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1.
Diabetes Care ; 47(4): 580-588, 2024 Apr 01.
Article de Anglais | MEDLINE | ID: mdl-38211595

RÉSUMÉ

OBJECTIVE: To compare the long-term effects of glucose-lowering medications (insulin glargine U-100, glimepiride, liraglutide, and sitagliptin) when added to metformin on insulin sensitivity and ß-cell function. RESEARCH DESIGN AND METHODS: In the Glycemia Reduction Approaches in Diabetes: A Comparative Effectiveness Study (GRADE) cohort with type 2 diabetes (n = 4,801), HOMA2 was used to estimate insulin sensitivity (HOMA2-%S) and fasting ß-cell function (HOMA2-%B) at baseline and 1, 3, and 5 years on treatment. Oral glucose tolerance test ß-cell responses (C-peptide index [CPI] and total C-peptide response [incremental C-peptide/incremental glucose over 120 min]) were evaluated at the same time points. These responses adjusted for HOMA2-%S in regression analysis provided estimates of ß-cell function. RESULTS: HOMA2-%S increased from baseline to year 1 with glargine and remained stable thereafter, while it did not change from baseline in the other treatment groups. HOMA2-%B and C-peptide responses were increased to variable degrees at year 1 in all groups but then declined progressively over time. At year 5, CPI was similar between liraglutide and sitagliptin, and higher for both than for glargine and glimepiride [0.80, 0.87, 0.74, and 0.64 (nmol/L)/(mg/dL) * 100, respectively; P < 0.001], while the total C-peptide response was greatest with liraglutide, followed in descending order by sitagliptin, glargine, and glimepiride [1.54, 1.25, 1.02, and 0.87 (nmol/L)/(mg/dL) * 100, respectively, P < 0.001]. After adjustment for HOMA2-%S to obtain an estimate of ß-cell function, the nature of the change in ß-cell responses reflected those in ß-cell function. CONCLUSIONS: The differential long-term effects on insulin sensitivity and ß-cell function of four different glucose-lowering medications when added to metformin highlight the importance of the loss of ß-cell function in the progression of type 2 diabetes.


Sujet(s)
Diabète de type 2 , Insulinorésistance , Metformine , Sulfonylurées , Humains , Diabète de type 2/traitement médicamenteux , Insuline glargine/usage thérapeutique , Hypoglycémiants/usage thérapeutique , Glucose/usage thérapeutique , Liraglutide/pharmacologie , Liraglutide/usage thérapeutique , Insulinorésistance/physiologie , Peptide C , Glycémie , Metformine/usage thérapeutique , Phosphate de sitagliptine/usage thérapeutique
2.
J Mol Model ; 29(8): 241, 2023 Jul 12.
Article de Anglais | MEDLINE | ID: mdl-37436478

RÉSUMÉ

CONTEXT: The design and synthesis of safe and highly active sulfonylurea herbicides is still a challenge. Therefore, following some principles of structure-activity relationship (SAR) of sulfonylurea herbicides, this work focuses on evaluating two sulfonylurea derivatives bearing electron-withdrawing substituents, namely, -(CO)OCH3 and -NO2 on the aryl group, on herbicidal activity. To understand the effects caused by the substituent groups, the molecular and electronic structures of the sulfonylureas were evaluated by density functional theory. Likewise, the crystalline supramolecular arrangements of both compounds were analyzed by Hirshfeld surface, QTAIM, and NBO, with the aim of verifying changes in intermolecular interactions caused by substituent groups. Finally, through a toxicophoric analysis, we were able to predict the interacting groups in their biological target, acetolactate synthase, and verify the interactions with the binding site. METHODS: All theoretical calculations were conducted using the highly parameterized empirical exchange-correlation functional M06-2X accompanied by the diffuse and polarized basis set 6-311++G(d,p). The atomic coordinates were obtained directly from the crystalline structures, and from the energies of the frontier molecular orbitals (HOMO and LUMO), chemical descriptors were obtained that indicated the influence of the functional groups in the sulfonylureas on the reactivity of the molecules. The intermolecular interactions in the crystals were analyzed using the Hirshfeld, QTAIM, and NBO surfaces. Toxicophoric modeling was performed by the PharmaGist webserver and molecular docking calculations were performed by the GOLD 2022.1.0 software package so that the ligand was fitted to the binding site in a 10 Å sphere. For this, genetic algorithm parameters were used using the ChemPLP scoring function for docking and ASP for redocking.


Sujet(s)
Acetolactate synthase , Herbicides , Simulation de docking moléculaire , Modèles moléculaires , Acetolactate synthase/composition chimique , Acetolactate synthase/métabolisme , Herbicides/composition chimique , Herbicides/pharmacologie , Sulfonylurées/composition chimique , Sulfonylurées/pharmacologie , Pyrimidines
5.
J Manag Care Spec Pharm ; 28(11): 1253-1259, 2022 Nov.
Article de Anglais | MEDLINE | ID: mdl-36282929

RÉSUMÉ

BACKGROUND: Although metformin is generally universally recommended as a first-line pharmacologic therapy for most people living with type 2 diabetes, second-line and third-line choices can require a tailored approach to achieve optimal blood glucose and glycated hemoglobin levels. OBJECTIVE: To examine national trends in second- and third-line antihyperglycemic medications following metformin monotherapy, comparing 2015 and 2019. METHODS: This retrospective cohort analysis of deidentified pharmacy claims from a large national pharmacy benefits manager from January 1, 2015, to December 31, 2015, and again in January 1, 2019, to December 31, 2019, included adults (aged ≥ 18 years) continuously enrolled in commercial or Medicare insurance plans who filled an index metformin prescription in either year. Proportions of patients by second-line and third-line antihyperglycemic class were calculated. RESULTS: Second-line use of sulfonylureas (-10.1%; P < 0.001), combination drugs (-3.0%; P < 0.001), and dipeptidyl peptidase-4 inhibitors (-2.0%; P = 0.031) significantly declined, whereas second-line use of sodium-glucose cotransporter 2 inhibitors (SGLT2is) (+4.9%; P < 0.001) and glucagon-like peptide-1 receptor agonists (GLP-1Ras) (+10.0%; P < 0.001) significantly increased. Similarly, third-line use of sulfonylureas declined (-5.5%; P = 0.005), whereas third-line use of SGLT2is (+3.4%; P = 0.005) and GLP-1RAs (+8.3%; P < 0.001) increased. Similar trends between 2015 and 2019 were found in commercial and Medicare subgroups. Among all groups in 2015 compared with 2019, sulfonylureas were the most prescribed second-line class and insulins the most common third-line class. Although SGLT2i and GLP-1RA together represented more than one-third of second-line and third-line prescriptions for commercially insured patients in 2019 (34.3% and 35.0%, respectively), these classes were less frequently prescribed in the Medicare subgroup (18% and 25.6%, respectively). CONCLUSIONS: This report provides updated second-line and third-line antihyperglycemic medication prescribing trends in the United States, which suggests that evidence-based guidelines are being used in practice to prevent complications and individualize diabetes care. DISCLOSURES: Ms Swart and Drs Peasah and Good are employed by UPMC Health Plan. Dr Neilson was employed by UPMC Health Plan at the time of the study. Drs Munshi and Henderson were employed by Evernorth at the time of the study.


Sujet(s)
Diabète de type 2 , Inhibiteurs de la dipeptidyl-peptidase IV , Metformine , Adulte , Humains , Sujet âgé , États-Unis , Metformine/usage thérapeutique , Glycémie , Hémoglobine glyquée/analyse , Récepteur du peptide-1 similaire au glucagon , Études rétrospectives , Medicare (USA) , Hypoglycémiants/usage thérapeutique , Inhibiteurs de la dipeptidyl-peptidase IV/usage thérapeutique , Sulfonylurées/usage thérapeutique , Dipeptidyl-Peptidases and Tripeptidyl-Peptidases/usage thérapeutique , Sodium/analyse , Sodium/usage thérapeutique
6.
J Feline Med Surg ; 24(8): e153-e162, 2022 08.
Article de Anglais | MEDLINE | ID: mdl-35531962

RÉSUMÉ

OBJECTIVES: This study aimed to compare the analgesic effect between carprofen and grapiprant every 12 or 24 h on postoperative pain in cats undergoing ovariohysterectomy, in addition to the effects on the hematological, biochemical and urinalysis variables. METHODS: A total of 32 female cats were randomly divided into three groups, according to the treatment administered with the first dose given orally 90 mins before surgery, as follows: CAR (cats received 4 mg/kg carprofen, n = 11); GRA1 (cats received 2 mg/kg grapiprant, n = 10); and GRA2 (cats received 2 mg/kg grapiprant q12h, n = 11). Pain was assessed by UNESP-Botucatu Multidimensional Composite Pain Scale (UNESP) and Glasgow Feline Composite Measure Pain Scale (GLASGOW) for cats preoperatively (baseline) and at 1, 3, 6, 8, 12 and 24 h after extubation. Venous blood was collected at baseline, and 12 and 24 h after the administration of carprofen or grapiprant to perform a complete blood count (CBC), the percentage of Heinz bodies and serum biochemistry (alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, gamma-glutamyltransferase, creatinine and urea). Urinalysis was performed at baseline and 24 h after extubation. Glucose levels were evaluated at baseline and 1 h postoperatively. RESULTS: Pain scores were not significantly different among groups in both scales, although pain was higher at 3 h in comparison with 24 h in all groups. In the GRA1 and GRA2 groups, 67% (14/21) of cats needed rescue analgesia compared with 18% (2/11) in the CAR group. Glucose increased from baseline to 1 h in the GRA1 and GRA2 groups. None of the CBC, serum biochemistry and urinalysis variables differed among groups. CONCLUSIONS AND RELEVANCE: Grapiprant did not promote adequate analgesia during the first 3 h postoperatively in cats undergoing ovariohysterectomy compared with carprofen, and no benefits were observed by administering grapiprant every 12 h.


Sujet(s)
Maladies des chats , Examen des urines , Analgésiques/usage thérapeutique , Animaux , Carbazoles , Maladies des chats/traitement médicamenteux , Chats , Femelle , Glucose , Hystérectomie/méthodes , Hystérectomie/médecine vétérinaire , Imidazoles , Ovariectomie/méthodes , Ovariectomie/médecine vétérinaire , Douleur postopératoire/traitement médicamenteux , Douleur postopératoire/prévention et contrôle , Douleur postopératoire/médecine vétérinaire , Pyridines , Sulfonylurées , Examen des urines/médecine vétérinaire
7.
Diabetes Res Clin Pract ; 187: 109875, 2022 May.
Article de Anglais | MEDLINE | ID: mdl-35472491

RÉSUMÉ

AIMS: To describe the clinical and genetic characteristics and long-term follow-up of a cohort with maturity-onset diabetes of the young (MODY), and to evaluate how molecular diagnosis impacted on treatment. METHODS: A large observational, retrospective, cohort study included individuals referred to the University of São Paulo's Monogenic Diabetes Unit between 2011 and 2020. Comprehensive clinical and genetic evaluations were performed. RESULTS: Overall, 228 individuals (190 GCK-MODY and 38 HNF1A-MODY) were enrolled. Sixty-two different GCK gene mutations (5 novel) and 17 HNF1A gene mutations (2 novel) were found. Data were available on treatment status for 76 index individuals with GCK-MODY. Before molecular diagnosis, nutritional intervention alone was used in 41 cases (53.9%). After molecular diagnosis, this number increased to 72 (94.8%). Glycated haemoglobin (HbA1c) remained stable over the 6-year follow-up period: 6.5% (47 mmol/mol) at the first and 6.3% (45 mmol/mol) at the final visit (p = 0.056). Prior to molecular diagnosis, 7/21 (33.3%) HNF1A-MODY individuals were using sulfonylurea compared to 17/21 (81%) after testing. After a median of 5 years on sulfonylureas, HbA1c values improved from 7.5% (58 mmol/mol) to 6.5% (48 mmol/mol) (p = 0.006). CONCLUSIONS: Molecular diagnosis resulted in appropriate adjustment of treatment in approximately 80% of participants with GCK-MODY or HNF1A-MODY.


Sujet(s)
Diabète de type 2 , Études de cohortes , Diabète de type 2/diagnostic , Diabète de type 2/traitement médicamenteux , Diabète de type 2/génétique , Glucokinase/génétique , Facteur nucléaire hépatocytaire HNF-1 alpha/génétique , Humains , Mutation , Études rétrospectives , Sulfonylurées/usage thérapeutique
8.
Diabetes Care ; 45(4): 919-927, 2022 04 01.
Article de Anglais | MEDLINE | ID: mdl-35147696

RÉSUMÉ

OBJECTIVE: To assess the association of sodium-glucose cotransporter 2 (SGLT2) inhibitors with diabetic ketoacidosis compared with dipeptidyl peptidase 4 (DPP-4) inhibitors and sulfonylureas in patients with type 2 diabetes. RESEARCH DESIGN AND METHODS: We conducted a new-user active comparator cohort study to examine two pairwise comparisons: 1) SGLT2 inhibitors versus DPP-4 inhibitors and 2) SGLT2 inhibitors versus sulfonylureas. The main outcome was diabetic ketoacidosis present on hospital admission. We adjusted for confounders through propensity score matching. We used Cox proportional hazards regression with a robust variance estimator to estimate hazard ratios (HRs) and corresponding 95% CIs while adjusting for calendar time. RESULTS: In cohort 1 (n = 85,125 for SGLT2 inhibitors and n = 85,125 for DPP-4 inhibitors), the incidence rates of diabetic ketoacidosis per 1,000 person-years were 6.0 and 4.3 for SGLT2 inhibitors and DPP4 inhibitors, respectively. In cohort 2 (n = 72,436 for SGLT2 inhibitors and n = 72,436 for sulfonylureas), the incidence rates of diabetic ketoacidosis per 1,000 person-years were 6.3 and 4.5 for SGLT2 inhibitors and sulfonylureas, respectively. In Cox proportional hazards regression models, the use of SGLT2 inhibitors was associated with a higher rate of diabetic ketoacidosis compared with DPP-4 inhibitors (adjusted HR [aHR] 1.63; 95% CI 1.36, 1.96) and sulfonylureas (aHR 1.56; 95% CI 1.30, 1.87). CONCLUSIONS: In this comparative safety study using real-world data, patients with type 2 diabetes who were newly prescribed SGLT2 inhibitors had a higher rate of diabetic ketoacidosis compared with DPP-4 inhibitors and sulfonylureas. Clinicians should be vigilant about this association.


Sujet(s)
Diabète de type 2 , Acidocétose diabétique , Inhibiteurs de la dipeptidyl-peptidase IV , Inhibiteurs du cotransporteur sodium-glucose de type 2 , Études de cohortes , Diabète de type 2/complications , Diabète de type 2/traitement médicamenteux , Diabète de type 2/épidémiologie , Acidocétose diabétique/induit chimiquement , Acidocétose diabétique/complications , Acidocétose diabétique/épidémiologie , Inhibiteurs de la dipeptidyl-peptidase IV/effets indésirables , Glucose , Humains , Hypoglycémiants/effets indésirables , Sodium , Inhibiteurs du cotransporteur sodium-glucose de type 2/effets indésirables , Sulfonylurées/effets indésirables
10.
J Environ Sci Health B ; 57(1): 39-46, 2022.
Article de Anglais | MEDLINE | ID: mdl-34962432

RÉSUMÉ

This study evaluated the effect of light availability in the culture environment and the application of a post emergence herbicide, halosulfuron methyl, on the management of Cyperus rotundus. The experiment was arranged in a 2 × 6 factorial design; the first factor was two levels of light availability: photosynthetically active radiation at 1180.4 and 411.6 µmols m-2 s-1, and the second factor was halosulfuron methyl doses from 28.13 to 140.62 g ha-1. Photosynthetic efficiency, biomass allocation, accumulation of starch in tubers, and percentage control of C. rotundus were evaluated from 7 to 28 days after herbicide application. Doses greater than 70.30 g ha-1 of halosulfuron methyl were efficient to control C. rotundus, regardless of light availability. However, C. rotundus was managed faster under full sunlight than under shading. The efficiency of the photosystem, starch accumulation, and biomass formation decreased with increasing doses of halosulfuron methyl. In a shaded environment, a dose of 28.13 g ha-1 was sufficient to reduce 96.74% of the dry mass and 91.33% of the number of C. rotundus tubers. The decrease in light intensity associated with the use of halosulfuron methyl represents a promising practice for the control of C. rotundus.


Sujet(s)
Cyperus , Herbicides , Herbicides/pharmacologie , Amidon , Sulfonylurées
11.
Environ Monit Assess ; 193(4): 194, 2021 Mar 16.
Article de Anglais | MEDLINE | ID: mdl-33728504

RÉSUMÉ

The speed of the sorption reaction alters the bioavailability of herbicides in the soil and, consequently, the transport and transformation processes of the molecule in the environment. In this research, the sorption kinetics of sulfometuron-methyl was evaluated in different Brazilian soils in which sugarcane is grown. The sorption speed was carried out by the batch equilibrium method. The amount of sulfometuron-methyl adsorbed and remaining in the soil solution was used to build kinetic models in fifteen soils. Pearson's correlation coefficients were determined between maximum sorption capacity and soil properties. The pseudo-second-order model presented the best fit to report the sorption kinetics of sulfometuron-methyl in soils. The sorption equilibrium time varied between 69.1 and 524.7 min. The properties of cation exchange capacity (CEC), soil hydrogenionic potential (pH), and total organic carbon (TOC) affected the sorption kinetics of sulfometuron-methyl. The pH showed a negative correlation with the maximum adsorption capacity at equilibrium, while TOC and CEC positively correlated with the maximum adsorption. The results demonstrate that the sorption speed of sulfometuron-methyl varies between soils; this must be considered when defining the rate of use of the herbicide for weed control, minimizing the risk of environmental contamination.


Sujet(s)
Herbicides , Polluants du sol , Adsorption , Brésil , Surveillance de l'environnement , Cinétique , Sol , Polluants du sol/analyse , Sulfonylurées
12.
Curr Rev Clin Exp Pharmacol ; 16(3): 228-234, 2021.
Article de Anglais | MEDLINE | ID: mdl-32914719

RÉSUMÉ

BACKGROUND: Monogenic Diabetes (MFD) represents close to 2% of all the cases of diabetes diagnosed in people younger than 45 years old. Maturity-Onset Diabetes of the Young (MODY), neonatal diabetes, and several syndromic forms of diabetes are included among the most accounts for about typical forms of MDF. MODY is the most frequent type of MFD, with MODY 1, 2, 3, and 5 being the most prevalent forms. The aim of this narrative review is to describe pregnancy associated changes in the pharmacological profile of the antidiabetic drugs used in women with the most frequent MODY subtypes. METHODS: A comprehensive literature search was carried out to identify eligible studies from MEDLINE/ PubMed, EMBASE, and SCIELO databases from 1970 to 2019 first semester. RESULTS: Pregnancy introduces changes in the pharmacodynamic and pharmacokinetic profile of some of the treatments used in MODY. MODY 3 (also known as HNF1-A MODY) is the most frequent MDF. MODY 3 patients are highly sensitive to Sulfonylureas (SU). This is also the case for MODY pregnant women. This high sensitivity to SU is also registered in patients with MODY 1 (HNF4-A MODY). Pharmacodynamic changes have been proposed to explain this behavior (Epac2 hyperactivity). However, changes in expression/activity of the metabolizing CYP2C9 cytochrome and/or alterations in the drug transporters oatp1 (Slc21a1), Lst-1 (Slc21a6), OATPD (SLC21A11), and oat2 may better explain, at least in part, this phenomenon by an increase in the concentration of the active drug. CONCLUSION: The impact of changes in the pharmacological behavior of drugs like SU and other metabolized/transported by mechanisms altered in a pregnancy complicated by MODY is unknown. However, switching-to-insulin recommendation formulated for MODY 1 and 3 seems to be justified. Further research in this field is needed for a better understanding of changes in drug activity associated with this particular subset of patients with MFD.


Sujet(s)
Diabète de type 2 , Diabète de type 2/traitement médicamenteux , Femelle , Humains , Hypoglycémiants/pharmacologie , Nouveau-né , Insuline , Adulte d'âge moyen , Grossesse , Sulfonylurées/usage thérapeutique
13.
Ecotoxicol Environ Saf ; 207: 111222, 2021 Jan 01.
Article de Anglais | MEDLINE | ID: mdl-32890950

RÉSUMÉ

Sulfometuron-methyl is a broad-spectrum herbicide, used throughout Brazil; however, its environmental impacts in biochar (BC) amended soils is not fully understood. Biochar is known to enhance soil quality but can also have undesired effects such as altering the bioavailability and behavior of herbicides. Microbial communities can degrade herbicides such as sulfometuron-methyl in soils; however, they are known to be affected by BC. Therefore, it is important to understand the tripartite interaction between these factors. This research aimed to evaluate the sorption-desorption and biodegradation of sulfometuron-methyl in Amazonian soils amended with BC, and to assess the effects of the interactions between BC and sulfometuron-methyl on soil bacterial communities. Soil samples were collected from field plots amended with BC at three doses (0, 40 and 80 t ha-1) applied ten years ago. The herbicide sorption and desorption were evaluated using a batch equilibrium method. Mineralization and biodegradation studies were conducted in microcosms incubated with 14C-sulfometuron-methyl for 80 days. Systematic soil sampling, followed by DNA extraction, quantification (qPCR) and 16S rRNA amplicon sequencing were performed. The presence of BC increased the sorption of the herbicide to the soil by 11% (BC40) and 16% (BC80) compared to unamended soil. The presence of BC also affected the degradation of 14C-sulfometuron-methyl, reducing the mineralization rate and increasing the degradation half-life times (DT50) from 36.67 days in unamended soil to 52.11 and 55.45 days in BC40 and BC80 soils, respectively. The herbicide application altered the bacterial communities, affecting abundance and richness, and changing the taxonomic diversity (i.e., some taxa were promoted and other inhibited). A tripartite interaction was found between BC, the herbicide and soil bacterial communities, suggesting that it is important to consider the environmental impact of soil applied herbicides in biochar amended soils.


Sujet(s)
Dépollution biologique de l'environnement , Herbicides/analyse , Polluants du sol/analyse , Sulfonylurées/analyse , Adsorption , Bactéries/métabolisme , Biodisponibilité , Brésil , Charbon de bois , ARN ribosomique 16S/métabolisme , Sol
14.
Diabetes Care ; 43(9): 2121-2127, 2020 09.
Article de Anglais | MEDLINE | ID: mdl-32641378

RÉSUMÉ

OBJECTIVE: Using the 2016 Medicare Part D coverage gap as an example, we explored effects of increased out-of-pocket costs on adherence to branded dipeptidyl peptidase 4 inhibitors (DPP-4i) in patients without financial subsidies relative to subsidized patients who do not experience increased spending during the gap. We also explored seasonality of reinitiation, because discontinuers may be more likely to reinitiate in January when benefits reset. RESEARCH DESIGN AND METHODS: We identified DPP-4i or sulfonylurea initiators, aged ≥66 years, from a 20% sample of 2015-2016 Medicare claims. Difference-in-differences Poisson regression was used to compare adherence before and after entering the coverage gap between nonsubsidized and subsidized patients. Among discontinuers, monthly hazard ratios (HRs) for reinitiation relative to January 2016 were derived with Cox models. As a second control, we repeated analyses using sulfonylureas, generic low-cost alternatives. RESULTS: In 2016, 8,096 subsidized and 6,173 nonsubsidized DPP-4i initiators entered the coverage gap. For nonsubsidized patients, copayment in the coverage gap was 45% ($227 per DPP-4i prescription), and adherence decreased from 68.4% to 49.0% after gap entry. Accounting for adherence differences in subsidized patients, nonsubsidized patients demonstrated reduced adherence to DPP-4i (difference-in-difference: -16.9%; 95% CI -18.7%, -15.1%) but not sulfonylureas (-1.6%; 95% CI -3.4%, 0.2%). Reinitiation was lowest in the months before January (HR 0.4-0.5) among nonsubsidized DPP-4i patients, demonstrating a strong seasonal pattern. CONCLUSIONS: Increased out-of-pocket costs negatively affect adherence and reinitiation of branded antihyperglycemic drugs among patients without financial subsidies. Despite closure of the coverage gap, affordability remains a concern given increasing list prices for many drugs on Medicare and the growing use of deductibles and coinsurance by commercial health plans.


Sujet(s)
Diabète , Coûts des médicaments , Hypoglycémiants/économie , Hypoglycémiants/usage thérapeutique , Medicare part D (USA) , Sujet âgé , Sujet âgé de 80 ans ou plus , Diabète/traitement médicamenteux , Diabète/économie , Diabète/épidémiologie , Inhibiteurs de la dipeptidyl-peptidase IV/économie , Inhibiteurs de la dipeptidyl-peptidase IV/usage thérapeutique , Coûts des médicaments/statistiques et données numériques , Femelle , Dépenses de santé/statistiques et données numériques , Dépenses de santé/tendances , Humains , Mâle , Medicare part D (USA)/économie , Medicare part D (USA)/statistiques et données numériques , Adulte d'âge moyen , Sulfonylurées/économie , Sulfonylurées/usage thérapeutique , États-Unis/épidémiologie
15.
Int J Mol Sci ; 21(12)2020 Jun 16.
Article de Anglais | MEDLINE | ID: mdl-32560043

RÉSUMÉ

Chagas disease, caused by Trypanosoma cruzi (T. cruzi), affects nearly eight million people worldwide. There are currently only limited treatment options, which cause several side effects and have drug resistance. Thus, there is a great need for a novel, improved Chagas treatment. Bifunctional enzyme dihydrofolate reductase-thymidylate synthase (DHFR-TS) has emerged as a promising pharmacological target. Moreover, some human dihydrofolate reductase (HsDHFR) inhibitors such as trimetrexate also inhibit T. cruzi DHFR-TS (TcDHFR-TS). These compounds serve as a starting point and a reference in a screening campaign to search for new TcDHFR-TS inhibitors. In this paper, a novel virtual screening approach was developed that combines classical docking with protein-ligand interaction profiling to identify drug repositioning opportunities against T. cruzi infection. In this approach, some food and drug administration (FDA)-approved drugs that were predicted to bind with high affinity to TcDHFR-TS and whose predicted molecular interactions are conserved among known inhibitors were selected. Overall, ten putative TcDHFR-TS inhibitors were identified. These exhibited a similar interaction profile and a higher computed binding affinity, compared to trimetrexate. Nilotinib, glipizide, glyburide and gliquidone were tested on T. cruzi epimastigotes and showed growth inhibitory activity in the micromolar range. Therefore, these compounds could lead to the development of new treatment options for Chagas disease.


Sujet(s)
Maladie de Chagas/enzymologie , Antifoliques/pharmacologie , Trypanocides/pharmacologie , Maladie de Chagas/traitement médicamenteux , Simulation numérique , Repositionnement des médicaments , Antifoliques/composition chimique , Glipizide/composition chimique , Glipizide/pharmacologie , Glibenclamide/composition chimique , Glibenclamide/pharmacologie , Humains , Ligands , Simulation de docking moléculaire , Structure moléculaire , Pyrimidines/composition chimique , Pyrimidines/pharmacologie , Relation structure-activité , Sulfonylurées/composition chimique , Sulfonylurées/pharmacologie , Trypanocides/composition chimique , Trypanosoma cruzi/effets des médicaments et des substances chimiques
17.
Ecotoxicology ; 29(2): 217-225, 2020 Mar.
Article de Anglais | MEDLINE | ID: mdl-32030573

RÉSUMÉ

The expansion of land use for agricultural interests and the excessive use of herbicides are among the causes of biodiversity losses in the Brazilian Cerrado biome. Therefore, we aimed to test the hypothesis that Dipteryx alata Vogel, a common species in this biome, is sensitive to nicosulfuron because of its high phytotoxicity. We evaluated physiological, biochemical and morphological responses in D. alata plants exposed to increasing doses of the herbicide. Young plants were transplanted to 10 L pots containing substrate composed of soil and sand (2:1) after fertilization. After an acclimation period, the following doses of nicosulfuron were applied: 0 (control), 6, 12, 24, 48, and 60 g a.e. ha-1. The experiment was conducted in a randomized block design factorial scheme with six doses of nicosulfuron, three evaluation times, and five replicates per treatment. The effects of the herbicide were assessed by measuring gas exchange, chlorophyll a fluorescence, photosynthetic pigments, membrane permeability, antioxidant enzymes and acetolactate synthase. Nicosulfuron altered the photosynthetic machinery and enzymatic metabolism of D. alata. Reductions in physiological traits, increased catalase and ascorbate peroxidase activities, enhanced malondialdehyde concentrations rate of electrolyte leakage and decreased acetolactate synthase activity in response to nicosulfuron all suggest that D. alata is sensitive to this herbicide.


Sujet(s)
Dipteryx/physiologie , Herbicides/toxicité , Pyridines/toxicité , Sulfonylurées/toxicité , Agriculture , Antioxydants/métabolisme , Brésil , Catalase/métabolisme , Chlorophylle A , Photosynthèse
18.
Ann Hepatol ; 19(3): 320-328, 2020.
Article de Anglais | MEDLINE | ID: mdl-31980358

RÉSUMÉ

INTRODUCTION: This study aimed to compare the therapeutic efficacy of metformin and other anti-hyperglycemic agents in hepatocellular carcinoma (HCC) patients with type 2 diabetes (T2D). MATERIALS: A systematic electronic search on keywords including HCC and different anti-hyperglycemic agents was performed through electronic databases including Medline and EMBASE. The primary outcome was the overall survival (OS). The secondary outcomes were the recurrence-free survival (RFS) and progression-free survival (PFS). RESULTS: Six retrospective cohort studies were included for analysis: Four studies with curative treatment for HCC (618 patients with metformin and 532 patients with other anti-hyperglycemic agents) and two studies with non-curative treatment for HCC (92 patients with metformin and 57 patients with other anti-hyperglycemic agents). Treatment with metformin was associated with significantly longer OS (OR1yr=2.62, 95%CI: 1.76-3.90; OR3yr=3.14, 95%CI: 2.33-4.24; OR5yr=3.31, 95%CI: 2.39-4.59, all P<0.00001) and RFS (OR1yr=2.52, 95%CI: 1.84-3.44; OR3yr=2.87, 95%CI: 2.15-3.84; all P<0.00001; and OR5yr=2.26, 95%CI: 0.94-5.45, P=0.07) rates vs. those of other anti-hyperglycemic agents after curative therapies for HCC. However, both of the two studies reported that following non-curative HCC treatment, there were no significant differences in the OS and PFS rates between the metformin and non-metformin groups (I2>50%). CONCLUSIONS: Metformin significantly prolonged the survival of HCC patients with T2D after the curative treatment of HCC. However, the efficacy of metformin needs to be further determined after non-curative therapies for HCC patients with T2D.


Sujet(s)
Carcinome hépatocellulaire/thérapie , Diabète de type 2/traitement médicamenteux , Hypoglycémiants/usage thérapeutique , Tumeurs du foie/thérapie , Taux de survie , Carcinome hépatocellulaire/complications , Diabète de type 2/complications , Survie sans rechute , Hépatectomie , Humains , Tumeurs du foie/complications , Metformine/usage thérapeutique , Survie sans progression , Ablation par radiofréquence , Radiochirurgie , Sulfonylurées/usage thérapeutique , Thiazolidinediones/usage thérapeutique
19.
Chemosphere ; 236: 124333, 2019 Dec.
Article de Anglais | MEDLINE | ID: mdl-31319303

RÉSUMÉ

The use of herbicides in Brazil has been carried out based on the manufacturer's recommendation, often disregarding the high variability of soil attributes. The use of statistical methods to predict the herbicide retention processes in the soil can contribute to the improvement of weed control efficiency associated with the lower risk of environmental contamination. This research evaluated the use of Artificial Neural Networks (ANNs) to predict soil sorption and desorption, as well as the environmental contamination potential of diuron, hexazinone and sulfometuron-methyl herbicides in Brazilian soils. The sorption and desorption coefficients of the three herbicides were determined in laboratory tests for 15 soils from different Brazilian states. To predict the sorption and desorption of diuron, hexazinone and sulfometuron-methyl were used a multilayer perceptron ANNs (MLP). The inputs were the characteristics of the herbicides and the physical and chemical attributes of the soils, and the outputs of were the sorption and desorption coefficients (Kfs and Kfd). The risk of leaching of diuron, hexazinone, and sulfometuron-methyl herbicides were evaluated considering the sorption values observed and those estimated by the models. The Artificial Neural Network (ANN) models were efficient for the prediction of sorption and desorption of diuron, hexazinone, and sulfometuron-methyl herbicides. The physicochemical properties of the herbicides were more important for the modeling of multilayer perceptron ANNs than the soil attributes. The herbicides diuron, hexazinone, and sulfometuron-methyl have a high potential risk for contamination of groundwater in different Brazilian states.


Sujet(s)
Diuron/composition chimique , Herbicides/composition chimique , Sulfonylurées/composition chimique , Triazines/composition chimique , Brésil , 29935
20.
J Environ Sci Health B ; 54(7): 560-568, 2019.
Article de Anglais | MEDLINE | ID: mdl-31246136

RÉSUMÉ

After application, herbicides often reach the soil and affect non-target soil microorganisms, decreasing their population, diversity or affecting metabolic activity. Therefore, laboratory studies were performed to evaluate the effects of diuron, hexazinone and sulfometuron-methyl alone and mixed upon carbon transformation by soil microorganisms in clayey and sandy soils and the effect on bacterial diversity and structure. Control treatment without herbicide application was also performed. Sub-samples from the control and herbicide treatments (10 g - in triplicate) were collected before herbicide application and 7, 14, 28 and 42 days after treatment (DAT), then 1 mL of 14C-glucose solution was applied. The released 14CO2 was trapped in 2 M NaOH solution and the radioactivity was analyzed by liquid scintillation counting (LSC), 12 h after glucose application. The effect of herbicides on bacterial diversity was evaluated by T-RFLP. The experiment was conducted in a complete randomized design. Hexazinone did not affect 14CO2 evolution. Diuron showed a greater 14CO2 evolution in sandy and clayey soil, while sulfometuron-methyl led to an increase in sandy soil, at 42 DAT. A greater evolution of carbon was observed in the treatment with herbicide mixture in sandy soil, compared with the same treatment in clayey soil or control. However, the herbicide mixture application did not affect the soil biological activity measured by the respiration rate induced by substrate. On the other hand, the herbicide mixtures affected the bacterial diversity in both soils, being the strongest effect to diuron and sulfometuron-methyl in clayey soil and hexazinone in sandy soil.


Sujet(s)
Bactéries/effets des médicaments et des substances chimiques , Diuron/toxicité , Microbiologie du sol , Sulfonylurées/toxicité , Triazines/toxicité , Bactéries/métabolisme , Carbone/métabolisme , Dioxyde de carbone/métabolisme , Herbicides/toxicité , Polymorphisme de restriction , Sol/composition chimique , Polluants du sol/toxicité
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