A real-world pharmacovigilance study of drug-induced QT interval prolongation: analysis of spontaneous reports submitted to FAERS.

Purpose: To identify the most commonly reported drugs associated with QT interval prolongation in the FDA Adverse Event Reporting System (FAERS) and evaluate their risk for QT interval prolongation. Methods: We employed the preferred term (PT) "electrocardiogram QT prolonged" from the Medical Dictionary for Regulatory Activities (MedDRA) 26.0 to identify adverse drug events (ADEs) of QT interval prolongation in the FAERS database from the period 2004-2022. Reporting odds ratio (ROR) was performed to quantify the signals of ADEs. Results: We listed the top 40 drugs that caused QT interval prolongation. Among them, the 3 drugs with the highest number of cases were quetiapine (1,151 cases, ROR = 7.62), olanzapine (754 cases, ROR = 7.92), and citalopram (720 cases, ROR = 13.63). The two most frequently reported first-level Anatomical Therapeutic Chemical (ATC) groups were the drugs for the nervous system (n = 19, 47.50%) and antiinfectives for systemic use (n = 7, 17.50%). Patients with missing gender (n = 3,482, 23.68%) aside, there were more females (7,536, 51.24%) than males (5,158, 35.07%) were involved. 3,720 patients (25.29%) suffered serious clinical outcomes resulting in deaths or life-threatening conditions. Overall, most drugs that caused QT interval prolongation had early failure types according to the assessment of the Weibull's shape parameter (WSP) analysis. Conclusions: Our study offered a list of drugs that frequently caused QT interval prolongation based on the FAERS system, along with a description of some risk profiles for QT interval prolongation brought on by these drugs. When prescribing these drugs in clinical practice, we should closely monitor the occurrence of ADE for QT interval prolongation.

In vitro corrosion and cytocompatibility of Mg-Zn-Ca alloys coated with FHA.

In the field of orthopedics, it's crucial to effectively slow down the degradation rate of Mg alloys. This study aims to improve the degradation behavior of Mg-Zn-Ca alloys by electrodepositing fluorohydroxyapatite (FHA). We investigated the microstructure and bond strength of the deposition, as well as degradation and cellular reactions. After 15-30 days of degradation in Hanks solution, FHA deposited alloys showed enhanced stability and less pH change. The strong interfacial bond between FHA and the Mg-Zn-Ca substrate was verified through scratch tests (Critical loads: 10.73 ± 0.014 N in Mg-Zn-0.5Ca alloys). Cellular studies demonstrated that FHA-coated alloys exhibited good cytocompatibility and promoted the growth of MC3T3-E1 cells. Further tests showed FHA-coated alloys owed improved early bone mineralization and osteogenic properties, especially in Mg-Zn-0.5Ca. This research highlighted the potential of FHA-coated Mg-Zn-0.5Ca alloys in orthopedics applications.

Injectable antibacterial Ag-HA/ GelMA hydrogel for bone tissue engineering.

Background: Fracture or bone defect caused by accidental trauma or disease is a growing medical problem that threats to human health.Currently, most orthopedic implant materials must be removed via follow-up surgery, which requires a lengthy recovery period and may result in bacterial infection. Building bone tissue engineering scaffolds with hydrogel as a an efficient therapeutic strategy has outstanding bionic efficiency.By combining some bionic inorganic particles and hydrogels to imitate the organic-inorganic characteristics of natural bone extracellular matrix, developing injectable multifunctional hydrogels with bone tissue repair effects and also displaying excellent antibacterial activity possesses attractive advantages in the field of minimally invasive therapy in clinical. Methods: In the present work, a multifunctional injectable hydrogel formed by photocrosslinking was developed by introducing hydroxyapatite (HA) microspheres to Gelatin Methacryloyl (GelMA) hydrogel. Results: The composite hydrogels exhibited good adhesion and bending resistance properties due to the existence of HA. In addition, when the concentration of GelMA is 10% and the concentration of HA microspheres is 3%, HA/GelMA hydrogel system displayed increased microstructure stability, lower swelling rate, increased viscosity, and improved mechanical properties. Furthermore, the Ag-HA/GelMA demonstrated good antibacterial activity against Staphylococcus aureus and Escherichia coli, which could signifificantly lower the risk of bacterial infection following implantation. According to cell experiment, the Ag-HA/GelMA hydrogel is capable of cytocompatibility and has low toxicity to MC3T3 cell. Conclusion: Therefore, the new photothermal injectable antibacterial hydrogel materials proposed in this study will provide a promising clinical bone repair strategy and is expected to as a minimally invasive treatment biomaterial in bone repair fields.

Abundant tannic acid modified gelatin/sodium alginate biocomposite hydrogels with high toughness, antifreezing, antioxidant and antibacterial properties.

The acidity of high tannic acid (TA) content solution can destroy the structure of protein, such as gelatin (G). This causes a big challenge to introduce abundant TA into the G-based hydrogels. Here, the G-based hydrogel system with abundant TA as hydrogen bonds provider was constructed by a "protective film" strategy. The protective film around the composite hydrogel was first formed by the chelation of sodium alginate (SA) and Ca2+. Subsequently, abundant TA and Ca2+ were successively introduced into the hydrogel system by immersing method. This strategy effectively protected the structure of the designed hydrogel. After treatment with 0.3 w/v TA and 0.06 w/v Ca2+ solutions, the tensile modulus, elongation at break and toughness of G/SA hydrogel increased about 4-, 2-, and 6-fold, respectively. Besides, G/SA-TA/Ca2+ hydrogels exhibited good water retention, anti-freezing, antioxidant, antibacterial properties and low hemolysis ratio. Cell experiments showed that G/SA-TA/Ca2+ hydrogels possessed good biocompatibility and could promote cell migration. Therefore, G/SA-TA/Ca2+ hydrogels are expected to be used in the field of biomedical engineering. The strategy proposed in this work also provides a new idea for improving the properties of other protein-based hydrogels.

In situ titanium phosphate formation on a titanium implant as ultrahigh bonding with nano-hydroxyapatite coating for rapid osseointegration.

Titanium (Ti) has been widely used as a dental implant material due to its excellent mechanical property and good biocompatibility. However, its poor biological activity severely limits its ability to bond with bony tissues. To ameliorate this situation, a preparation method of ultra-high bonding nano-hydroxyapatite (n-HA) coating on the Ti surface is urgently needed. Here, Ti phosphate/n-HA (TiP-Ca) composite coatings with ultra-high bonding were prepared by a two-step hydrothermal treatment. The TiP coating was first formed in situ on the pure Ti substrate and then n-HA crystals further grew on the TiP surface. The formation mechanism of composite coating and reasons for increased bonding strength were systematically investigated. The results show that the TiP-Ca coating remains stable and exhibits an ultra-high bonding strength with the Ti implant (up to 783.30 ± 207.46 N). An effective solution was designed to address the problems of easy peel off. Cell experiments showed that TiP-Ca could promote the adhesion of MC3T3-E1 and expression of OCN, Runx2, and ALP. In vivo evaluation further confirmed that the TiP-Ca composite coating significantly enhanced osseointegration. The designed coating shows great potential in clinical application of implants.

Bone-like hydroxyapatite anchored on alginate microspheres for bone regeneration.

Inspired by the initial mineralization process in bone matrix vesicles (MVs), we used Dulbecco's Modified Eagle's Medium (DMEM) to establish the similar physiological environment to that in MVs for biomimetic mineralization on alginate (ALG) microspheres. The results showed that HA crystals were firstly formed and anchored on the membrane of microspheres like the initial deposition of hydroxyapatite crystals inside MVs. With the continuous growth and accumulation of mineral crystals, HA coating was finally formed on ALG microspheres. The mineralized ALG microspheres (M-ALG microspheres) show good biocompatibility and osteogenic performance. The HA coating is also conducive to the active migration of osteoblasts to the surface of M-ALG microspheres. Collectively, bone-like HA crystals anchored on ALG microspheres may provide a good prospect to promote the repair of bone defects.

Fabrication of adhesive hydrogels based on poly (acrylic acid) and modified hyaluronic acid.

Hydrogel wound dressings with good flexibility and adhesiveness to resist deformation during wound movement are urgently needed in clinical application. In this work, the hydrogels based on poly (acrylic acid) and N-hydroxysuccinimide grafted hyaluronic acid (PAA/HA-NHS) with good elasticity and adhesiveness were prepared by chemical cross-linking and hydrogen bonding. The elastic and adhesive properties within the PAA hydrogels could reach a balance by adjusting the concentration of potassium persulfate (KPS) and N, N'-methylenebisacrylamide (MBA). Subsequently, HA-NHS was incorporated into the PAA hydrogel system. The mechanical test revealed that the elongation at break and interfacial toughness of the PAA/HA-NHS hydrogels could reach 265.79 ± 21.93% and 52.88 ± 3.51 J/m2, respectively. In addition, the hydrogels possess a connected porous network and well water absorption ability (with porosity of 51.90 ± 0.11% and swelling ratio in wet state of 122.17 ± 2.78%). In vitro experiment demonstrates that the PAA/HA-NHS hydrogels exhibit nontoxic and cell in-adhesive properties. The PAA/HA-NHS hydrogels could cover the wound spots directly, stretch with the skin movement and gently remove from the wound tissue due to the suitable adhesiveness and poor cell adhesion. In conclusion, the PAA/HA-NHS hydrogels show great application value in the field of wound dressing.

Enhenced cell adhesion on collagen I treated parylene-C microplates.

On account of unique mechanical property and inertia, parylene-C has become a promising material for microdevices especially in three-dimensional microstructures loaded with cells. However, parylene-C is not favorable for cell adhesion, and a routine procedure is to modify it with a new adhesive layer. Herein, the parylene-C substrates with or without collagen Ӏ (Col-I) coating were adopted to estimate the influence of micro-environment change on cell attachment and spreading. After modification with Col-I, cauliflower-like particles presented on the substrate surface. Contact angle was significantly decreased after Col-I modification, which suggested the surface hydrophilicity was enhanced. Furthermore, cells cultured on parylene-C surface with Col-I treatment showed increased proliferation rate and spreading areas. In order to test the adhesion strength, a series of fixed size parylene-C microplates was fabricated, and cell suspension concentration was adjusted to culture a single cell on one microplate. The microplate was folded by the autogenous shrinkage force of cell. The folding angles of parylene-C microplates with Col-I treatment exhibited higher folding angle (112.6 ± 15.6°) than untreated samples (46.7 ± 5.9°). The work proved the existence of Col-I layer was particularly important, especially in analysis of cells mechanics using parylene-C microplate as a substrate.

High strength polyvinyl alcohol/polyacrylic acid (PVA/PAA) hydrogel fabricated by Cold-Drawn method for cartilage tissue substitutes.

Poly (vinyl alcohol) (PVA) hydrogel has been considered as promising cartilage replacement materials due to its excellent characteristics such as high water content, low frictional behavior and excellent biocompatibility. However, lack of sufficient mechanical properties and cytocompatibility are two key obstacles for PVA hydrogel to be applied as cartilage substitutes. Herein, Polyacrylic acid (PAA) has been introduced into PVA hydrogel to balance these problems. Compared with pure PVA hydrogel, PVA/PAA hydrogel has the equal excellent biocompatibility, and its cell adhesion is significantly improved. In order to further improve the mechanical properties of hydrogels, Cold-Drawn treatment of hydrogels is performed in this paper. Compared to pure 12% PVA hydrogel, 40.8-fold, 50.8-fold, and 46.8-fold increase in tensile strength, tensile modulus, and toughness, respectively, which can be obtained from 12% PVA/PAA Cold-Drawn hydrogel. These biocompatible composite hydrogels have a great application potential as cartilage tissue substitutes.

Biomimetic polyvinyl alcohol/type II collagen hydrogels for cartilage tissue engineering.

Type II collagen (Col-II) is one of the important organic components of the cartilage extracellular matrix (ECM). Such natural material is known for its good biocompatibility, but it could not provide a good supporting environment for seed cells due to its rapid degradation and poor strength. In the present work, different contents of Col-II were incorporated into porous polyvinyl alcohol (PVA) to fabricate porous PVA/Col-II composite hydrogels for cartilage tissue engineering. The results illustrate that, after incorporation of Col-II, the elasticity modulus of the composite hydrogels firstly increases, and then decreases (under moisture state). The elasticity modulus of PVA/Col-II (at the ratio of 1:1) hydrogels reaches 11 ± 1.7 KPa, about two-fold higher than pure PVA hydrogels (4.9 ± 0.6 KPa). Meanwhile, all hydrogels exhibit relatively high water content (> 95%) and porosity (> 75%). The degradation analysis indicates that Col-II incorporation induce a high degradation ratio of the composite hydrogels. Cell culture results show PVA/Col-II hydrogels have no negative effects on cells viability and proliferation. The PVA/Col-II hydrogels may possess a potential application in the field of articular cartilage tissue engineering and regeneration.

[Research progress on osteochondral tissue engineering].

Osteochondral defects is a common clinical joint disease. The complexity of cartilage-bone interface and the poor self-repair capacity of cartilage are both reasons for current relatively limited clinical treatments. The introduction of tissue engineering provides a new treatment method for osteochondral repair. This paper reviews three main elements of cartilage-bone tissue engineering: seed cell source and culture method, cytokines regulation and synergistic effect, and scaffold components and type. We mainly focused on current status quo and future progress of cartilage-bone repair scaffolds. This paper provides some reference for the further development of osteochondral tissue engineering.

Carbon nanotube reinforced polyvinyl alcohol/biphasic calcium phosphate scaffold for bone tissue engineering.

In this paper, a well-developed porous carbon nanotube (CNT) reinforced polyvinyl alcohol/biphasic calcium phosphate (PVA/BCP) scaffold was fabricated by a freeze-thawing and freeze-drying method. The microstructure, mechanical properties and the composition of the scaffolds were characterized by field emission scanning electron microscopy (FE-SEM), X-ray diffraction (XRD) and Fourier-transform infrared spectroscopy (FTIR). The results illustrate that after the incorporation of CNTs, the compressive strength of the hydrogels (moisture state) reached 81 ± 6 kPa, presenting a significantly higher value than that of pure PVA/BCP hydrogels (48 ± 2 kPa). Meanwhile, CNT reinforced PVA/BCP scaffolds exhibited a porous structure and high interconnectivity (80 ± 0.6%). The degradation analysis indicated that the degradation ratio of scaffolds can be varied by changing the concentrations of BCP powders and CNTs. Cell culture results show that PVA/BCP/CNT porous scaffolds have no negative effects on the survival and proliferation of cells. These results strongly show that the composite scaffolds may possess a potential application in the field of bone tissue engineering and regeneration.

Iontophoresis-assisted accelerated riboflavin/ultraviolet A scleral cross-linking: A potential treatment for pathologic myopia.

Scleral collagen cross-linking is one of the most promising treatments to control the pathologic process of myopia. However, the exact procedure and its impact on animal models of myopia are still to be explored. We modified the scleral riboflavin/ultraviolet A (UVA) cross-linking procedure with an iontophoresis-assisted drug delivery system and an accelerated UVA irradiation (10 mW/cm2, 9 min) and applied this treatment to an animal model of myopia. Ninety-six New Zealand White rabbits developed relatively stable myopia by visual deprivation and then underwent the modified scleral cross-linking surgery. All the statistics and sample collection were obtained from 4 postoperative time points (1-day, 10-day, 1-month and 3-month groups). We found that the ultimate stress, Young's modulus and physiological Young's modulus of treated myopia sclera were significantly increased and maintained in 4 groups. The abnormal elongation of the myopic eye was effectively controlled 1 month after the treatment and even almost halted 3 months after the treatment. The histochemical assay revealed no notable post-surgery damage or apoptosis in the retina and choroid. Vigorous collagen synthesis was observed in scleral fibroblasts of the treated samples but were rarely observed in the untreated ones under electron microscopy. Furthermore, the remarkable difference in collagen gene expression and protein content between treated and untreated samples also indicated that an alteration in collagen metabolism may be triggered by the treatment. The effectiveness and safety exploration suggested that the modified scleral cross-linking procedure may be a potential method to control the pathologic process of myopia.

[Gene expression of down-regulation of lysyl oxidases family in keratoconus corneal fibroblasts induced by combination of mechanical stretching and prostaglandin E 2].

In order to investigate the effects of mechanical stretching combined with prostaglandin E 2 (PGE 2) on the gene expression of lysyl oxidases (LOXs) in keratoconus, we treated cultured corneal fibroblasts from healthy human cornea and keratoconus patient cornea with PGE 2 and/or cyclic stretch (12% elongation, 0.1 Hz, 12 h). Real-time fluorescent quantitative polymerase chain reaction was used to detect the gene expression of LOXs. The results showed that the gene expression of LOXs in keratoconus group was significantly lower than that in the healthy one. Compared to the static control group, 12% stretching alone up-regulated gene expression of LOXL-2, LOXL-4 in the healthy group, whereas it down-regulated LOXL-3, LOXL-4 in the keratoconus group. Combination of 12% stretching and PEG 2 induced LOXL-4 down-regulation in in healthy group, and all LOXs except LOXL-1 in keratoconus group. The results suggested that combination of mechanical stretching and PGE 2 down-regulate the gene expression of LOXs in keratoconus. Lower LOXs expression may lead to impaired cross-linking, and thus to a loss of cohesion between collagen fibrils, affecting corneal structural stability by collagen lamellae slippage. This may facilitate the development of keratoconus. Exploring the effects of mechanical stretching and inflammatory factor on the expression LOXs in this paper will help us to understand the possible mechanism of how the keratoconus occurs and develops well, and provide the reference for the prevention and treatment of keratoconus.

Induction of matrix metalloproteinase-1 by tumor necrosis factor-α is mediated by interleukin-6 in cultured fibroblasts of keratoconus.

Inflammatory molecules and matrix metalloproteinase (MMPs) have been found over-expressed in the tear film of patients with keratoconus. However, the mechanistic link between inflammatory molecules and MMPs in the pathogenesis of keratoconus remains still elusive. Therefore, we investigated the effect of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) on MMP-1 expression and used IL-6 antibody (IL-6 Ab) to examine the role of IL-6 on TNF-α mediated regulation of MMP-1 in fibroblasts of normal cornea and keratoconus. Real-time polymerase chain reaction, Enzyme-linked immunosorbent assay, and Western blot data demonstrated that MMP-1 and IL-6 were expressed in fibroblasts of normal cornea and keratoconus. Levels of MMP-1 and IL-6 were significantly higher in keratoconus than normal cornea. TNF-α treatment led to a significant increase in IL-6 levels. IL-6 treatment induced MMP-1 synthesis in normal cornea and keratoconus. TNF-α increased MMP-1 expression in a dose- and time-dependent manner and this response was completely inhibited by the IL-6 Ab. In conclusion, these results indicate that fibroblasts of keratoconus shows increased levels of IL-6 and MMP-1 gene and protein expression and IL-6 mediates the TNF-α-induced MMP-1 expression.