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1.
Artigo em Inglês | MEDLINE | ID: mdl-38554232

RESUMO

BACKGROUND AND OBJECTIVE: Abrocitinib is an oral small-molecule Janus kinase (JAK)-1 inhibitor approved for the treatment of moderate-to-severe atopic dermatitis. In vitro studies indicated that abrocitinib is a weak time-dependent inhibitor of cytochrome P450 (CYP) 2C19/3A and a weak inducer of CYP1A2/2B6/2C19/3A. To assess the potential effect of abrocitinib on concomitant medications, drug-drug interaction (DDI) studies were conducted for abrocitinib with sensitive probe substrates of these CYP enzymes. The impact of abrocitinib on hormonal oral contraceptives (ethinyl estradiol and levonorgestrel), as substrates of CYP3A and important concomitant medications for female patients, was also evaluated. METHODS: Three Phase 1 DDI studies were performed to assess the impact of abrocitinib 200 mg once daily (QD) on the probe substrates of: (1) 1A2 (caffeine), 2B6 (efavirenz) and 2C19 (omeprazole) in a cocktail study; (2) 3A (midazolam); and (3) 3A (oral contraceptives). RESULTS: After multiple doses of abrocitinib 200 mg QD, there is a lack of effect on the pharmacokinetics of midazolam, efavirenz and contraceptives. Abrocitinib increased the area under the concentration time curve from 0 to infinity (AUCinf) and the maximum concentration (Cmax) of omeprazole by approximately 189 and 134%, respectively. Abrocitinib increased the AUCinf of caffeine by 40% with lack of effect on Cmax. CONCLUSIONS: Based on the study results, abrocitinib is a moderate inhibitor of CYP2C19. Caution should be exercised when using abrocitinib concomitantly with narrow therapeutic index medicines that are primarily metabolized by CYP2C19 enzyme. Abrocitinib is a mild inhibitor of CYP1A2; however, the impact is not clinically relevant, and no general dose adjustment is recommended for CYP1A2 substrates. Abrocitinib does not inhibit CYP3A or induce CYP1A2/2B6/2C19/3A and does not affect the pharmacokinetics of contraceptives. CLINICAL TRIALS REGISTRATION: ClinicalTrials.gov registration IDs: NCT03647670, NCT05067439, NCT03662516.

2.
Eur J Clin Pharmacol ; 80(5): 747-757, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38363388

RESUMO

PURPOSE: This study aimed to investigate the potential impact of tacrolimus (TAC) exposure on clinical outcomes after lung transplantation. METHODS: This retrospective observational study enrolled a total of 228 lung transplant recipients. TAC trough levels (C0) were collected for 3 intervals: 0-3 months, 3-12 months, and 12-24 months. The intra-patient variability (IPV) was calculated using coefficient of variation. Genotyping of CYP3A5*3 (rs776746) was performed. Patients were further divided into groups based on the C0 cut-off value of 8 ng/mL and IPV cut-off value of 30%. Cox proportional hazards regression models were used to explore the potential impact of C0 and IPV on outcomes of interests, including de-novo donor-specific antibodies (dnDSA), chronic lung allograft dysfunction (CLAD) and mortality. RESULTS: The influence of CYP3A5*3 polymorphism was only significant for C0 and IPV during the first 3 months. Low C0 (< 8 ng/mL) at 3-12 months increased the risk of dnDSA (hazard ratio [HR] 2.696, 95% confidence interval [CI] 1.046-6.953) and mortality (HR 2.531, 95% CI 1.368-4.685), while High IPV (≥ 30%) during this period was associated with an increased risk of mortality (HR 2.543, 95% CI 1.336-4.839). Patients with Low C0/High IPV combination had significantly higher risks for dnDSA (HR 4.381, 95% CI 1.279-15.008) and survival (HR 6.179, 95% CI 2.598-14.698), surpassing the predictive power provided by C0 or IPV alone. CONCLUSION: A combination of Low C0/High IPV might be considered in categorizing patients towards risk of adverse clinical outcomes following lung transplantation.


Assuntos
Transplante de Rim , Transplante de Pulmão , Humanos , Tacrolimo/uso terapêutico , Imunossupressores/uso terapêutico , Citocromo P-450 CYP3A , Estudos Retrospectivos , Transplante de Pulmão/efeitos adversos , Anticorpos , Rejeição de Enxerto
3.
CPT Pharmacometrics Syst Pharmacol ; 13(4): 599-611, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38298058

RESUMO

These analyses characterized tofacitinib pharmacokinetics (PKs) in children and adolescents with juvenile idiopathic arthritis (JIA). Data were pooled from phase I (NCT01513902), phase III (NCT02592434), and open-label, long-term extension (NCT01500551) studies of tofacitinib tablet/solution (weight-based doses administered twice daily [b.i.d.]) in patients with JIA aged 2 to less than 18 years. Population PK modeling used a nonlinear mixed-effects approach, with covariates identified using stepwise forward-inclusion backward-deletion procedures. Simulations were performed to derive dosing recommendations for children and adolescents with JIA. Two hundred forty-six pediatric patients were included in the population PK model. A one-compartment model with first-order elimination and absorption with body weight as a covariate for oral clearance and apparent volume of distribution sufficiently described the data. Oral solution was associated with comparable average concentration (Cavg) and slightly higher (113.9%) maximum concentration (Cmax) versus tablet, which was confirmed by a subsequent randomized, open-label, bioavailability study conducted in healthy adult participants (n = 12) by demonstrating adjusted geometric mean ratios (90% confidence interval) between oral solution and tablet of 1.04 (1.00-1.09) and 1.10 (1.00-1.21) for area under the curve extrapolated to infinity and Cmax, respectively (NCT04111614). A dosing regimen of 3.2 mg b.i.d. solution in patients 10 to less than 20 kg, 4 mg b.i.d. solution in patients 20 to less than 40 kg, and 5 mg b.i.d. tablet/solution in patients greater than or equal to 40 kg, irrespective of age, was proposed to achieve constant Cavg across weight groups. In summary, population PK characterization informed a simplified tofacitinib dosing regimen that has been implemented in pediatric patients with JIA.


Assuntos
Artrite Juvenil , Adulto , Humanos , Criança , Adolescente , Artrite Juvenil/tratamento farmacológico , Piperidinas/farmacocinética , Pirimidinas , Comprimidos
4.
Cell Cycle ; 23(2): 131-149, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38341861

RESUMO

Colorectal cancer (CRC) ranks among the most prevalent global malignancies, posing significant threats to human life and health due to its high recurrence and metastatic potential. Small extracellular vesicles (sEVs) released by CRC play a pivotal role in the formation of the pre-metastatic niche (PMN) through various mechanisms, preparing the groundwork for accelerated metastatic invasion. This review systematically describes how sEVs promote CRC metastasis by upregulating inflammatory factors, promoting immunosuppression, enhancing angiogenesis and vascular permeability, promoting lymphangiogenesis and lymphatic network remodeling, determining organophilicity, promoting stromal cell activation and remodeling and inducing the epithelial-to-mesenchymal transition (EMT). Furthermore, we explore potential mechanisms by which sEVs contribute to PMN formation in CRC and propose novel insights for CRC diagnosis, treatment, and prognosis.


Assuntos
Neoplasias Colorretais , Transição Epitelial-Mesenquimal , Vesículas Extracelulares , Microambiente Tumoral , Humanos , Vesículas Extracelulares/metabolismo , Neoplasias Colorretais/patologia , Neoplasias Colorretais/metabolismo , Animais , Metástase Neoplásica , Neovascularização Patológica/metabolismo , Neovascularização Patológica/patologia , Linfangiogênese
5.
Biomacromolecules ; 25(3): 1825-1837, 2024 Mar 11.
Artigo em Inglês | MEDLINE | ID: mdl-38336482

RESUMO

A synthetic biopolymer derived from furandicarboxylic acid monomer and hydroxyethyl-terminated poly(ether sulfone) is presented. The synthesis involves 4,4'-dichlorodiphenyl sulfone and 4,4-dihydroxydiphenyl sulfone, resulting in poly(butylene furandicarboxylate)-poly(ether sulfone) copolyesters (PBFES) through melt polycondensation with titanium-catalyzed polymerization. This facile method yields segmented polyesters incorporating polysulfone, creating a versatile group of high-temperature thermoplastics with adjustable thermomechanical properties. The PBFES copolyesters demonstrate an impressive tensile modulus of 2830 MPa and a tensile strength of 84 MPa for PBFES55. Additionally, the poly(ether sulfone) unit imparts a relatively high glass transition temperature (Tg), ranging from 36.6 °C for poly(butylene 2,5-furandicarboxylate) to 112.3 °C for PBFES62. Moreover, the complete amorphous film of PBFES exhibits excellent transparency and solvent resistance, making it suitable for applications, such as food packaging materials.


Assuntos
Alcenos , Materiais Biocompatíveis , Poliésteres , Polímeros , Sulfonas , Éteres
6.
Transpl Immunol ; 83: 102008, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38342328

RESUMO

BACKGROUND: Post-transplant diabetes mellitus (PTDM) is a common complication after transplantation. We aim to explore potential risk factors of PTDM and its association with outcomes after lung transplantation (LTx). METHODS: A retrospective study was conducted in 100 patients who underwent LTx at our institution from 2017 to 2021. Patients' information was collected, and genotyping for single nucleotide polymorphisms known to potentially increase the risk of Type 2 DM was performed. Univariate and multivariate analyses were conducted to identify risk factors for PTDM. The primary outcome was the incidence of PTDM. Secondary outcomes were associations between PTDM and clinical outcomes following LTx. RESULTS: Thirty-nine patients (39.0%) developed PTDM, while 10 patients (25.6%) recovered subsequently. The incidence of PTDM was associated with age > 45 (HR: 2.919, 95% CI [1.021-8.348]), pre-transplant HbA1c > 5.7% (HR: 2.344, 95% CI [1.201-4.573]), KCNJ11 rs5215 (HR: 2.090, 95% CI [1.050-4.162]) and tacrolimus concentration > 8 ng/mL in the first month (HR: 2.090, 95% CI [1.050-4.162]). Patients with PTDM experienced elevated fasting blood glucose levels (FBG) during the first month post-transplantation (p < 0.001), and required a longer duration for FBG to return to normal levels (p < 0.001). However, the presence of PTDM did not significantly impact renal function, incidence of infection episodes, chronic lung allograft dysfunction or mortality following LTx. CONCLUSION: Advanced age, elevated HbA1c levels, KCNJ11 gene polymorphism, and early exposure to tacrolimus are all significant risk factors for PTDM following LTx. The clinical implications of these factors warrant attention.


Assuntos
Diabetes Mellitus , Transplante de Rim , Transplante de Pulmão , Humanos , Estudos Retrospectivos , Tacrolimo/efeitos adversos , Hemoglobinas Glicadas , Incidência , Imunossupressores/efeitos adversos , Transplante de Rim/efeitos adversos , Diabetes Mellitus/etiologia , Fatores de Risco , Transplante de Pulmão/efeitos adversos , Complicações Pós-Operatórias/epidemiologia
7.
Lupus Sci Med ; 11(1)2024 Jan 31.
Artigo em Inglês | MEDLINE | ID: mdl-38302132

RESUMO

OBJECTIVES: To illuminate the poorly understood aetiology of SLE by comparing the gene expression profile of SLE neutrophils with that of neutrophils from patients infected by SARS-CoV-2, a disease (COVID-19) with well-defined antigens and a similar type I interferon response. METHODS: RNA sequencing of neutrophils from patients with SLE (n=15) and healthy controls (n=12) was analysed for differential gene expression and modulated pathways. The same analyses were performed on a similar neutrophil dataset from patients with SARS-CoV-2 infection (n=30) and healthy controls (n=8). Next, we carried out comparative analyses to identify common and unique transcriptional changes between the two disease contexts, emphasising genes regulated in opposite directions. RESULTS: We identified 372 differentially expressed genes in SLE neutrophils compared with healthy donor neutrophils (≥2 fold, p<0.05), 181 of which were concordant with transcriptional changes in SARS-CoV-2-infected individuals compared with their respective healthy controls. In contrast, 118 genes demonstrated statistically significant alterations exclusive to SLE, including 28 genes that were differentially expressed in opposite directions in the two diseases. CONCLUSIONS: The substantial overlap between neutrophil responses in SLE and COVID-19 suggests that the unknown cause of SLE is functionally similar to a viral infection and drives a similar immune activation and type I interferon response. Conversely, the genes regulated in the opposite direction represent responses unique to SLE. These include tyrosylprotein sulfotransferase-1 and nucleic acid deaminases of the APOBEC family, which can catalyse cytosine-to-uridine editing of both RNA and DNA, and other RNA-modifying enzymes.


Assuntos
COVID-19 , Interferon Tipo I , Lúpus Eritematoso Sistêmico , Humanos , Neutrófilos , Transcriptoma , COVID-19/genética , SARS-CoV-2/genética , SARS-CoV-2/metabolismo , Lúpus Eritematoso Sistêmico/genética , RNA/metabolismo , Interferon Tipo I/genética
8.
J Clin Pharmacol ; 2024 Feb 08.
Artigo em Inglês | MEDLINE | ID: mdl-38327217

RESUMO

The determination of the appropriate initial dose for tacrolimus is crucial in achieving the target concentration promptly and avoiding adverse effects and poor prognosis. However, the trial-and-error approach is still common practice. This study aimed to establish a prediction model for an initial dosing algorithm of tacrolimus in patients receiving a lung transplant. A total of 210 lung transplant recipients were enrolled, and 26 single nucleotide polymorphisms (SNP) from 18 genes that could potentially affect tacrolimus pharmacokinetics were genotyped. Associations between SNPs and tacrolimus concentration/dose ratio were analyzed. SNPs that remained significant in pharmacogenomic analysis were further combined with clinical factors to construct a prediction model for tacrolimus initial dose. The dose needed to reach steady state tacrolimus concentrations and achieve the target range was used to validate model prediction efficiency. Our final model consisted of 7 predictors-CYP3A5 rs776746, SLCO1B3 rs4149117, SLC2A2 rs1499821, NFATc4 rs1955915, alanine aminotransferase, direct bilirubin, and hematocrit-and explained 41.4% variance in the tacrolimus concentration/dose ratio. It achieved an area under the receiver operating characteristic curve of 0.804 (95% confidence interval, 0.746-0.861). The Hosmer-Lemeshow test yielded a nonsignificant P value of .790, suggesting good fit of the model. The predicted dose exhibited good correlation with the observed dose in the early postoperative period (r = 0.748, P less than .001). Our study provided a genotype-guided prediction model for tacrolimus initial dose, which may help to guide individualized dosing of tacrolimus in the lung transplant population in clinical practice.

9.
Pulm Pharmacol Ther ; 84: 102280, 2023 Dec 06.
Artigo em Inglês | MEDLINE | ID: mdl-38065402

RESUMO

BACKGROUND: Lung transplant recipients (LTRs) have a higher risk of hospitalization and mortality due to COVID-19 compared with the immunocompetent population. The use of nirmatrelvir/ritonavir (NR), an effective oral treatment for COVID-19, is quite challenging due to its potent drug-drug interactions with immunosuppressants and azole antifungals. As there are few clinical reports of the use of NR in LTRs, we measured tacrolimus levels in patients receiving NR in our hospital to improve safety when prescribing NR. METHODS: In total, 48 adult LTRs who received NR between November 19, 2022, and January 19, 2023, at China-Japan Friendship Hospital were retrospectively included and followed for 20 days after initiating NR. Tacrolimus was held at least 12 h before initiating NR and re-administered based on the trough levels after completing NR treatment. All concomitant medications, drug concentrations, laboratory results, and genotypes were recorded and analyzed. RESULTS: Most patients showed stable tacrolimus trough levels despite high individual variability. Four patients exhibited supratherapeutic trough levels of tacrolimus (more than 15 ng/mL). Two patients who received 0.5 mg of tacrolimus during NR treatment had trough levels below 3.0 ng/mL. In addition, we found that in 13 patients, the trough levels were 130% of baseline after cessation of tacrolimus, and logistic regression revealed that increased trough level was significantly associated with age more than 60 years. CONCLUSIONS: NR can be safely used in LTRs with close monitoring of tacrolimus levels and appropriate dose adjustments. However, more attention should be paid to elderly patients, as NR may more severely affect their drug metabolism. Due to the limited sample size, further studies are needed to guide the optimal use of tacrolimus following treatment with NR and explore the risk factors significantly affecting the interactions between NR and tacrolimus.

10.
Chem Commun (Camb) ; 59(97): 14403-14406, 2023 Dec 05.
Artigo em Inglês | MEDLINE | ID: mdl-37975177

RESUMO

The introduction of a small amount of TiO2 changes the surface properties of the SiO2 material, which further significantly affects the dispersion state of Ti(SO4)2. The differences in acidity and redox caused by the distribution of Ti(SO4)2 are closely related to the catalyst performance for dimethyl ether (DME) oxidation. In particular, the calcination temperature could adjust the surface hydroxyl content of TiO2/SiO2, which determines the dispersion of Ti(SO4)2 components, resulting in distinct acid sites and Ti valence. The most number of weak acid sites and the highest proportion of Ti3+/Ti4+ in the Ti(SO4)2/TS-400 °C catalyst remarkably promote the formation of dimethoxymethane (DMM) from 14.4% to 82.6%, compared to the Ti(SO4)2/SiO2 catalyst.

11.
Acc Chem Res ; 56(23): 3358-3368, 2023 Dec 05.
Artigo em Inglês | MEDLINE | ID: mdl-37984414

RESUMO

ConspectusSince carbon-based energy continues to dominate (over 80%) the global primary energy supply, carbon dioxide capture, utilization, and sequestration (CCUS) is deemed to be a promising and viable option to mitigate greenhouse gas emissions and climate change, for which CO2 capture is critical to the overall success of CCUS. Although liquid amine scrubbing is a mature technology for carbon capture, it is energy-intensive and costly due to energy consumption in solvent heating and water evaporation apart from the energy needed to break amine-CO2 bonding. To address this challenge, Song's group developed a new design approach for adsorptive CO2 capture and separation, namely, "molecular basket" sorbents (MBS), without the need for dealing with solvent heating and water evaporation. The solid MBS consisting of polymeric amines (such as PEI) immobilized into nanoporous materials (such as SBA-15) possesses a high capacity for CO2 capture with high selectivity, fast kinetics, and good regenerability. Consequently, MBS can greatly reduce energy consumption and carbon capture cost. Conventional adsorbents such as zeolites, activated carbon, alumina, and silica have low adsorption capacities, and their use of CO2 adsorption requires prior removal of moisture and cooling of flue gas (∼35 °C). On the contrast, the CO2 sorption capacity of MBS can even be promoted by the presence of moisture/steam and reaches the best performance closer to flue gas temperature (∼75 °C). This Account presents an overview of our research progress in the material development and fundamental understanding of MBS for CO2 capture and the separation of CO2 from various gas streams. It begins with an illustration of the MBS concept, followed by efforts to improve the performance and pilot-scale demonstration of MBS for CO2 capture. With the systematic characterization of MBS by various ex situ and in situ techniques, a better understanding is developed for the CO2 sorption process mechanistically. Furthermore, this Account demonstrates how the fundamental understanding of the CO2 sorption mechanism promotes the further development of more robust and advanced sorbent materials with improved CO2 sorption capacity, kinetics of sorption and desorption, and cyclic stability. Finally, an outlook is provided for the future design and development of novel sorbent materials and the CO2 sorption process for various gas streams including flue gas, biogas, air, and hydrogen streams.

12.
JACS Au ; 3(11): 3141-3154, 2023 Nov 27.
Artigo em Inglês | MEDLINE | ID: mdl-38034970

RESUMO

Selective oxidation of C-H bonds under mild conditions is one of the most important and challenging issues in utilization of energy-related molecules. Molybdenum oxide nanostructures containing Mo5+ species are effective for these reactions, but the accurate identification of the structure of active Mo5+ species and the catalytic mechanism remain unclear. Herein, unsaturated penta-coordinated Mo5c5+ with a high fraction in MoOx fabricated by the hydrothermal method were identified as the active sites for low-temperature oxidation of dimethyl ether (DME) by the deep correlation of characterizations, density functional theory calculations, and activity results, giving a methyl formate selectivity of 96.3% and DME conversion of 12.5% at unreported 110 °C. Low-temperature electron spin resonance (ESR) and quasi in situ X-ray photoelectron spectra (XPS) with the designed experiments confirm that the Mo5c5+ species can be formed in situ. Molybdenum located at the pentachronic site is preferable to significantly promote the oxidation of the C-H bond in CH3O* at lower temperatures.

13.
Front Pharmacol ; 14: 1285078, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38026995

RESUMO

Paxlovid (nirmatrelvir/ritonavir) is an antiviral drug used to treat COVID-19, nirmatrelvir, a SARS-CoV-2 main protease inhibitor, works by inhibiting viral replication in the early stages, and ritonavir is a strong cytochrome P450 (CYP) 3A inhibitor that helps the nirmatrelvir reach and maintain the therapeutic concentrations. Paxlovid has a potential risk of drug interaction by elevating the plasma concentration of other drugs metabolized by CYP3A, like tacrolimus. This report examines the case of a 57-year-old female lung transplant patient self-administered Paxlovid for 5 days without discontinuing tacrolimus. She presented to the hospital with symptoms of headache, dizziness, palpitations, abdominal distension, nausea, vomiting, and diarrhea. The patient presented with tacrolimus toxicity and the blood concentration of tacrolimus was measured at 106 ng/mL. Urgent medical intervention was initiated, and Rifampin was administered to induce enzyme activity and rapidly decrease the concentration of tacrolimus. By adjusting the tacrolimus dosage, the final concentration was brought within the appropriate range. Clinical pharmacists should prioritize medication education for transplant patients to prevent severe drug interactions and minimize the impact on the patient's overall well-being.

14.
Transl Neurodegener ; 12(1): 43, 2023 09 11.
Artigo em Inglês | MEDLINE | ID: mdl-37697342

RESUMO

Neurodegenerative diseases, such as Alzheimer's disease, Parkinson's disease, amyotrophic lateral sclerosis, and Huntington's disease, affect millions of people worldwide. Tremendous efforts have been put into disease-related research, but few breakthroughs have been made in diagnostic and therapeutic approaches. Extracellular vesicles (EVs) are heterogeneous cell-derived membrane structures that arise from the endosomal system or are directly separated from the plasma membrane. EVs contain many biomolecules, including proteins, nucleic acids, and lipids, which can be transferred between different cells, tissues, or organs, thereby regulating cross-organ communication between cells during normal and pathological processes. Recently, EVs have been shown to participate in various aspects of neurodegenerative diseases. Abnormal secretion and levels of EVs are closely related to the pathogenesis of neurodegenerative diseases and contribute to disease progression. Numerous studies have proposed EVs as therapeutic targets or biomarkers for neurodegenerative diseases. In this review, we summarize and discuss the advanced research progress on EVs in the pathological processes of several neurodegenerative diseases. Moreover, we outline the latest research on the roles of EVs in neurodegenerative diseases and their therapeutic potential for the diseases.


Assuntos
Doença de Alzheimer , Esclerose Amiotrófica Lateral , Vesículas Extracelulares , Doenças Neurodegenerativas , Doença de Parkinson , Humanos , Doenças Neurodegenerativas/diagnóstico , Doenças Neurodegenerativas/terapia
15.
Sci Rep ; 13(1): 14008, 2023 08 27.
Artigo em Inglês | MEDLINE | ID: mdl-37635176

RESUMO

The purpose of this study is to evaluate the efficacy of prophylactic use amphotericin B in patients with hematologic disorders complicated by neutropenia. We searched the PubMed, EMBASE, The Cochrane Library, CBM, CNKI, VIP and WanFang Data database and the China Clinical Trials Registry ( www.chictr.org.cn ) to collect randomized controlled trials (RCTs) of amphotericin B for patients with hematologic disorders complicated by neutropenia from inception to May 2023. The Cochrane risk-of-bias tool for RCTs was used to assess the bias risk of the included studies. The meta-analysis was performed using RevMan 5.3 software. A total of 6 studies with a total of 1019 patients were included. The results of the meta-analysis showed that the treatment group was superior to the control group in terms of the fungal infection rate, and the differences were statistically significant [RR = 0.47, 95% CI (0.32, 0.69), P < 0.0001]. There was no significant difference between the two groups in terms of the mortality [RR = 0.87, 95% CI (0.61, 1.23), P = 0.43] and the incidence of colonization [OR = 0.51, 95% CI (0.25, 1.03), P = 0.06]. The evidence shows that amphotericin B prophylactic use for patients with hematologic disorders complicated by neutropenia can decrease the fungal infection rate. However, there was no significant difference in reducing mortality or the incidence of colonization. Due to the limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusion.


Assuntos
Doenças Hematológicas , Neutropenia , Humanos , Anfotericina B/efeitos adversos , Neutropenia/complicações , Neutropenia/tratamento farmacológico , Doenças Hematológicas/complicações , Doenças Hematológicas/tratamento farmacológico , China/epidemiologia , Bases de Dados Factuais
16.
J Chromatogr A ; 1706: 464259, 2023 Sep 13.
Artigo em Inglês | MEDLINE | ID: mdl-37567001

RESUMO

The determination of intracellular tacrolimus concentration in peripheral blood mononuclear cells (PBMCs) is crucial for assessing the effect-site concentration of tacrolimus. Analytical methods previously reported required a minimum of 3 mL of whole blood sample for measuring the tacrolimus concentration. In this study, we developed a highly sensitive method using EASY nLC 1200 combined with Q Exactive orbitrap mass spectrometer for detecting tacrolimus in PBMCs, requiring only 0.5-2 mL of sample. Furthermore, we compared two primary normalization methods for PBMCs tacrolimus concentration using Passing-Bablok regression, Bland-Altman analysis, Spearman's rank correlation, and Mountain plot. The newly established method was employed to compare tacrolimus concentrations in whole blood and PBMCs among 194 lung transplant recipients. The developed method exhibited high sensitivity with a lower limit of quantitation at 5 pg/mL, and excellent intra- and inter-days accuracy and precision. The comparison between different normalization methods for PBMCs tacrolimus concentration revealed a strong correlation between PBMCs count and intracellular protein amount within these cells. This finding suggests that both PBMCs count and intracellular protein amount can be used for normalizing intracellular tacrolimus levels and can be mutually converted. However, a weaker correlation was observed between PBMCs and whole-blood tacrolimus concentrations in lung transplant recipients, warranting further investigation. The method reported herein enables the quantification of PBMCs tacrolimus concentration using smaller volumes of whole blood samples, which has significant implications for both patients and laboratory personnel.


Assuntos
Leucócitos Mononucleares , Tacrolimo , Humanos , Leucócitos Mononucleares/química , Espectrometria de Massas em Tandem/métodos , Cromatografia Líquida/métodos , Imunossupressores , Monitoramento de Medicamentos/métodos
17.
Pulm Pharmacol Ther ; 82: 102243, 2023 10.
Artigo em Inglês | MEDLINE | ID: mdl-37454870

RESUMO

PURPOSE: Chronic lung allograft dysfunction (CLAD) was a common complication following lung transplantation that contributed to long-term morbidity and mortality. Statin therapy had been suggested to attenuate recipient inflammation and immune response, potentially reducing the risk and severity of CLAD. This study aimed to evaluate the impact of statin use and in vivo exposure on the incidence of CLAD in lung transplant recipients (LTRs), as well as their effects on immune cells and inflammatory factors. METHODS: A retrospective cohort study was conducted on patients who underwent lung transplantation between January 2017 and December 2020. The incidence of CLAD, as per the 2019 ISHLT criteria, was assessed as the clinical outcome. The plasma concentrations of statin were measured using a validated UPLC-MS/MS method, while inflammation marker levels were determined using ELISA kits. RESULTS: The statin group exhibited a significantly lower rate of CLAD (P = 0.002). Patients receiving statin therapy showed lower CD4+ T-cell counts, total T-lymphocyte counts, and IL-6 levels (P = 0.017, P = 0.048, and P = 0.038, respectively). Among the CLAD groups, the atorvastatin level (2.51 ± 1.31 ng/ml) was significantly lower than that in the non-CLAD group (OR = 1.438, 95%CI (1.007-2.053), P = 0.046). CONCLUSION: Statin therapy significantly reduced the incidence of CLAD, as well as immune cell counts and inflammatory cytokine levels in LTRs. Although the statin exposure was significantly lower in CLAD patients, it was not associated with the incidence of CLAD.


Assuntos
Inibidores de Hidroximetilglutaril-CoA Redutases , Transplante de Pulmão , Disfunção Primária do Enxerto , Humanos , Aloenxertos/efeitos dos fármacos , Aloenxertos/imunologia , Cromatografia Líquida , População do Leste Asiático , Inibidores de Hidroximetilglutaril-CoA Redutases/sangue , Inibidores de Hidroximetilglutaril-CoA Redutases/farmacologia , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Inflamação/tratamento farmacológico , Inflamação/prevenção & controle , Pulmão/efeitos dos fármacos , Pulmão/imunologia , Transplante de Pulmão/efeitos adversos , Estudos Retrospectivos , Espectrometria de Massas em Tandem , Transplantados , Disfunção Primária do Enxerto/etiologia , Disfunção Primária do Enxerto/imunologia , Disfunção Primária do Enxerto/prevenção & controle , Fatores de Risco
19.
IEEE Trans Pattern Anal Mach Intell ; 45(11): 13974-13990, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37486848

RESUMO

Despite its popularity as a one-shot Neural Architecture Search (NAS) approach, the applicability of differentiable architecture search (DARTS) on complex vision tasks is still limited by the high computation and memory costs incurred by the over-parameterized supernet. We propose a new architecture search method called EasyNAS, whose memory and computational efficiency is achieved via our devised operator merging technique which shares and merges the weights of candidate convolution operations into a single convolution, and a dynamic channel refinement strategy. We also introduce a configurable search space-to-supernet conversion tool, leveraging the concept of atomic search components, to enable its application from classification to more complex vision tasks: detection and semantic segmentation. In classification, EasyNAS achieves state-of-the-art performance on the NAS-Bench-201 benchmark, attaining an impressive 76.2% accuracy on ImageNet. For detection, it achieves a mean average precision (mAP) of 40.1 with 120 frames per second (FPS) on MS-COCO test-dev. Additionally, we transfer the discovered architecture to the rotation detection task, where EasyNAS achieves a remarkable 77.05 mAP 50 on the DOTA-v1.0 test set, using only 21.1 M parameters. In semantic segmentation, it achieves a competitive mean intersection over union (mIoU) of 72.6% at 173 FPS on Cityscape, after searching for only 0.7 GPU-day.

20.
Microorganisms ; 11(5)2023 May 17.
Artigo em Inglês | MEDLINE | ID: mdl-37317284

RESUMO

Many patients suffering from autoimmune diseases have autoantibodies against proteins encoded by genomic retroelements, suggesting that normal epigenetic silencing is insufficient to prevent the production of the encoded proteins for which immune tolerance appears to be limited. One such protein is the transmembrane envelope (Env) protein encoded by human endogenous retrovirus K (HERV-K). We reported recently that patients with rheumatoid arthritis (RA) have IgG autoantibodies that recognize Env. Here, we use RNA sequencing of RA neutrophils to analyze HERV-K expression and find that only two loci with an intact open-reading frame for Env, HERV-K102, and K108 are expressed, but only the former is increased in RA. In contrast, other immune cells express more K108 than K102. Patient autoantibodies recognized endogenously expressed Env in breast cancer cells and in RA neutrophils but not healthy controls. A monoclonal anti-Env antibody also detected Env on the surface of RA neutrophils but very little on the surface of other immune cells. We conclude that HERV-K102 is the locus that produces Env detectable on the surface of neutrophils in RA. The low levels of HERV-K108 transcripts may contribute only marginally to cell surface Env on neutrophils or other immune cells in some patients.

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