMO
One of the greatest challenges in the deployment of chemotherapeutic drugs against brain tumors is ensuring that sufficient drug concentrations reach the tumor, while minimizing drug accumulation at undesired sites. Recently, injection of therapeutic agents following blood-brain barrier (BBB) opening by focused ultrasound (FUS) with microbubbles (MBs) has been shown to enhance drug delivery in targeted brain regions. Nevertheless, the distribution and quantitative deposition of agents delivered to the brain are still hard to estimate. Based on our previous work on superparamagnetic iron oxide (SPIO)-loaded MBs, we present a novel theranostic complex of SPIO-Doxorubicin (DOX)-conjugated MB (SD-MB) for drug delivery to the brain. Magnetic labeling of the drug enables direct visualization via magnetic resonance imaging, and also facilitates magnetic targeting (MT) to actively enhance targeted deposition of the drug. In a rat glioma model, we demonstrated that FUS sonication can be used with SD-MBs to simultaneously facilitate BBB opening and allow dual ultrasound/magnetic targeting of chemotherapeutic agent (DOX) delivery. The accumulation of SD complex within brain tumors can be significantly enhanced by MT (25.7 fold of DOX, 7.6 fold of SPIO). The change in relaxation rate R2 (1/T2) within tumors was highly correlated with SD deposition as quantified by high performance liquid chromatography (R(2) = 0.93) and inductively coupled plasma-atomic emission spectroscopy (R(2) = 0.94), demonstrating real-time monitoring of DOX distribution. Our results suggest that SD-MBs can serve as multifunction agents to achieve advanced molecular theranostics.
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Antineoplásicos/administração & dosagem , Neoplasias Encefálicas/diagnóstico por imagem , Neoplasias Encefálicas/tratamento farmacológico , Doxorrubicina/administração & dosagem , Compostos Férricos/administração & dosagem , Imageamento por Ressonância Magnética/métodos , Microbolhas , Ultrassonografia , Animais , Antineoplásicos/farmacocinética , Barreira Hematoencefálica , Modelos Animais de Doenças , Doxorrubicina/farmacocinética , Glioma/diagnóstico por imagem , Glioma/tratamento farmacológico , Magnetismo , RatosRESUMO
BACKGROUND: Tourette syndrome (TS) is a complex, heterozygous genetic disorder. The number of molecular genetic studies have investigated several candidate genes, particularly those implicated in the dopamine system. The dopamine D3 receptor (DRD3) gene has been considered as a candidate gene in TS. There was not any report about the association study of TS and DRD3 gene in Han Chinese population. We combined a case-control genetic association analysis and nuclear pedigrees transmission disequilibrium test (TDT) analysis to investigate the association between DRD3 gene rs6280 single nucleotide polymorphisms (SNPs) and TS in a Han Chinese population. METHODS: A total of 160 TS patients was diagnosed by the diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. The DRD3 gene rs6280 SNPs were genotyped by TaqMan SNP genotyping assay technique in all subjects. We used a case-control genetic association analysis to compare the difference in genotype and allele frequencies between 160 TS patients and 90 healthy controls. At the same time, we used TDT analysis to identify the DRD3 gene rs6280 transmission disequilibrium among 101 nuclear pedigrees. RESULTS: The genotype and allele frequency of DRD3 gene rs6280 SNPs had no statistical difference between control group (90) and TS group (160) (χ2 = 3.647, P = 0.161; χ2 = 0.643, P = 0.423) using Chi-squared test. At the basis of the 101 nuclear pedigrees, TDT analysis showed no transmission disequilibrium of DRD3 gene rs6280 SNPs (χ2 = 0; P = 1). CONCLUSIONS: Our findings provide no evidence for an association between DRD3 gene rs6280 and TS in the Han Chinese population.
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Polimorfismo de Nucleotídeo Único/genética , Receptores de Dopamina D3/genética , Síndrome de Tourette/etiologia , Adolescente , Criança , Feminino , Frequência do Gene/genética , Predisposição Genética para Doença/genética , Genótipo , Humanos , MasculinoRESUMO
The aim of this study was to assess levels of autoantibodies and cytokines in patients with Tourette's syndrome (TS, n = 40) and healthy control individuals (n = 40). Plasma interleukin (IL)-1ß, IL-6, IL-17, and soluble gp130 concentrations were significantly higher in the TS group compared with the control group (P < 0.001); whereas the soluble IL-6 receptor concentration was significantly decreased in the TS group compared with the control group (P < 0.001). Significantly more patients in the TS group were positive for antibrain and antinuclear antibodies, and antistreptolysin compared with the control group (P < 0.05). These findings suggest that immune activity is altered in patients with TS.
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Autoanticorpos/sangue , Interleucinas/sangue , Síndrome de Tourette/imunologia , Adolescente , Biomarcadores/sangue , Criança , Receptor gp130 de Citocina/sangue , Feminino , Humanos , Interleucina-17/sangue , Interleucina-1beta/sangue , Interleucina-6/sangue , Linfócitos/imunologia , Linfócitos/metabolismo , Masculino , Receptores de Interleucina-6/sangue , Estudos Soroepidemiológicos , Síndrome de Tourette/sangue , Síndrome de Tourette/epidemiologia , Adulto JovemRESUMO
AIM: To study the effects of long-term, low-dose sex hormone replacement therapy (HRT) on the volume and biochemical changes of the hippocampus in postmenopausal women carrying apolipoprotein E (apoE) gene epsilon3 or epsilon4. METHODS: Eighty-three postmenopausal women who had used a low dose of HRT for over 4 years were selected as the HRT group, and 99 postmenopausal women with matched age and education were enrolled as the control group. ApoE alleles were analyzed by PCR. Magnetic resonance imaging was performed to determine the volume of the brain hippocampus. Proton magnetic resonance spectroscopy was used to detect the biochemical changes in the anterior cingulate cortex and hippocampus in apoE epsilon4 and epsilon3 carriers. Six common cognitive tests were used to make an overall evaluation of cognitive function. RESULTS: Analysis with the apoE epsilon4 carriers showed that the volume of the hippocampus of the control group were significantly lower than those of the HRT group. The biochemical analysis showed that there was an increase of N-acetylaspartate (NAA)/total creatine (tCr) and a decrease of myoinositol (mI)/tCr in the hippocampus of apoE epsilon4 carriers in the HRT group, compared with the control group. For the apoE epsilon3 carriers, the least squares means (LSMEAN) of the HRT group was higher than that of the control group. CONCLUSION: This study showed that long-term, low dose HRT might be beneficial for reducing the risk of AD development in vulnerable postmenopausal women. Meanwhile, HRT could increase the LSMEAN of apoE epsilon3 carriers.