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Pharmaceuticals, Volume 14, Issue 10 (October 2021) – 118 articles

Cover Story (view full-size image): Tumors develop within a complex microenvironment consisting of diverse cell types surrounded by a matrix rich of proteins, termed tumor stroma. Stroma includes immune cells, fibroblasts, and vascular endothelial cells. Cancer cells rely on extensive support from the stroma to survive, proliferate, and invade, making stroma elements important potential targets for anticancer therapy. One of those elements is the fibroblast activation protein (FAP), which is overexpressed on activated fibroblasts on several tumors while absent in healthy tissues and nonmalignant tumors. Given the diversity of tumors that express FAP, it would be a great progress if nuclear medicine could have a diagnostic and therapeutic tool suitable for in vivo stroma tumor imaging and targeted radiotherapy. View this paper
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15 pages, 1275 KiB  
Article
The Probiotic VSL#3® Does Not Seem to Be Efficacious for the Treatment of Gastrointestinal Symptomatology of Patients with Fibromyalgia: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial
by Elena P. Calandre, Javier Hidalgo-Tallon, Rocio Molina-Barea, Fernando Rico-Villademoros, Cristina Molina-Hidalgo, Juan M. Garcia-Leiva, Maria Dolores Carrillo-Izquierdo and Mahmoud Slim
Pharmaceuticals 2021, 14(10), 1063; https://doi.org/10.3390/ph14101063 - 19 Oct 2021
Cited by 7 | Viewed by 4699
Abstract
Gastrointestinal symptomatology is frequent among patients with fibromyalgia, which increases disease burden and lacks specific treatment, either pharmacological or non-pharmacological. We aimed to evaluate the efficacy and tolerability of a multi-strain probiotic, VSL#3®, for the treatment of fibromyalgia-associated gastrointestinal manifestations. This [...] Read more.
Gastrointestinal symptomatology is frequent among patients with fibromyalgia, which increases disease burden and lacks specific treatment, either pharmacological or non-pharmacological. We aimed to evaluate the efficacy and tolerability of a multi-strain probiotic, VSL#3®, for the treatment of fibromyalgia-associated gastrointestinal manifestations. This randomized, placebo-controlled trial included 12 weeks of probiotic or placebo treatment followed by 12 weeks of follow up. The primary outcome variable was the mean change from the baseline to the endpoint in the composite severity score of the three main gastrointestinal symptoms reported by patients with fibromyalgia (abdominal pain, abdominal bloating and meteorism). Secondary outcome variables were the severity of additional gastrointestinal symptoms, fibromyalgia severity, depression, sleep disturbance, health-related quality of life and patients’ overall impression of improvement. No differences were found between VSL#3® (n = 54) and the placebo (n = 56) in the primary outcome (estimated treatment difference: 1.1; 95% confidence interval [CI]: ?2.1, 4.2; p = 0.501), or in any of the secondary outcomes. However, responders to VSL#3 were more likely to maintain any improvement during the follow-up period compared to responders in the placebo arm. Overall, VSL#3 tolerability was good. Our data could not demonstrate any beneficial effects of VSL#3® either on the composite score of severity of abdominal pain, bloating and meteorism or in any of the secondary outcome variables. More research is needed to elucidate specific factors that may predict a favourable response to treatment in patients with fibromyalgia. Full article
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<p>Disposition of trial participants.</p>
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<p>Proportion of responders to treatment.</p>
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<p>Composite score of abdominal pain, bloating and meteorism after discontinuing the study treatment.</p>
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99 pages, 23166 KiB  
Review
Mechanistic Understanding from Molecular Dynamics in Pharmaceutical Research 2: Lipid Membrane in Drug Design
by Tomasz Róg, Mykhailo Girych and Alex Bunker
Pharmaceuticals 2021, 14(10), 1062; https://doi.org/10.3390/ph14101062 - 19 Oct 2021
Cited by 39 | Viewed by 15444
Abstract
We review the use of molecular dynamics (MD) simulation as a drug design tool in the context of the role that the lipid membrane can play in drug action, i.e., the interaction between candidate drug molecules and lipid membranes. In the standard “lock [...] Read more.
We review the use of molecular dynamics (MD) simulation as a drug design tool in the context of the role that the lipid membrane can play in drug action, i.e., the interaction between candidate drug molecules and lipid membranes. In the standard “lock and key” paradigm, only the interaction between the drug and a specific active site of a specific protein is considered; the environment in which the drug acts is, from a biophysical perspective, far more complex than this. The possible mechanisms though which a drug can be designed to tinker with physiological processes are significantly broader than merely fitting to a single active site of a single protein. In this paper, we focus on the role of the lipid membrane, arguably the most important element outside the proteins themselves, as a case study. We discuss work that has been carried out, using MD simulation, concerning the transfection of drugs through membranes that act as biological barriers in the path of the drugs, the behavior of drug molecules within membranes, how their collective behavior can affect the structure and properties of the membrane and, finally, the role lipid membranes, to which the vast majority of drug target proteins are associated, can play in mediating the interaction between drug and target protein. This review paper is the second in a two-part series covering MD simulation as a tool in pharmaceutical research; both are designed as pedagogical review papers aimed at both pharmaceutical scientists interested in exploring how the tool of MD simulation can be applied to their research and computational scientists interested in exploring the possibility of a pharmaceutical context for their research. Full article
(This article belongs to the Special Issue In Silico Approaches in Drug Design)
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Figure 1
<p>Chemical structure of lipids mentioned in this paper.</p>
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<p>Schematic of the energy landscape of a system; with basic unbiased MD or MC simulation, if performed below a certain temperature, only the region of the local minimum will be explored, thus a result for <inline-formula><mml:math id="mm78" display="block"><mml:semantics><mml:mrow><mml:mover accent="true"><mml:mrow><mml:mi>P</mml:mi><mml:mo stretchy="false">(</mml:mo><mml:mrow><mml:msup><mml:mover accent="true"><mml:mi>r</mml:mi><mml:mo stretchy="false">→</mml:mo></mml:mover><mml:mi>N</mml:mi></mml:msup><mml:mo>,</mml:mo><mml:mi>T</mml:mi></mml:mrow><mml:mo stretchy="false">)</mml:mo></mml:mrow><mml:mo stretchy="true">¯</mml:mo></mml:mover></mml:mrow></mml:semantics></mml:math></inline-formula> will only be obtained here. Finding the free energy change to another region of conformation space, where the energy barrier must be crossed and <inline-formula><mml:math id="mm79" display="block"><mml:semantics><mml:mrow><mml:mover accent="true"><mml:mrow><mml:mi>P</mml:mi><mml:mo stretchy="false">(</mml:mo><mml:mrow><mml:msup><mml:mover accent="true"><mml:mi>r</mml:mi><mml:mo stretchy="false">→</mml:mo></mml:mover><mml:mi>N</mml:mi></mml:msup><mml:mo>,</mml:mo><mml:mi>T</mml:mi></mml:mrow><mml:mo stretchy="false">)</mml:mo></mml:mrow><mml:mo stretchy="true">¯</mml:mo></mml:mover></mml:mrow></mml:semantics></mml:math></inline-formula> determined along the path, is not practically possible without the advanced biasing schemes we discuss.</p>
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<p>(<bold>A</bold>) Schematic representation of replica exchange (based on ref. [<xref ref-type="bibr" rid="B28-pharmaceuticals-14-01062">28</xref>]); (<bold>B</bold>) force bias/Jarzynsky, reproduced with permission from ref. [<xref ref-type="bibr" rid="B94-pharmaceuticals-14-01062">94</xref>]; (<bold>C</bold>) RAMD, reproduced with permission from ref. [<xref ref-type="bibr" rid="B102-pharmaceuticals-14-01062">102</xref>]; (<bold>D</bold>) thermodynamics integration, reproduced with permission from ref. [<xref ref-type="bibr" rid="B103-pharmaceuticals-14-01062">103</xref>].</p>
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<p>Schematic representation of metadynamics.</p>
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<p>Schematic representation of umbrella sampling algorithm.</p>
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<p>Chemical structure of drugs introduced in <xref ref-type="sec" rid="sec3-pharmaceuticals-14-01062">Section 3</xref>.</p>
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<p>Location of the drugs and small molecules in four regions of a lipid bilayer. (<bold>A</bold>) Top panel: Snapshot of lipid bilayer composed of POPC; Lower panel: corresponding density profiles showing location of lipids, water, phosphate atoms, carbonyl atom (C35), and atoms of double bond of oleoyl chain (C9=C10) of POPC (see <xref ref-type="fig" rid="pharmaceuticals-14-01062-f001">Figure 1</xref>). Data from 1000 ns simulation of hydrated POPC bilayer with our OPLSaa lipid force field [<xref ref-type="bibr" rid="B141-pharmaceuticals-14-01062">141</xref>,<xref ref-type="bibr" rid="B142-pharmaceuticals-14-01062">142</xref>,<xref ref-type="bibr" rid="B143-pharmaceuticals-14-01062">143</xref>]. (<bold>B</bold>) Snapshots showing location of small molecules in different regions of the bilayer: kanamycin A locates to region 1 (reproduced with permission from [<xref ref-type="bibr" rid="B133-pharmaceuticals-14-01062">133</xref>]), indocyanine green locates to region 2 and 4, and entangled in PEG corona (reproduced with permission from [<xref ref-type="bibr" rid="B144-pharmaceuticals-14-01062">144</xref>]), ubiquinone locates to region 3 and 4 (reproduced with permission from [<xref ref-type="bibr" rid="B145-pharmaceuticals-14-01062">145</xref>]).</p>
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<p>(<bold>A</bold>) Distribution of values of the angle between the vector representing the itraconazole long axis (red arrow at the chemical structure of itraconazole) and the bilayer normal [<xref ref-type="bibr" rid="B184-pharmaceuticals-14-01062">184</xref>]. (<bold>B</bold>) Snapshot showing itraconazole molecules in a lipid bilayer, purple spheres are phosphate groups of the POPC molecules [<xref ref-type="bibr" rid="B184-pharmaceuticals-14-01062">184</xref>]. (<bold>C</bold>) Chemical structures of piroxicam tautomers. (<bold>D</bold>) Distribution of angles between the vector representing the piroxicam long and short axes (red arrows at the chemical structure of PxA) and bilayer normal; PxA—black line, PxE—read line, zwitterionic—green line, cationic—blue line [<xref ref-type="bibr" rid="B185-pharmaceuticals-14-01062">185</xref>].</p>
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<p>Chemical structure of the chemical compounds introduced in <xref ref-type="sec" rid="sec4-pharmaceuticals-14-01062">Section 4</xref>.</p>
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<p>(<bold>A</bold>) Free energy profiles along the bilayer normal of zwitterionic (dashed line) and neutral (full line) ciprofloxacin molecules; the membrane center is at z = 0. Snapshots of ciprofloxacin molecule in the bilayer center: (<bold>B</bold>) uncharged, (<bold>C</bold>) zwitterionic form. Lipids are not shown for clarity. Reproduced with permission from ref. [<xref ref-type="bibr" rid="B233-pharmaceuticals-14-01062">233</xref>].</p>
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<p>(<bold>A</bold>) Snapshots of MD simulation showing a stack of neutral ciprofloxacin entering the lipid bilayer. (<bold>B</bold>) Electrostatic potential maps at the molecular van der Waals surface in a dielectric continuum corresponding to the water phase calculated using the DFT method and chemical structure of ciprofloxacin. (<bold>C</bold>) Snapshots of MD simulation showing transmembrane arrangement of mangostin molecules and its chemical structure. A and B reproduced with permission from ref. [<xref ref-type="bibr" rid="B233-pharmaceuticals-14-01062">233</xref>]; C reproduced with permission from ref. [<xref ref-type="bibr" rid="B241-pharmaceuticals-14-01062">241</xref>].</p>
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<p>Snapshots of the <italic>stratum corneum</italic> model with selected enhancers: Oleic Acid (OLE), Palmitic Acid (PLA), Geranic Acid (GRA), Undecanoic acid (UND), DMSO (DMS), Geraniol (GOL), Glycerylmonooleate (GMO), Isopropyl palmiate (ISP), Limonene (LEM), and Octyl pyrrolidone (OCP). Reproduced from ref. [<xref ref-type="bibr" rid="B604-pharmaceuticals-14-01062">604</xref>].</p>
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<p>Chemical structure of drugs introduced in <xref ref-type="sec" rid="sec5-pharmaceuticals-14-01062">Section 5</xref>.</p>
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<p>(<bold>A</bold>) Profile of the order parameter S<sub>CD</sub> for lipids located in three zones: distances 0–1, 1–2, &gt;2 nm from a drug molecule (reproduced with permission from ref. [<xref ref-type="bibr" rid="B187-pharmaceuticals-14-01062">187</xref>]). (<bold>B</bold>) Profile of the lateral pressure in bilayers composed of DPPC, DPPC and cholesterol and DPPC and other steroids (reproduced with permission from ref. [<xref ref-type="bibr" rid="B680-pharmaceuticals-14-01062">680</xref>]).</p>
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<p>Snapshot of a lipid bilayer with a single glycyrrhizic acid molecule (<bold>a</bold>), and profiles of order parameter for lipids near and far from glycyrrhizic acid molecule (<bold>b</bold>). Reproduced with permission from ref. [<xref ref-type="bibr" rid="B453-pharmaceuticals-14-01062">453</xref>].</p>
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<p>(<bold>A</bold>) Snapshots of stages of pore formation along the collective variable ξ. Reproduced with permission from ref [<xref ref-type="bibr" rid="B832-pharmaceuticals-14-01062">832</xref>]. Snapshot demonstrating the insertion of a single helix into the membrane (colored by residue polarity) where pores formed of (<bold>B</bold>) 3 and (<bold>C</bold>) 5 helices are present. Reproduced with permission from ref [<xref ref-type="bibr" rid="B833-pharmaceuticals-14-01062">833</xref>].</p>
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<p>Chemical structure of drugs introduced in <xref ref-type="sec" rid="sec6-pharmaceuticals-14-01062">Section 6</xref>.</p>
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<p>Accumulation of drugs in the membrane and its consequences for drug–protein interactions. Based on <xref ref-type="fig" rid="pharmaceuticals-14-01062-f002">Figure 2</xref> from ref. [<xref ref-type="bibr" rid="B927-pharmaceuticals-14-01062">927</xref>].</p>
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<p>Partitioning of desflurane into the membrane and Gloeobacter violaceus ligand-gated ion channel studied using a flooding simulation. Snapshots of the simulated model at the (<bold>A</bold>) beginning and (<bold>B</bold>) end of the simulation. Desflurane molecules were colored according to their location: blue—water phase, green—lipid bilayer, red—ion channel. Reproduced with permission from ref. [<xref ref-type="bibr" rid="B307-pharmaceuticals-14-01062">307</xref>].</p>
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<p>Entry/exit pathways of carazolol observed in the RAMD simulations. Left and right panels show sets of simulations with different acceleration magnitudes. The color scale is from yellow at the beginning of the simulation to blue at the end of the simulation. The starting conformation of the receptor is shown in a cartoon representation. Reproduced with permission from ref. [<xref ref-type="bibr" rid="B200-pharmaceuticals-14-01062">200</xref>].</p>
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<p>(<bold>A</bold>) Snapshots of five CYP enzymes simulated attached to the membrane (left) and simulated in water (right) with open (minimum radius 1.5 Å) channels shown. Reproduced with permission from ref. [<xref ref-type="bibr" rid="B962-pharmaceuticals-14-01062">962</xref>]. (<bold>B</bold>) Snapshots of the models of membrane-bound CYP 2C9 and (<bold>C</bold>) visualization of the channels observed in MD simulations of these models. Reproduced with permission from ref. [<xref ref-type="bibr" rid="B960-pharmaceuticals-14-01062">960</xref>].</p>
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<p>(<bold>A</bold>) Schematic of the catalytic mechanism of MB–COMT. (<bold>B</bold>) The behavior of MB–COMT selective vs. non–selective inhibitors in the membrane. (<bold>C</bold>) Quantitative experimental and computational results for the interactions of the ADOMET and catalytic domain of COMT in complex and separately with lipids: (<bold>C1</bold>) the free energy changes calculated computationally with umbrella sampling methods; (<bold>C2</bold>) quartz crystal microbalance (QCM) frequency changes during interaction of COMT with the lipid bilayer; (<bold>C3</bold>) dissociation constant from liposomes determined by isothermal calorimetry. Reproduced with permission from ref. [<xref ref-type="bibr" rid="B381-pharmaceuticals-14-01062">381</xref>]. Copyright 2018 the Royal Society of Chemistry.</p>
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<p>Transmembrane domain of TRKB dimer formed by the crisscross oriented helices forms a pocket for antidepressant binding. (<bold>A</bold>) Antidepressant fluoxetine is embedded in the crevice between the two helices of the TRKB transmembrane domain. Protein backbone shown in white cartoon and protein residues and fluoxetine in licorice representation. (<bold>B</bold>) Binding site for antidepressants at the outer opening of the crossed dimer is stabilized by the phospholipids. Protein backbone shown as green cartoon, the phospholipids in licorice and fluoxetine in vdW representations.</p>
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<p>Schematic representation of how cholesterol and antidepressants regulate the activity of TRKB receptors through driving the orientation of its transmembrane helices. The rise of cholesterol content in the membrane increases its thickness. This forces the transition of TRKB transmembrane dimers towards the states with shorter C-terminal distances between the ends of the helixes (red rectangles). In turn, the C-terminal distances determine the arrangement of TRKB kinase domains (shown in orange) and the phosphorylation states of tyrosine 816 (black and yellow stars for native and phosphorylated states, respectively). The antidepressant fluoxetine (shown in blue), when bound to the pocket, preserves the stable transmembrane dimer conformation in a similar fashion to that observed at moderate cholesterol level and optimal for receptor activation.</p>
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<p>Maps showing orientation-position relations of the hydroxyl groups of HMI-1a3 and PYR-1gP. Reproduced with permission from ref. [<xref ref-type="bibr" rid="B336-pharmaceuticals-14-01062">336</xref>].</p>
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<p>Conformation of talin FERM domain (<bold>A</bold>) extended conformation from crystal structure (PBD ID 3IVF) and after CG simulations [<xref ref-type="bibr" rid="B1059-pharmaceuticals-14-01062">1059</xref>], (<bold>B</bold>) compact conformation [<xref ref-type="bibr" rid="B1061-pharmaceuticals-14-01062">1061</xref>].</p>
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11 pages, 436 KiB  
Article
Poppers Use and High Methaemoglobinaemia: ‘Dangerous Liaisons’
by Malcolm Barrangou-Poueys-Darlas, Marie Gerardin, Sylvie Deheul, Marion Istvan, Marylène Guerlais, FAN, Pascale Jolliet, Thomas Dejoie and Caroline Victorri-Vigneau
Pharmaceuticals 2021, 14(10), 1061; https://doi.org/10.3390/ph14101061 - 19 Oct 2021
Cited by 6 | Viewed by 8486
Abstract
Poppers are legal and largely used in France despite severe side effects, such as methaemoglobinaemia (MetHbia). Our work aimed to assess the prevalence of poppers consumers among patients with a MetHbia higher than or equal to 5% in French university hospitals and its [...] Read more.
Poppers are legal and largely used in France despite severe side effects, such as methaemoglobinaemia (MetHbia). Our work aimed to assess the prevalence of poppers consumers among patients with a MetHbia higher than or equal to 5% in French university hospitals and its evolution before and after the legalization of poppers in France. We conducted a national multicentre observational retrospective study. All patients for whom at least one MetHbia measurement was performed from 2012 to 2017 in university hospitals where the French addictovigilance network (FAN) is implanted were included. For each MetHbia measurement exceeding or equal to 5%, a return to the clinical file was made by the FAN to assess poppers consumption. We calculated the prevalence of MetHbia exceeding or equal to 5% and 25% and the prevalence of poppers consumption before and after the legalization. A total of 239 (0.14%) patients had a MetHbia level exceeding or equal to 5% with 25 (10.46%) cases of poppers consumption. Poppers consumption represented 68.4% (13 out of 19) of cases with MetHbia greater than or equal to 25%. Poppers consumption among patients with MetHbia exceeding or equal to 5% increased after the legalization from 4.76% to 11.67% (prevalence ratio PR = 2.45, 95% CI = [0.98–8.37], p-value = 0.190). The proportion of patients with a MetHbia level of 25% or more increased after the legalization from 4.76% to 8.63% (PR = 1.81, 95% CI = [0.68–6.82], p-value = 0.374). The use of poppers is very frequently reported by patients with MetHbia greater than or equal to 25%. Full article
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<p>Flow chart of CEIP-A participating in the study and identified popper consumption cases. CEIP-A: Drug Dependence Evaluation and Information Centres (Centre d’évaluation et d’Information sur la Pharmacodépendance—Addictovigilance). MetHbia: Methaemoglobinaemia.</p>
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18 pages, 2761 KiB  
Article
Macrosphelide A Exhibits a Specific Anti-Cancer Effect by Simultaneously Inactivating ENO1, ALDOA, and FH
by Kyoung Song, Nirmal Rajasekaran, Chaithanya Chelakkot, Hun Seok Lee, Seung-Mann Paek, Hobin Yang, Lina Jia, Hee Geon Park, Woo Sung Son, Yu-Jin Kim, Joon-Seok Choi, Hae Min Jeong, Young-Ger Suh, Hwayoung Yun and Young Kee Shin
Pharmaceuticals 2021, 14(10), 1060; https://doi.org/10.3390/ph14101060 - 19 Oct 2021
Cited by 6 | Viewed by 4274
Abstract
Aerobic glycolysis in cancer cells, also known as the Warburg effect, is an indispensable hallmark of cancer. This metabolic adaptation of cancer cells makes them remarkably different from normal cells; thus, inhibiting aerobic glycolysis is an attractive strategy to specifically target tumor cells [...] Read more.
Aerobic glycolysis in cancer cells, also known as the Warburg effect, is an indispensable hallmark of cancer. This metabolic adaptation of cancer cells makes them remarkably different from normal cells; thus, inhibiting aerobic glycolysis is an attractive strategy to specifically target tumor cells while sparing normal cells. Macrosphelide A (MSPA), an organic small molecule, is a potential lead compound for the design of anti-cancer drugs. However, its role in modulating cancer metabolism remains poorly understood. MSPA target proteins were screened using mass spectrometry proteomics combined with affinity chromatography. Direct and specific interactions of MSPA with its candidate target proteins were confirmed by in vitro binding assays, competition assays, and simulation modeling. The siRNA-based knockdown of MSPA target proteins indirectly confirmed the cytotoxic effect of MSPA in HepG2 and MCF-7 cancer cells. In addition, we showed that MSPA treatment in the HEPG2 cell line significantly reduced glucose consumption and lactate release. MSPA also inhibited cancer cell proliferation and induced apoptosis by inhibiting critical enzymes involved in the Warburg effect: aldolase A (ALDOA), enolase 1 (ENO1), and fumarate hydratase (FH). Among these enzymes, the purified ENO1 inhibitory potency of MSPA was further confirmed to demonstrate the direct inhibition of enzyme activity to exclude indirect/secondary factors. In summary, MSPA exhibits anti-cancer effects by simultaneously targeting ENO1, ALDOA, and FH. Full article
(This article belongs to the Topic Compounds with Medicinal Value)
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<p>(<b>A</b>) The cytotoxic effects of macrosphelide A (MSPA) in cancer cell lines and non-cancer cell lines at 48 h, 72 h, and 96 h time points. The mock group represents vehicle-treated cell lines. Data represent the mean ± SD (<span class="html-italic">n</span> = 3). * <span class="html-italic">p</span> &lt; 0.05, ** <span class="html-italic">p</span> &lt; 0.01 **** <span class="html-italic">p</span> &lt; 0.0001 versus vehicle-treated group (mock). (<b>B</b>) Apoptosis was determined using annexin V/7-aminoactinomycin D (7-ADD) staining in HepG2 and HL60 cell lines. Combined annexin V and 7-AAD reactivity allowed cells to be classified into four groups: early apoptotic cells (annexin V (+) and 7-AAD (−)), late apoptotic or dead cells (annexin V (+) and 7-AAD (+)), dead cells (annexin V (−) and 7-AAD (+)), and live cells (annexin V (−) and 7-AAD (−)). Data represent the mean ± SD (<span class="html-italic">n</span> = 3). * <span class="html-italic">p</span> &lt; 0.05, versus vehicle-treated cells. (<b>C</b>) HepG2 cells were treated with 500 µM of MSPA for 72 h and stained with annexin V Alexa Fluor 488 (green fluorescence). Cell nuclei are stained blue (Hoechst stain). Data represent the mean ± SD (<span class="html-italic">n</span> = 3). *** <span class="html-italic">p</span> &lt; 0.001 versus control (mock).</p>
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<p>(<b>A</b>) Analysis of the putative target proteins of MSPA by Coomassie-stained SDS-PAGE analysis. Bands submitted to in-gel tryptic digestion for further mass spectrometric analysis are marked with blue arrows (first arrow and second arrow). Standard molecular weight (kDa) is on the left. (<b>B</b>) Detection of the interaction between biotinylated MSPA (or butenylated biotin, MSPA biotin-961, or MSPA biotin-735) and aldolase A (<span class="html-italic">ALDOA</span>), glyceraldehyde 3-phosphate dehydrogenase (<span class="html-italic">GAPDH</span>), enolase 1 (<span class="html-italic">ENO1</span>), and fumarate hydratase (<span class="html-italic">FH</span>) proteins. (<b>C</b>) Results of an in vitro binding assay to determine interactions between MSPA and <span class="html-italic">ALDOA</span>, <span class="html-italic">GAPDH</span>, <span class="html-italic">ENO1</span>, and <span class="html-italic">FH</span>; biotinylated MSPB was used as negative controls. (<b>D</b>) The binding specificity of MSPA in target proteins was confirmed using a competitive binding assay. Excess non-biotinylated MSPA (0× (12.5 µM), 100× (125 µM), and 1000× (1.25 mM)) was added to HL60 cell lysates as a competitor of biotinylated MSPA.</p>
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<p>MSPA impairs glycolysis through modifying the enzymes (<b>A</b>), measurement of the effect of MSPA on the enzymatic activity of <span class="html-italic">ALDOA, ENO1</span>, <span class="html-italic">FH</span>, and <span class="html-italic">GAPDH</span> in HepG2 cell lines (<b>B</b>), relative lactate production (left) and (<b>C</b>), relative glucose consumption (right) in NT (DMSO-treated) and MSPA (50, 100, and 500 uM)-treated HepG2 cells for 72 h. (<b>D</b>), Extracellular acidification rate and (<b>E</b>), oxygen consumption rate in HepG2 cells treated with 50 µM, 100 µM and 500 µM of MSPA for 48 h. Data represent the mean ± SD (<span class="html-italic">n</span> = 3). * <span class="html-italic">p</span> &lt; 0.05, ** <span class="html-italic">p</span> &lt; 0.01, *** <span class="html-italic">p</span> &lt; 0.001, **** <span class="html-italic">p</span> &lt; 0.0001 versus the control group.</p>
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<p>(<b>A</b>) The effect of siRNA-mediated gene knockdown on the expression level of <span class="html-italic">ALDOA</span>, <span class="html-italic">ENO1</span>, and <span class="html-italic">FH</span> mRNA. (<b>B</b>) The effect of <span class="html-italic">ALDOA</span>-, <span class="html-italic">ENO1</span>-, and <span class="html-italic">FH</span>-targeted siRNAs in HepG2 and MCF-7 cells. Lysates were prepared from cells pretreated with 1.2 nM of siRNA against a single-target enzyme. β-actin was used as a loading control. Total cellular proteins were separated using SDS-PAGE, transferred to PVDF membranes, and detected using specific antibodies against <span class="html-italic">ALDOA</span>, <span class="html-italic">ENO1</span>, <span class="html-italic">FH</span>, and β-actin. (<b>C</b>) The viability of HepG2 and MCF-7 cells (expressed as a percentage of the control) was determined using a CellTiter Glo luminescent assay kit. The cells were treated for 72 h with 1.2 nM of single-target siRNA (<span class="html-italic">ALDOA</span>, <span class="html-italic">ENO1</span>, or <span class="html-italic">FH</span>) and 1.2 nM of siRNA against more than one target (a combination of <span class="html-italic">ALDOA</span>, <span class="html-italic">ENO1</span>, and <span class="html-italic">FH</span>). Data were obtained from three independent experiments and presented as mean ± SD., **** <span class="html-italic">p</span> &lt; 0.0001 versus the negative control siRNA (NC) group.</p>
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<p>(<b>A</b>) Molecular docking calculations of MSPA–protein complexes (<span class="html-italic">GAPDH</span> (green), <span class="html-italic">FH</span> (brown), <span class="html-italic">ALDOA</span> (red), and <span class="html-italic">ENO1</span> (blue)). The graph depicts total binding energy plotted against time. (<b>B</b>) Structural representation of molecular docking analysis of MSPA in complex with the human <span class="html-italic">ENO1</span> protein. Models of complexed <span class="html-italic">ENO1</span> proteins are represented as electrostatic surface potentials (ESPs) using the ball and stick method. Positively charged surface regions are colored blue, and negatively charged surface regions are colored red. Heavy atoms are colored yellow (for sulfur), red (for oxygen), and blue (for nitrogen) in the ball and stick model of the binding site. The MSPA molecule is colored green, and interactions between proteins are represented with cyan lines (for hydrogen bonds), yellow dots (for salt bridges), and gray dots (for hydrophobic interactions).</p>
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<p>A schematic representation of the molecular mechanisms of MSPA activity; the compound inhibits cancer cell proliferation by targeting <span class="html-italic">ALDOA</span>, <span class="html-italic">ENO1</span>, and <span class="html-italic">FH</span>.</p>
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14 pages, 2725 KiB  
Article
Physicochemical Characteristics and In Vitro Toxicity/Anti-SARS-CoV-2 Activity of Favipiravir Solid Lipid Nanoparticles (SLNs)
by Alaa S. Tulbah and Wing-Hin Lee
Pharmaceuticals 2021, 14(10), 1059; https://doi.org/10.3390/ph14101059 - 19 Oct 2021
Cited by 25 | Viewed by 3872
Abstract
The rise of coronavirus (COVID-19) cases worldwide has driven the need to discover and develop novel therapeutics with superior efficacy to treat this disease. This study aims to develop an innovative aerosolized nano-formulation of favipiravir (FPV) as an anti-viral agent against coronavirus infection. [...] Read more.
The rise of coronavirus (COVID-19) cases worldwide has driven the need to discover and develop novel therapeutics with superior efficacy to treat this disease. This study aims to develop an innovative aerosolized nano-formulation of favipiravir (FPV) as an anti-viral agent against coronavirus infection. The local delivery of FPV nanoparticles (NPs) via nebulization ensures that the drug can reach the site of infection, the lungs. Solid lipid NPs of favipiravir (FPV-SLNs) were formulated utilizing the hot-evaporation method. The physicochemical formulation properties were evaluated using dynamic light scattering (DLS), Fourier-transform infrared spectroscopy (FTIR), and differential scanning calorimetry (DSC). The aerosol formulation performance was evaluated using an Andersen Cascade Impactor (ACI) at a flow rate of 15 L/min. The FPV-SLN formulation’s in vitro anti-viral activity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was also evaluated using the SARS-CoV-2 pathogen (hCoV-19/Egypt/NRC-3/2020 isolate). The FPV-SLNs’ morphology was defined utilizing transmission electron microscopy, showing an irregular shape. By means of FPV-SLNs’ nebulization, a fine particle fraction of 60.2 ± 1.7% was produced with 60.2 ± 1.7%, and this finding suggests that FPV-SLNs were appropriate for inhalation drug delivery with a particle size of 537.6 ± 55.72 nm. Importantly, the FPV-SLNs showed anti-viral activity against SARS-CoV-2 with CC50 and IC50 values of 449.6 and 29.9 µg/mL, respectively. This study suggests that inhaled solid lipid NPs of favipiravir could potentially be used against coronavirus. Full article
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<p>Transmission electron micrograph of FPV-SLN formulation.</p>
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<p>In vitro drug release across a dialysis membrane of FPV-SLNs (<span class="html-italic">n</span> = 3, mean ± SD).</p>
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<p>Drug release kinetics of FPV-SLNs fitted to mathematical kinetic model. (<b>A</b>) Zero order, (<b>B</b>) first order, (<b>C</b>) Higuchi model (<b>D</b>) Korsmeyer–Peppas model and (<b>E</b>) Hixson–Crowell model. It should be noted that only cumulative release of FPV until 2 h is fitted to the model. Solid black circle refers to FPV release.</p>
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<p>FTIR spectra of (<b>A</b>) unprocessed FPV, (<b>B</b>) Compritol 888, (<b>C</b>) Tween 80, and (<b>D</b>) FPV-SLNs.</p>
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<p>Differential scanning calorimetry thermographs of (<b>A</b>) unprocessed FPV, (<b>B</b>) Compritol 888, (<b>C</b>) Tween 80, and (<b>D</b>) FPV-SLNs.</p>
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<p>Summarized data showing ACI different stages deposition of nebulized FPV-SLN formulations (<span class="html-italic">n</span> = 3, mean ± SD).</p>
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<p>Determination of the antiviral activity of FPV-SLNs against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The dots represent the cell viability readouts at different treatment concentrations, and the squares represent the virus inhibition percentages of the treatment on Vero E6 cells. Data represent mean ± SD (<span class="html-italic">n</span> = 3).</p>
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19 pages, 887 KiB  
Review
Zebrafish as a Model System to Study the Mechanism of Cutaneous Wound Healing and Drug Discovery: Advantages and Challenges
by Ruth Naomi, Hasnah Bahari, Muhammad Dain Yazid, Hashim Embong and Fezah Othman
Pharmaceuticals 2021, 14(10), 1058; https://doi.org/10.3390/ph14101058 - 18 Oct 2021
Cited by 28 | Viewed by 6685
Abstract
In humans, cutaneous wounds may heal without scars during embryogenesis. However, in the adult phase, the similar wound may undergo a few events such as homeostasis, blood clotting, inflammation, vascularization, and the formation of granulation tissue, which may leave a scar at the [...] Read more.
In humans, cutaneous wounds may heal without scars during embryogenesis. However, in the adult phase, the similar wound may undergo a few events such as homeostasis, blood clotting, inflammation, vascularization, and the formation of granulation tissue, which may leave a scar at the injury site. In consideration of this, research evolves daily to improve the healing mechanism in which the wound may heal without scarring. In regard to this, zebrafish (Danio rerio) serves as an ideal model to study the underlying signaling mechanism of wound healing. This is an important factor in determining a relevant drug formulation for wound healing. This review scrutinizes the biology of zebrafish and how this favors the cutaneous wound healing relevant to the in vivo evidence. This review aimed to provide the current insights on drug discovery for cutaneous wound healing based on the zebrafish model. The advantages and challenges in utilizing the zebrafish model for cutaneous wound healing are discussed in this review. This review is expected to provide an idea to formulate an appropriate drug for cutaneous wound healing relevant to the underlying signaling mechanism. Therefore, this narrative review recapitulates current evidence from in vivo studies on the cutaneous wound healing mechanism, which favours the discovery of new drugs. This article concludes with the need for zebrafish as an investigation model for biomedical research in the future to ensure that drug repositions are well suited for human skin. Full article
(This article belongs to the Special Issue Zebrafish as a Powerful Tool for Drug Discovery 2021)
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<p>Developmental stages of zebrafish. Figure is reused under the permission obtained from Creative Commons Attribution-ShareAlike License [<a href="#B20-pharmaceuticals-14-01058" class="html-bibr">20</a>].</p>
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<p>Stages of cutaneous wound healing in mammals. Figure is reused under the permission obtained from Creative Commons Attribution-ShareAlike License [<a href="#B27-pharmaceuticals-14-01058" class="html-bibr">27</a>].</p>
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<p>Mechanism of wound healing in zebrafish. Figure is re-used under the permission obtained from licensed under a Creative Commons Attribution 4.0 International License [<a href="#B29-pharmaceuticals-14-01058" class="html-bibr">29</a>].</p>
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23 pages, 5080 KiB  
Review
Epilepsy in Neurodegenerative Diseases: Related Drugs and Molecular Pathways
by Amanda Cano, Elena Fonseca, Miren Ettcheto, Elena Sánchez-López, Itziar de Rojas, Silvia Alonso-Lana, Xavier Morató, Eliana B. Souto, Manuel Toledo, Mercè Boada, Marta Marquié and Agustín Ruíz
Pharmaceuticals 2021, 14(10), 1057; https://doi.org/10.3390/ph14101057 - 18 Oct 2021
Cited by 41 | Viewed by 11408
Abstract
Epilepsy is a chronic disease of the central nervous system characterized by an electrical imbalance in neurons. It is the second most prevalent neurological disease, with 50 million people affected around the world, and 30% of all epilepsies do not respond to available [...] Read more.
Epilepsy is a chronic disease of the central nervous system characterized by an electrical imbalance in neurons. It is the second most prevalent neurological disease, with 50 million people affected around the world, and 30% of all epilepsies do not respond to available treatments. Currently, the main hypothesis about the molecular processes that trigger epileptic seizures and promote the neurotoxic effects that lead to cell death focuses on the exacerbation of the glutamate pathway and the massive influx of Ca2+ into neurons by different factors. However, other mechanisms have been proposed, and most of them have also been described in other neurodegenerative diseases, such as Alzheimer’s disease, Parkinson’s disease, Huntington’s disease, or multiple sclerosis. Interestingly, and mainly because of these common molecular links and the lack of effective treatments for these diseases, some antiseizure drugs have been investigated to evaluate their therapeutic potential in these pathologies. Therefore, in this review, we thoroughly investigate the common molecular pathways between epilepsy and the major neurodegenerative diseases, examine the incidence of epilepsy in these populations, and explore the use of current and innovative antiseizure drugs in the treatment of refractory epilepsy and other neurodegenerative diseases. Full article
(This article belongs to the Special Issue Epilepsy and Neurodegeneration: Current Therapeutic Implications 2021)
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<p>General molecular mechanisms of the development of seizure activity in epilepsy and associated ASDs.</p>
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<p>Seizure activity derived from the main pathological molecular pathways of Alzheimer’s disease. The pathological hallmarks of Alzheimer’s disease promote an increase in neuroinflammation and intracellular Ca<sup>2+</sup> through ACh and NMDA receptors and Na<sup>+</sup>/Ca<sup>2+</sup> channels. This promotes an increase in neuroinflammation and neuronal hyperexcitability, which in turn increases the neurodegeneration process (and <span class="html-italic">vice versa</span>) in a vicious cycle. NE, norepinephrine.</p>
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<p>Related molecular pathways between Parkinson’s disease and epilepsy. (<b>A</b>) Neuronal excitability via mitochondrial dysfunction derived from the accumulation of abnormal α-synuclein. Abnormal α-synuclein promotes membrane depolarization, massive influx of intracellular Ca<sup>2+</sup>, and oxidative stress through the induction of mitochondrial dysfunction and Lewy bodies’ formation. This promotes an increase in neuroinflammation and neuronal hyperexcitability, which in turn increases the neurodegeneration process (and <span class="html-italic">vice versa</span>) in a vicious cycle. (<b>B</b>) Proepileptic/antiepileptic properties of dopamine conditioned by its binding to the D<sub>1</sub>/D<sub>2</sub> family of receptors. Binding of dopamine to D<sub>1</sub>R promotes an increase in cAMP, which leads to the activation of NMDA-Rs and blockage of GLUT1, thus promoting a massive influx of intracellular Ca<sup>2+</sup> and a reduction in glutamate reuptake. This gives rise to an increase in neuroinflammation and neuronal hyperexcitability, which in turn increases the neurodegeneration process (and <span class="html-italic">vice versa</span>) in a vicious cycle. Binding of dopamine to D<sub>2</sub>R inhibits the production of cAMP, thus promoting the opposite effect of that of D<sub>1</sub>R activation. NE, norepinephrine; ROS, reactive oxygen species.</p>
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<p>Related molecular pathways between Parkinson’s disease and epilepsy. (<b>A</b>) Neuronal excitability via mitochondrial dysfunction derived from the accumulation of abnormal α-synuclein. Abnormal α-synuclein promotes membrane depolarization, massive influx of intracellular Ca<sup>2+</sup>, and oxidative stress through the induction of mitochondrial dysfunction and Lewy bodies’ formation. This promotes an increase in neuroinflammation and neuronal hyperexcitability, which in turn increases the neurodegeneration process (and <span class="html-italic">vice versa</span>) in a vicious cycle. (<b>B</b>) Proepileptic/antiepileptic properties of dopamine conditioned by its binding to the D<sub>1</sub>/D<sub>2</sub> family of receptors. Binding of dopamine to D<sub>1</sub>R promotes an increase in cAMP, which leads to the activation of NMDA-Rs and blockage of GLUT1, thus promoting a massive influx of intracellular Ca<sup>2+</sup> and a reduction in glutamate reuptake. This gives rise to an increase in neuroinflammation and neuronal hyperexcitability, which in turn increases the neurodegeneration process (and <span class="html-italic">vice versa</span>) in a vicious cycle. Binding of dopamine to D<sub>2</sub>R inhibits the production of cAMP, thus promoting the opposite effect of that of D<sub>1</sub>R activation. NE, norepinephrine; ROS, reactive oxygen species.</p>
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<p>Related molecular pathways between Huntington’s disease and epilepsy. (<b>A</b>) General mechanisms by which mHtt leads to the development of seizures. (<b>B</b>) Neuronal excitability via mitochondrial dysfunction derived from the damage promoted by mHtt. mHtt promotes membrane depolarization, massive influx of intracellular Ca<sup>2+</sup>, and oxidative stress through the induction of mitochondrial dysfunction and microglia activation and the inhibition of astrocyte GLUT1Rs, BDNF, and GABAergic neurons. All this promotes an increase in neuroinflammation and neuronal hyperexcitability, which in turn increases the neurodegeneration process (and <span class="html-italic">vice versa</span>) in a vicious cycle.</p>
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<p>Seizure activity derived from the main pathological molecular pathways of multiple sclerosis. Autoimmune responses promote demyelination and axonal injury, which in turn trigger the activation of microglia, oligodendrocytes, and macrophages, thus initiating neuroinflammation and neurodegeneration. All this increases neuronal hyperexcitability, which in turn increases the neurodegeneration process (and <span class="html-italic">vice versa</span>) in a vicious cycle.</p>
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14 pages, 464 KiB  
Article
Individualized versus Standardized Risk Assessment in Patients at High Risk for Adverse Drug Reactions (The IDrug Randomized Controlled Trial)–Never Change a Running System?
by Katja S. Just, Catharina Scholl, Miriam Boehme, Kathrin Kastenmüller, Johannes M. Just, Markus Bleckwenn, Stefan Holdenrieder, Florian Meier, Klaus Weckbecker and Julia C. Stingl
Pharmaceuticals 2021, 14(10), 1056; https://doi.org/10.3390/ph14101056 - 18 Oct 2021
Viewed by 2647
Abstract
The aim of this study was to compare effects of an individualized with a standardized risk assessment for adverse drug reactions to improve drug treatment with antithrombotic drugs in older adults. A randomized controlled trial was conducted in general practitioner (GP) offices. Patients [...] Read more.
The aim of this study was to compare effects of an individualized with a standardized risk assessment for adverse drug reactions to improve drug treatment with antithrombotic drugs in older adults. A randomized controlled trial was conducted in general practitioner (GP) offices. Patients aged 60 years and older, multi-morbid, taking antithrombotic drugs and at least one additional drug continuously were randomized to individualized and standardized risk assessment groups. Patients were followed up for nine months. A composite endpoint defined as at least one bleeding, thromboembolic event or death reported via a trigger list was used. Odds ratios (OR) and 95% confidence intervals (CI) were calculated. In total, N = 340 patients were enrolled from 43 GP offices. Patients in the individualized risk assessment group met the composite endpoint more often than in the standardized group (OR 1.63 [95%CI 1.02–2.63]) with multiple adjustments. The OR was higher in patients on phenprocoumon treatment (OR 1.99 [95%CI 1.05–3.76]), and not significant on DOAC treatment (OR 1.52 [95%CI 0.63–3.69]). Pharmacogenenetic variants of CYP2C9, 2C19 and VKORC1 were not observed to be associated with the composite endpoint. The results of this study may indicate that the time point for implementing individualized risk assessments is of importance. Full article
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<p>Adjusted ORs and corresponding 95% CI for the composite endpoint and the single items death, bleeding and thromboembolic events in the ITT cohort and for the composite endpoint including only VKA and DOAC users (all Model 3).</p>
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15 pages, 1252 KiB  
Article
In Vitro Effect of Taraxacum officinale Leaf Aqueous Extract on the Interaction between ACE2 Cell Surface Receptor and SARS-CoV-2 Spike Protein D614 and Four Mutants
by Hoai Thi Thu Tran, Michael Gigl, Nguyen Phan Khoi Le, Corinna Dawid and Evelyn Lamy
Pharmaceuticals 2021, 14(10), 1055; https://doi.org/10.3390/ph14101055 - 17 Oct 2021
Cited by 16 | Viewed by 32362
Abstract
To date, there have been rapidly spreading new SARS-CoV-2 “variants of concern”. They all contain multiple mutations in the ACE2 receptor recognition site of the spike protein, compared to the original Wuhan sequence, which is of great concern, because of their potential for [...] Read more.
To date, there have been rapidly spreading new SARS-CoV-2 “variants of concern”. They all contain multiple mutations in the ACE2 receptor recognition site of the spike protein, compared to the original Wuhan sequence, which is of great concern, because of their potential for immune escape. Here we report on the efficacy of common dandelion (Taraxacum officinale) to block protein–protein interaction of SARS-COV-2 spike to the human ACE2 receptor. This could be shown for the wild type and mutant forms (D614G, N501Y, and a mix of K417N, E484K, and N501Y) in human HEK293-hACE2 kidney and A549-hACE2-TMPRSS2 lung cells. High-molecular-weight compounds in the water-based extract account for this effect. Infection of the lung cells using SARS-CoV-2 spike D614 and spike Delta (B.1.617.2) variant pseudotyped lentivirus particles was efficiently prevented by the extract and so was virus-triggered pro-inflammatory interleukin 6 secretion. Modern herbal monographs consider the usage of this medicinal plant as safe. Thus, the in vitro results reported here should encourage further research on the clinical relevance and applicability of the extract as prevention strategy for SARS-CoV-2 infection in terms of a non-invasive, oral post-exposure prophylaxis. Full article
(This article belongs to the Special Issue COVID-19 in Pharmaceuticals)
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<p>Metabolic analysis of <span class="html-italic">T. officinale</span> (TO) and <span class="html-italic">C. intybus</span> (CI) leaf extract using UPLC-TOF-MS. Measurements were done in high resolution mode with negative electrospray ionization (ESI−) and positive electrospray ionization (ESI+).</p>
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<p>Effect of <span class="html-italic">T. officinale</span> and <span class="html-italic">C. intybus</span> extracts on SARS-CoV-2-Spike–ACE 2 inhibition. (<b>A</b>,<b>B</b>) Concentration-dependent effect of <span class="html-italic">T. officinale</span> (TO) and <span class="html-italic">C. intybus</span> (CI) extract. (<b>C</b>,<b>D</b>). Effect of fractions from TO and CI leaf extract. The extracts were freeze-dried and a molecular weight fractionation was subsequently carried out. The cut-off was set to 5 kDa (HMW &gt; 5 kDa, LMW &lt; 5kDa). H+L: HMW and LMW fractions; 50 mg of dried leaves per mL water was used as reference. HMW and LMW fraction quantities equivalent to dried leaves were used. The binding inhibition was assessed using ELISA technique. Bars are means + SD. Solvent control: distilled water (a.d.); * <span class="html-italic">p</span> &lt; 0.05, ** <span class="html-italic">p</span> &lt; 0.01. Significance of difference was calculated relative to the solvent control by one-way ANOVA.</p>
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<p>Binding inhibition of S1 spike protein to human HEK293-hACE2 cells by extract pre-incubation. Cells were pre-incubated for the indicated times with 10 mg/mL <span class="html-italic">T. officinale</span> (TO), its HMW fraction, equal to 10 mg/mL extract (HMW), and 10 mg/mL <span class="html-italic">C. intybus</span> (CI) or solvent control (a.d.) and subsequently treated with His-tagged S1 spike protein for 1 h without a washing step in between at 4 °C. Binding inhibition was assessed using flow cytometry. <span class="html-italic">N</span> = 3, bars are means + SD. Upper left: cytogram of gated HEK-hACE2 cells. Middle: overlay of representative fluorescence intensity histograms for ACE2 surface expression. Upper right: overlay of representative fluorescence intensity histograms for spike-binding inhibition by the extracts or a.d.; positive control: 20 µg/mL soluble hACE2. Cells were stained with anti-His-tag Alexa Fluor 647 conjugated monoclonal antibody; ** <span class="html-italic">p</span> &lt; 0.01. Significance of difference was calculated relative to the solvent control by one-way ANOVA.</p>
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<p>Binding inhibition of spike D614, and its mutants D614G, N501Y or mix (N501Y, K417N and E484K) to human HEK293-hACE2 and A549-hACE2-TMPRSS2 cells by extract pre- or post-incubation. Overlay of fluorescence intensity histogram for (<b>A</b>) unstained HEK cells, staining control (anti-His-tag Alexa Fluor 647), and cells incubated with His-tag-labelled spike D614, D614G or N501Y for 1 h at 4 °C. (<b>B</b>,<b>C</b>) cells pre-incubated with solvent control (a.d.), 10 mg/mL <span class="html-italic">T. officinale</span> (TO) or 10 mg/mL <span class="html-italic">C. intybus</span> (CI) for 30–60 s, and then treated with His-tag-labelled S1 spike D614, D614G or N501Y protein for 1 h without a washing step in between at 4 °C. (<b>D</b>–<b>G</b>) Effect of extract incubation on HEK or A549 cells either before or after incubation with His-tag-labelled spike D614, D614G, N501Y or mix (N501Y, K417N and E484K) protein at 37 °C. (<b>H</b>) Plant extracts were incubated in saliva from four human donors for 0.5 h at 37 °C. Afterwards, cells were pre-treated with 5 mg/mL extracts for 60 s at 37 °C before incubation with His-tag-labelled spike D614 protein for 0.5 h at 37 °C. Spike-binding inhibition to human cells was assessed using flow cytometric analysis of cells stained with anti-His-tag Alexa Fluor 647 conjugated monoclonal antibody. Bars are means +SD; * <span class="html-italic">p</span> &lt; 0.05, ** <span class="html-italic">p</span> &lt; 0.01. Significance of difference was calculated relative to the respective solvent control by one-way ANOVA.</p>
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<p>Effect of <span class="html-italic">T. officinale</span> extract on ACE2 enzyme activity and protein expression. (<b>A</b>) Viability of A549-hACE2-TMPRSS2 cells was determined using trypan blue cell staining after 84 h exposure to the extract. (<b>B</b>) Cells were incubated with TO extract or 500 ng/mL S1 protein and analyzed for enzyme activity using a fluorescence kit. (<b>C</b>,<b>D</b>) Cells were exposed for 6 h or 24 h to extract without (white bars) or with (black bars) 500 ng/mL S1 protein and analyzed for ACE2 protein expression using a human ACE2 ELISA kit; a.d.: solvent control. Bars are means + SD, <span class="html-italic">N</span> ≥ 3 independent experiments; * <span class="html-italic">p</span> &lt; 0.05, ** <span class="html-italic">p</span> &lt; 0.01. Significance of difference was calculated relative to the respective control by one-way ANOVA.</p>
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<p>Viral transduction inhibition of A549-hACE2-TMPRSS2 cells by <span class="html-italic">T. officinale</span> extract. (<b>A</b>) Cells were pre-treated with <span class="html-italic">T. officinale</span> (TO) or HMW extract for 0.5 h before infection with 7500 TU/mL SARS-CoV-2 spike D614 or Delta (B.1.617.2) variant for 24 h; (<b>B</b>,<b>C</b>) Cells were transduced with 7500 TU/mL SARS-CoV-2 for (B) 3 h before addition of TO for another 21 h or (C) 24 h. After transduction, the medium was exchanged with fresh medium containing TO or HMW extract at the indicated concentrations and post-incubated for 60 h. (<b>D</b>) Cells were pre-treated with 40 mg/mL TO for 3 h before transduction with the indicated virus titer for 24 h. After that, the medium was exchanged with fresh medium and incubated for another 48 h. Luminescence was then detected within 1 h. 0.35 mg/mL HMW extract equals to 20 mg/mL TO extract. Transduction control: (−) negative control: bald lentiviral pseudovirion; (+) positive control: firefly luciferase lentivirus; inhibitor positive control: 100 µg/mL anti-hACE2 antibody. (<b>E</b>) Pro-inflammatory IL-6 cytokine secretion analysis was done either after 24 h virus transduction together with extract (left), after 24 h + 60 h post-infection with extract (middle) or after 60 h post-infection with extract (right) using multiplexing flow cytometric analysis. Solvent control: distilled water (a.d.). N ≥ 3 independent experiments; * <span class="html-italic">p</span> &lt; 0.05, ** <span class="html-italic">p</span> &lt; 0.01. Significance of difference was calculated relative to the solvent control by one-way ANOVA.</p>
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13 pages, 312 KiB  
Review
The Impact of SARS-CoV-2 Infection, and Application of Immunosuppressive Agents in Kidney Transplant Recipients Suffering from COVID-19
by Horng-Ta Tseng, Xiang-Chi Wu, Chun-Yao Huang, Chun-Ming Shih, Yi-Wen Lin and Feng-Yen Lin
Pharmaceuticals 2021, 14(10), 1054; https://doi.org/10.3390/ph14101054 - 17 Oct 2021
Cited by 4 | Viewed by 2673
Abstract
In December 2019, the COVID-19 pandemic began to ravage the world quickly, causing unprecedented losses in human life and the economy. A statistical study revealed that the proportion of solid organ transplant (SOT) recipients with severe symptoms and deaths after being infected by [...] Read more.
In December 2019, the COVID-19 pandemic began to ravage the world quickly, causing unprecedented losses in human life and the economy. A statistical study revealed that the proportion of solid organ transplant (SOT) recipients with severe symptoms and deaths after being infected by SARS-CoV-2 is considerably higher than that of non-SOT recipients, and the prognosis is relatively poor. In addition, the clinical manifestation of SOT recipients suffering from COVID-19 is different from that of general COVID-19 patients. Acute kidney injury (AKI) is a common complication in COVID-19 patients, and it is likely more common among SOT recipients infected with SARS-CoV-2. Clinical experts consider that SOT recipients have long-term treatment with immunosuppressants, and the comorbidities are driven by a high rate of severe symptoms and mortality. Orthotopic kidney allograft transplantation is an effective treatment for patients suffering from end-stage kidney disease/kidney failure through which they can easily extend their life. Indeed, kidney transplant recipients have suffered significant damage during this pandemic. To effectively reduce the severity of symptoms and mortality of kidney transplant recipients suffering from COVID-19, precise application of various drugs, particularly immunosuppressants, is necessary. Therefore, herein, we will collate the current clinical experience of treating COVID-19 infection in kidney transplant recipients and discuss the adjustment of patients using immunosuppressive agents in the face of COVID-19. Full article
(This article belongs to the Special Issue COVID-19 in Pharmaceuticals)
26 pages, 1884 KiB  
Review
Mucin1 and Mucin16: Therapeutic Targets for Cancer Therapy
by Dong-Hee Lee, Seunghyun Choi, Yoon Park and Hyung-seung Jin
Pharmaceuticals 2021, 14(10), 1053; https://doi.org/10.3390/ph14101053 - 17 Oct 2021
Cited by 48 | Viewed by 10373
Abstract
The mucin (MUC) family is a group of highly glycosylated macromolecules that are abundantly expressed in mammalian epithelial cells. MUC proteins contribute to the formation of the mucus barrier and thus have protective functions against infection. Interestingly, some MUC proteins are aberrantly expressed [...] Read more.
The mucin (MUC) family is a group of highly glycosylated macromolecules that are abundantly expressed in mammalian epithelial cells. MUC proteins contribute to the formation of the mucus barrier and thus have protective functions against infection. Interestingly, some MUC proteins are aberrantly expressed in cancer cells and are involved in cancer development and progression, including cell growth, proliferation, the inhibition of apoptosis, chemoresistance, metabolic reprogramming, and immune evasion. With their unique biological and structural features, MUC proteins have been considered promising therapeutic targets and also biomarkers for human cancer. In this review, we discuss the biological roles of the transmembrane mucins MUC1 and MUC16 in the context of hallmarks of cancer and current efforts to develop MUC1- and MUC16-targeted therapies. Full article
(This article belongs to the Special Issue Anticancer Drugs 2021)
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<p>Schematic representation of the MUC1 and MUC16 structures. (<b>A</b>) MUC1 is a stable heterodimeric complex with an N-terminal subunit (MUC1-N) and C-terminal subunit (MUC1-C). The variable number tandem repeat (VNTR) region in MUC1-N is composed of a 20 amino acid repeat sequence that is extensively <span class="html-italic">O</span>-glycosylated at the serine and threonine residues. SEA domain is auto-cleaved and non-covalently linked to the extracellular domain (ECD) of the MUC1-C subunit. MUC1-C is anchored in the plasma membrane of cells via its transmembrane domain (TMD). The cytoplasmic domain (CD) of MUC1 contains potential binding motifs for various signaling proteins with phosphorylation sites. (<b>B</b>) MUC16 is a single transmembrane glycoprotein consisting of a large N-terminal domain (MUC16-N) and tandem repeat domain (MUC16-TR) that is interspersed with an SEA domain and C-terminal domain (MUC16-C).</p>
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<p><span class="html-italic">MUC1</span> and <span class="html-italic">MUC16</span> mRNA expression in tumor and normal tissues. Pan-cancer expression analysis of <span class="html-italic">MUC1</span> and <span class="html-italic">MUC16</span> genes was conducted using the GEPIA2 web server [<a href="#B55-pharmaceuticals-14-01053" class="html-bibr">55</a>]. Tumor tissues (T, red dots) represent TCGA tumors. Normal tissues (N, green dots) represent TCGA and GTEx normal tissues. Expression values are presented as log-normalized transcripts per million (TPM) with median values (horizontal black bar). The red and green colors of the cancer type abbreviations denote that <span class="html-italic">MUC1</span> or <span class="html-italic">MUC16</span> gene expression in significantly higher or lower in these tumor tissues compared with normal tissues. (<b>A</b>) <span class="html-italic">MUC1</span> is overexpressed in tumors of the breast (BRCA), cervix (CESC), brain (GBM, LGG), B-cell (DLBC), pancreas (PAAD), ovary (OV), thymus (THYM), and uterus (UCEC). (<b>B</b>) <span class="html-italic">MUC16</span> is overexpressed in tumors of the lung (LUAD), ovary (OV), pancreas (PAAD), and uterus (UCEC and UCS).</p>
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<p>Correlation between mucin expression and tumor-infiltrating T and NK cells. Tumor infiltration analysis of CD8+ T cells and NK cells was conducted using the TIMER2.0 web portal [<a href="#B91-pharmaceuticals-14-01053" class="html-bibr">91</a>]. The row names in the heatmap represent the TCGA tumor types and number of samples analyzed. Various deconvolution methods were applied to the prediction of tumor-infiltrating immune cells using TCGA bulk RNAseq data. The deconvolution methods are indicated by the column names, along with the type of lymphocyte, i.e., TIMER [<a href="#B92-pharmaceuticals-14-01053" class="html-bibr">92</a>], EPIC [<a href="#B93-pharmaceuticals-14-01053" class="html-bibr">93</a>], MCP-counter [<a href="#B94-pharmaceuticals-14-01053" class="html-bibr">94</a>], CIBERSORT [<a href="#B95-pharmaceuticals-14-01053" class="html-bibr">95</a>], quanTIseq [<a href="#B96-pharmaceuticals-14-01053" class="html-bibr">96</a>] and xCell [<a href="#B97-pharmaceuticals-14-01053" class="html-bibr">97</a>].</p>
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<p>Anti-cancer therapeutic candidates that target MUC1 and MUC16. The aberrant expression of MUC1 and MUC16 in tumors provides potential strategies for targeting these molecules to kill cancer cells. (<b>A</b>) The direct MUC1 inhibitor GO-203 is a cell-permeable peptide that binds and blocks MUC1-C. (<b>B</b>) The extracellular domain of mucin in cancer cells is a potential target for monoclonal antibody-based therapies. ADCs dump toxins into cancer cells through the endocytosis of MUC1- and MUC16-binding antibodies. BiTE can recruit CD3+ or CD28+ cytotoxic T lymphocytes to MUC1- or MUC16-overexpressing cancer cells. CAR-T or NK cells directly kill cancer cells by recognizing MUC1 and MUC16 antigens. (<b>C</b>) Cancer vaccines elicit an active immune response by stimulating antigen-presenting cells (e.g., dendritic cells) against mucin protein antigens.</p>
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26 pages, 2880 KiB  
Article
Synthesis, Computational Analysis, and Antiproliferative Activity of Novel Benzimidazole Acrylonitriles as Tubulin Polymerization Inhibitors: Part 2
by Anja Beč, Lucija Hok, Leentje Persoons, Els Vanstreels, Dirk Daelemans, Robert Vianello and Marijana Hranjec
Pharmaceuticals 2021, 14(10), 1052; https://doi.org/10.3390/ph14101052 - 17 Oct 2021
Cited by 9 | Viewed by 3311
Abstract
We used classical linear and microwave-assisted synthesis methods to prepare novel N-substituted, benzimidazole-derived acrylonitriles with antiproliferative activity against several cancer cells in vitro. The most potent systems showed pronounced activity against all tested hematological cancer cell lines, with favorable selectivity towards normal [...] Read more.
We used classical linear and microwave-assisted synthesis methods to prepare novel N-substituted, benzimidazole-derived acrylonitriles with antiproliferative activity against several cancer cells in vitro. The most potent systems showed pronounced activity against all tested hematological cancer cell lines, with favorable selectivity towards normal cells. The selection of lead compounds was also tested in vitro for tubulin polymerization inhibition as a possible mechanism of biological action. A combination of docking and molecular dynamics simulations confirmed the suitability of the employed organic skeleton for the design of antitumor drugs and demonstrated that their biological activity relies on binding to the colchicine binding site in tubulin. In addition, it also underlined that higher tubulin affinities are linked with (i) bulkier alkyl and aryl moieties on the benzimidazole nitrogen and (ii) electron-donating substituents on the phenyl group that allow deeper entrance into the hydrophobic pocket within the tubulin’s ?-subunit, consisting of Leu255, Leu248, Met259, Ala354, and Ile378 residues. Full article
(This article belongs to the Section Medicinal Chemistry)
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Graphical abstract

Graphical abstract
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<p>Benzimidazole-derived tubulin polymerization inhibitors: (<b>a</b>) Nocodazole; (<b>b</b>) 2-aryl-1,2,4-oxadiazolo-benzimidazole derivatives; (<b>c</b>) benzimidazole-2-urea derivatives.</p>
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<p>Benzimidazole acrylonitriles <b>I</b> and <b>II</b> as tubulin polymerization inhibitors.</p>
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<p>Effects of derivatives <b>50</b>, <b>64</b>, <b>68</b>, and <b>69</b> on normal PBMC. Apoptosis induction in PBMC from two healthy donors was determined by staining with IncuCyte<sup>®</sup> Caspase 3/7 Green Reagent and PI followed by live cell monitoring. The percentages of live (white), dead (red), and apoptotic (blue) cells after 72 h are shown (means ± standard error bars).</p>
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<p>Dose-dependent effects of compounds <b>50</b>, <b>64</b>, <b>68</b>, and <b>69</b> on in vitro tubulin polymerization. Purified porcine neuronal tubulin and GTP were mixed in a 96-well plate. Docetaxel and combretastatin A4 (CA4) (1 μM) were used as controls for tubulin-stabilizing and tubulin-destabilizing agents, respectively, while DMSO was used as a negative control. The effects on tubulin assembly were monitored in a Tecan Spark multimode plate reader at one minute intervals for one hour at 37 °C. Each condition was tested in duplicate. The level of polymerization was measured by an increase in fluorescence emission intensity at <span class="html-italic">λ</span><sub>em</sub> = 435 nm.</p>
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<p>Chemical structures of reference systems <b>m1</b>, <b>m2</b>, and colchicine, as discussed in the text.</p>
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<p>Representative structure of the <span class="html-italic">E</span>-isomer of <b>64</b> within the colchicine binding site (top) and relative contributions of individual residues to the overall binding free energy (bottom, in %), which lists all residues with favorable contributions higher than –0.5 kcal mol<sup>−1</sup> (in blue) and unfavorable contributions exceeding +0.1 kcal mol<sup>−1</sup> (in red).</p>
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<p>Synthesis of benzimidazole acrylonitriles <b>32</b>–<b>71</b>.</p>
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13 pages, 2171 KiB  
Article
Identification of Novel Anthracycline Resistance Genes and Their Inhibitors
by Onat Kadioglu, Mohamed Elbadawi, Edmond Fleischer and Thomas Efferth
Pharmaceuticals 2021, 14(10), 1051; https://doi.org/10.3390/ph14101051 - 16 Oct 2021
Cited by 4 | Viewed by 3269
Abstract
Differentially expressed genes have been previously identified by us in multidrug-resistant tumor cells mainly resistant to doxorubicin. In the present study, we exemplarily focused on some of these genes to investigate their causative relationship with drug resistance. HMOX1, NEIL2, and PRKCA [...] Read more.
Differentially expressed genes have been previously identified by us in multidrug-resistant tumor cells mainly resistant to doxorubicin. In the present study, we exemplarily focused on some of these genes to investigate their causative relationship with drug resistance. HMOX1, NEIL2, and PRKCA were overexpressed by lentiviral-plasmid-based transfection of HEK293 cells. An in silico drug repurposing approach was applied using virtual screening and molecular docking of FDA-approved drugs to identify inhibitors of these new drug-resistant genes. Overexpression of the selected genes conferred resistance to doxorubicin and daunorubicin but not to vincristine, docetaxel, and cisplatin, indicating the involvement of these genes in resistance to anthracyclines but not to a broader MDR phenotype. Using virtual drug screening and molecular docking analyses, we identified FDA-approved compounds (conivaptan, bexarotene, and desloratadine) that were interacting with HMOX1 and PRKCA at even stronger binding affinities than 1-(adamantan-1-yl)-2-(1H-imidazol-1-yl)ethenone and ellagic acid as known inhibitors of HMOX1 and PRKCA, respectively. Conivaptan treatment increased doxorubicin sensitivity of both HMOX1- and PRKCA-transfected cell lines. Bexarotene treatment had a comparable doxorubicin-sensitizing effect in HMOX1-transfected cells and desloratadine in PRKCA-transfected cells. Novel drug resistance mechanisms independent of ABC transporters have been identified that contribute to anthracycline resistance in MDR cells. Full article
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<p>Effect of MDR-related mechanisms on cancer progression.</p>
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<p>Transfection of HEK293 cells with <span class="html-italic">HMOX1, NEIL2</span>, and <span class="html-italic">PRKCA</span> plasmid constructs. (<b>A</b>) Verification of the clones after EcoRI digestion. (<b>B</b>) Verification of transfection with GFP signal observation under a fluorescent microscope. (<b>C</b>) Verification of protein overexpression for HMOX1, NEIL2, and PRKCA. β-actin was used as a loading control. NC, non-transfected control.</p>
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<p>Effect of HMOX1, NEIL2, and PRKCA overexpression on doxorubicin and daunorubicin resistance. Dose response curves for (<b>A</b>) doxorubicin and (<b>B</b>) daunorubicinIC<sub>50</sub> values for (<b>C</b>) doxorubicin and (<b>D</b>) daunorubicin treatment.</p>
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<p>Similarity-based analysis of (<b>A</b>) top 10 FDA-approved drugs after HMOX1 screening and (<b>B</b>) top 10 FDA-approved drugs after PRKCA screening.</p>
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<p>Molecular docking poses of conivaptan (blue) and bexarotene (green) on (<b>A</b>) HMOX1 and that of conivaptan (blue) and desloratadine (green) on (<b>B</b>) PRKCA. The known HMOX1 inhibitor 1-(adamantan-1-yl)-2-(1H-imidazol-1-yl)ethenone and the known PRKCA inhibitor ellagic acid are displayed in red. Amino acid residues forming hydrogen bonds are displayed in bold.</p>
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<p>Molecular docking poses of conivaptan (blue) and bexarotene (green) on (<b>A</b>) HMOX1 and that of conivaptan (blue) and desloratadine (green) on (<b>B</b>) PRKCA. The known HMOX1 inhibitor 1-(adamantan-1-yl)-2-(1H-imidazol-1-yl)ethenone and the known PRKCA inhibitor ellagic acid are displayed in red. Amino acid residues forming hydrogen bonds are displayed in bold.</p>
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<p>Effect of candidate inhibitors of HMOX1 or PRKCA on doxorubicin cytotoxicity in <span class="html-italic">HMOX1</span>- or <span class="html-italic">PRKCA</span>-transfected cell lines (cell viability, % of control: <span class="html-italic">y</span>-axis; concentration in µM: <span class="html-italic">x</span>-axis). (<b>A</b>) Conivaptan alone, (<b>B</b>) conivaptan with or without doxorubicin in <span class="html-italic">HMOX1</span>-transfected cells, (<b>C</b>) conivaptan with or without doxorubicin in <span class="html-italic">PRKCA</span>-transfected cells, (<b>D</b>) bexarotene alone, (<b>E</b>) bexarotene with or without doxorubicin in <span class="html-italic">HMOX1</span>-transfected cells, (<b>F</b>) desloratadine alone, and (<b>G</b>) desloratadine with or without doxorubicin in <span class="html-italic">PRKCA</span>-transfected cells.</p>
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20 pages, 2023 KiB  
Review
Extracellular Vesicles in Human Milk
by Yong Hu, Johannes Thaler and Rienk Nieuwland
Pharmaceuticals 2021, 14(10), 1050; https://doi.org/10.3390/ph14101050 - 15 Oct 2021
Cited by 40 | Viewed by 5725
Abstract
Milk supports the growth and development of infants. An increasing number of mostly recent studies have demonstrated that milk contains a hitherto undescribed component called extracellular vesicles (EVs). This presents questions regarding why milk contains EVs and what their function is. Recently, we [...] Read more.
Milk supports the growth and development of infants. An increasing number of mostly recent studies have demonstrated that milk contains a hitherto undescribed component called extracellular vesicles (EVs). This presents questions regarding why milk contains EVs and what their function is. Recently, we showed that EVs in human milk expose tissue factor, the protein that triggers coagulation or blood clotting, and that milk-derived EVs promote coagulation. Because bovine milk, which also contains EVs, completely lacks this coagulant activity, important differences are present in the biological functions of human milk-derived EVs between species. In this review, we will summarize the current knowledge regarding the presence and biochemical composition of milk EVs, their function(s) and potential clinical applications such as in probiotics, and the unique problems that milk EVs encounter in vivo, including survival of the gastrointestinal conditions encountered in the newborn. The main focus of this review will be human milk-derived EVs, but when available, we will also include information regarding non-human milk for comparison. Full article
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<p>Processing of milk before isolation of extracellular vesicles. Raw milk contains cells, cell fragments, milk fat globules, casein micelles, and extracellular vesicles (EVs). As a first step, cells, cell fragments and milk fat globules are mostly removed by centrifugation. Milk fat globules will float to the top due to their low density, and cells and cell fragments will form a pellet. The middle layer contains casein micelles and EVs. This middle layer is the starting material for the isolation of EVs. Casein micelles can be removed by acid-induced or enzyme-induced precipitation, centrifugation, or by EDTA-induced dissociation.</p>
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<p>Functions of milk-derived extracellular vesicles. Milk contains extracellular vesicles (EVs). (<b>A</b>) EVs in human milk expose tissue factor (TF), the protein that triggers blood clotting by binding and activating factor VII (FVII), thereby promoting haemostasis and wound healing. (<b>B</b>) Milk EVs may survive the gastrointestinal conditions of newborns, and such EVs are thought to participate in immune responses and homeostasis of the gastrointestinal tract. (<b>C</b>) Milk EVs attenuate virus infection with help from immune cells. (<b>D</b>) Milk EVs may kill harmful bacteria and promote the growth of beneficial bacteria within the gastrointestinal tract, which may have beneficial effects on growth and development of the newborn.</p>
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16 pages, 854 KiB  
Article
Side Effects of mRNA-Based COVID-19 Vaccines among Young Adults (18–30 Years Old): An Independent Post-Marketing Study
by Abanoub Riad, Andrea Pokorná, Jitka Klugarová, Natália Antalová, Lucia Kantorová, Michal Koščík and Miloslav Klugar
Pharmaceuticals 2021, 14(10), 1049; https://doi.org/10.3390/ph14101049 - 15 Oct 2021
Cited by 33 | Viewed by 7150
Abstract
Young adults had been widely perceived as a low-risk group for COVID-19 severity; therefore, they were deprioritised within the mass vaccination strategies as their prognosis of COVID-19 infection is relatively more favourable than older age groups. On the other hand, vaccination of this [...] Read more.
Young adults had been widely perceived as a low-risk group for COVID-19 severity; therefore, they were deprioritised within the mass vaccination strategies as their prognosis of COVID-19 infection is relatively more favourable than older age groups. On the other hand, vaccination of this demographic group is indispensable to achieve herd immunity. A cross-sectional survey-based study was used to evaluate the side effects of mRNA-based COVID-19 vaccines among university students in the Czech Republic. The validated questionnaire was delivered in a digital form, and it consisted of demographic data; COVID-19 vaccine-related anamnesis; and local, systemic, orofacial, and skin-related side effects’ prevalence, onset, and duration. Out of the 539 included participants, 70.1% were females and 45.8% were <23 years old. The vast majority (95.2%) reported at least one side effect. The most common side effect was injection site pain (91.8%), followed by fatigue (62.5%), headache (36.4%), and muscle pain (34.9%). The majority of local side effects occurred after both doses (74.4%), while most systemic side effects occurred after the second dose only (56.2%). Most local (94.2%) and systemic (93.3%) side effects resolved within three days after vaccination. Females participants’ adjusted odds ratio (AOR) showed they were 2.566 (CI 95%: 1.103–5.970) times more likely to experience post-vaccination side effects, and the participants who received two doses reported an increased AOR of 1.896 (0.708–5.077) for experiencing side effects. The results of this study imply that mRNA-based COVID-19 vaccines are highly probably safe for young adults, and further studies are required to investigate the role of medical anamnesis, prior COVID-19 infection, and gender in side effects incidence. Full article
(This article belongs to the Section Biopharmaceuticals)
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<p>Sample size of the young adults (18–30 years old) in the Czech Republic—Epi-Info <sup>TM</sup> version 7.2.4.</p>
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<p>Side Effects of mRNA-based COVID-19 Vaccines Experienced by Young Adults (18–30 years old), Czech Republic, April–June 2021 (<span class="html-italic">n</span> = 539).</p>
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19 pages, 4584 KiB  
Article
SARS-CoV-2 Fears Green: The Chlorophyll Catabolite Pheophorbide A Is a Potent Antiviral
by Guillermo H. Jimenez-Aleman, Victoria Castro, Addis Londaitsbehere, Marta Gutierrez-Rodríguez, Urtzi Garaigorta, Roberto Solano and Pablo Gastaminza
Pharmaceuticals 2021, 14(10), 1048; https://doi.org/10.3390/ph14101048 - 15 Oct 2021
Cited by 18 | Viewed by 7090
Abstract
SARS-CoV-2 pandemic is having devastating consequences worldwide. Although vaccination advances at good pace, effectiveness against emerging variants is unpredictable. The virus has displayed a remarkable resistance to treatments and no drugs have been proved fully effective against COVID-19. Thus, despite the international efforts, [...] Read more.
SARS-CoV-2 pandemic is having devastating consequences worldwide. Although vaccination advances at good pace, effectiveness against emerging variants is unpredictable. The virus has displayed a remarkable resistance to treatments and no drugs have been proved fully effective against COVID-19. Thus, despite the international efforts, there is still an urgent need for new potent and safe antivirals against SARS-CoV-2. Here, we exploited the enormous potential of plant metabolism using the bryophyte Marchantia polymorpha L. and identified a potent SARS-CoV-2 antiviral, following a bioactivity-guided fractionation and mass-spectrometry approach. We found that the chlorophyll derivative Pheophorbide a (PheoA), a porphyrin compound similar to animal Protoporphyrin IX, has an extraordinary antiviral activity against SARS-CoV-2, preventing infection of cultured monkey and human cells, without noticeable cytotoxicity. We also show that PheoA targets the viral particle, interfering with its infectivity in a dose- and time-dependent manner. Besides SARS-CoV-2, PheoA also displayed a broad-spectrum antiviral activity against enveloped RNA viral pathogens such as HCV, West Nile, and other coronaviruses. Our results indicate that PheoA displays a remarkable potency and a satisfactory therapeutic index, which together with its previous use in photoactivable cancer therapy in humans, suggest that it may be considered as a potential candidate for antiviral therapy against SARS-CoV-2. Full article
(This article belongs to the Special Issue COVID-19 in Pharmaceuticals)
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<p><span class="html-italic">M. polymorpha</span> extracts interfere with SARS-CoV-2-induced cytopathic effect and virus propagation. (<b>A</b>,<b>B</b>) Vero E6 cells were inoculated with SARS-CoV-2 (MOI = 0.001) in the presence of serial 2-fold dilutions of crude extracts from (<b>A</b>) two different <span class="html-italic">M. polymorpha</span> ecotypes, <span class="html-italic">ruderalis</span> (Ex1) and <span class="html-italic">polymorpha</span> (Ex2) or (<b>B</b>) WT, <span class="html-italic">Mpcoi1-2</span> or <span class="html-italic">Mpc1hdz Marchantia</span> plants, incubated for 72 h, time after which they were fixed and stained with a crystal violet solution. Mock-infected cells were used as the control of the integrity of the cell monolayer. Images show a representative experimental plate comparing <span class="html-italic">M. polymorpha</span> extracts with vehicle (DMSO)-treated cells. (<b>C</b>) Vero E6 cells were inoculated with SARS-CoV-2 (MOI = 0.001) in the presence of vehicle (DMSO), RMDV (25 µM) or a 100 µg/mL dilution of crude extracts. Uninfected samples were used as the control (mock). Total RNA was extracted 72 h post-infection and subjected to RT-qPCR to determine viral load. The dotted line indicates the limit of detection of the assay. Normalized viral RNA levels are shown as percentage of the viral RNA found in vehicle-treated cells. Data are shown as mean (± SD) of three biological replicates. Statistical significance was estimated using one-way ANOVA and a Dunnet’s post hoc test (* <span class="html-italic">p</span> &lt; 0.05).</p>
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<p>Extract fractionation and identification of antiviral fraction pools. (<b>A</b>) Vero E6 cells were inoculated with SARS-CoV-2 (MOI = 0.001) in the presence of serial 2-fold dilutions of vehicle (DMSO), a crude <span class="html-italic">Marchantia</span> extract and the fraction pools. Inoculated cultures were incubated for 72 h, time after which they were fixed and stained with a crystal violet solution. Mock-treated cells were used as the control of the integrity of the cell monolayer (non-infected). (<b>B</b>) Vero E6 cells were inoculated (MOI = 0.01) in the presence of serial dilution of the fractions and incubated for 24 h before fixation; processing for immunofluorescence microscopy and cytotoxicity assays was as described in the materials and methods section. Representative images of the fraction pool cell-based evaluation are shown. (<b>C</b>) Quantitation of infection efficiency, cell number and cell viability. These data are shown as average (± SD) of three biological replicates. Statistical significance was estimated using one-way ANOVA (Dunnet´s post hoc test, * <span class="html-italic">p</span> &lt; 0.05).</p>
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<p>Identification of the main antiviral compound in <span class="html-italic">Marchantia</span> extracts. (<b>A</b>) Representative TLC of <span class="html-italic">Marchantia</span> WT and <span class="html-italic">c1hdz</span> extracts. Compounds C, D and E (box) were tested for their antiviral potential. (<b>B</b>) Vero E6 cells were inoculated (MOI = 0.01) in the presence of the indicated compounds and incubated for 24 h before fixation and processing for immunofluorescence microscopy. Data are shown as average (± SD) of three biological replicates. Statistical significance was estimated using one-way ANOVA and a Dunnet´s post hoc test (* <span class="html-italic">p</span> &lt; 0.05). (<b>C</b>) Representative HPLC/MS analysis (shown for WT) of fractions C, D, and E, including exact mass determination of the antiviral candidate 1, and its inferred chemical structure.</p>
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<p>PheoA shows antiviral activity against SARS-CoV-2 in Vero E6 cells and human lung epithelial A549-ACE2 and Calu3 cell lines. (<b>A</b>–<b>C</b>) Commercially available PheoA was serially diluted and mixed (1:1, <span class="html-italic">v</span>/<span class="html-italic">v</span>) with SARS-CoV-2 preparations to achieve the indicated compound concentrations and a final MOI of 0.005 for (<b>A</b>) Vero E6 and (<b>B</b>) Calu3 and 0.01 for (<b>C</b>) A549-ACE2 cells. Cultures were incubated for 48 h, fixed and processed for automated immunofluorescence microscopy analysis. Parallel, uninfected cultures were processed for cytotoxicity evaluation using an MTT assay. Relative infection efficiency data (<span class="html-italic">n</span> = 3 per dose) are shown as individual data and a PROBIT regression curve (green line) using the represented values. Cytotoxicity data (<span class="html-italic">n</span> = 3 per dose) are shown as the individual data and a moving average trend line. (<b>D</b>) A549-ACE2 cells were inoculated at MOI = 0.01 in the presence of increasing concentrations of PheoA or RMDV (5 µM) and incubated for 48 h. Samples of the supernatants were collected, heat-inactivated and directly subjected to RT-qPCR to estimate overall infection efficiency. Data are expressed as relative values compared with the vehicle (DMSO)-treated cells and are shown as the mean (± SD) of three biological replicates (<span class="html-italic">n</span> = 3). Statistical significance was estimated using one-way ANOVA and a Dunnet´s post hoc test (* <span class="html-italic">p</span> &lt; 0.05).</p>
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<p>Antiviral spectrum of PheoA against different RNA viruses. The effectiveness of PheoA was tested against four different recombinant RNA viruses expressing reporter genes. (<b>A</b>) Huh7 cells were infected with HCVtcp in the presence of increasing PheoA doses and luciferase activity was determined 48 h post-inoculation. (<b>B</b>–<b>D</b>) Cells were inoculated in the presence of increasing concentrations of PheoA at MOI 0.01 and incubated to enable virus propagation. At the endpoint, cells were fixed and counter stained with DAPI to control for unexpected cytotoxic effects. Relative infection efficiency was estimated using automated microscopy and is expressed as percentage of the infection efficiency observed in control wells. (<b>B</b>) Huh7 cells were infected with hCoV-229E-GFP and fixed 48 h post-inoculation. (<b>C</b>) Huh7 cells were infected with WNV-GFP and fixed 48 h post-inoculation. (<b>D</b>) A549-ACE2 cells were inoculated with VSV-GFP and fixed 16 h post-inoculation. Individual replicate data are shown as green dots (<span class="html-italic">n</span> = 3) and the PROBIT regression curve used to estimate EC50 values is shown.</p>
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<p>Combination treatment of PheoA with RMDV. Vero E6 cells were inoculated at MOI = 0.005 in the presence of increasing concentrations of PheoA in combination with increasing doses of RMDV. Twenty-four hours post infection, cells were fixed and processed for automated immunofluorescence microscopy. Relative infection efficiency values were estimated as percentage of the values obtained in mock-treated cells. (<b>A</b>) Data are shown as average of two biological replicates. (<b>B</b>) Heatmap describing the areas of synergy within the combination treatments.</p>
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<p>Time-of-addition experiments indicate that PheoA interferes with early aspects of SARS-CoV-2 infection. Vero E6 cells were inoculated at MOI = 5 in the presence (gray) or absence (white) of the indicated doses of PheoA, RMDV or imatinib as described in both the text and the scheme. Cells were incubated for 6 h in the presence (gray) or absence (white) before chemical fixation and processing for immunofluorescence microscopy. (<b>A</b>) Schematic diagram of the times where compound was present in the assay. (<b>B</b>) Infection efficiency is expressed as the percentage of that observed in vehicle DMSO-treated cells and is shown as average and standard deviation of three biological replicates (<span class="html-italic">n</span> = 3). Statistical significance was estimated using one-way ANOVA and a Dunnet´s post hoc test (* <span class="html-italic">p</span> &lt; 0.05).</p>
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<p>PheoA interferes with SARS-CoV-2 virion infectivity in a dose- and time-dependent manner. SARS-CoV-2 virus stocks were diluted to obtain 1 × 10<sup>5</sup> TCID<sub>50</sub>/mL and were mixed with increasing concentrations of PheoA or the vehicle (DMSO). (<b>A</b>) Dose-dependent reduction in SARS-CoV-2 infectivity by PheoA. Virus-compound mixtures were incubated at room temperature for 30 min and were serially diluted to determine the remaining infectivity titer using endpoint dilution and determination of virus-induced cytopathic effect by crystal violet staining in Vero-E6 cells. (<b>B</b>) Pre-incubation time-dependent reduction in SARS-CoV-2 infectivity by PheoA. Experiments were carried out using a fixed dose of PheoA (340 nM) and increasing pre-incubation times before serial dilution for TCID<sub>50</sub> determination. Values are expressed as LOG TCID<sub>50</sub>/mL and shown as the average and standard deviation of three independent experiments (<span class="html-italic">n</span> = 3). Statistical significance was estimated using one-way ANOVA and a Dunnet’s post hoc test (* <span class="html-italic">p</span> &lt; 0.05).</p>
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20 pages, 11500 KiB  
Article
Formulation Study of a Co-Processed, Rice Starch-Based, All-in-One Excipient for Direct Compression Using the SeDeM-ODT Expert System
by Karnkamol Trisopon, Nisit Kittipongpatana, Phanphen Wattanaarsakit and Ornanong Suwannapakul Kittipongpatana
Pharmaceuticals 2021, 14(10), 1047; https://doi.org/10.3390/ph14101047 - 14 Oct 2021
Cited by 7 | Viewed by 5110
Abstract
A co-processed, rice starch-based excipient (CS), previously developed and shown to exhibit good pharmaceutical properties, is investigated as an all-in-one excipient for direct compression (DC). An SeDeM-ODT expert system is applied to evaluate the formulation containing CS, in comparison with those containing the [...] Read more.
A co-processed, rice starch-based excipient (CS), previously developed and shown to exhibit good pharmaceutical properties, is investigated as an all-in-one excipient for direct compression (DC). An SeDeM-ODT expert system is applied to evaluate the formulation containing CS, in comparison with those containing the physical mixture and the commercial DC excipients. The results revealed that CS showed acceptable values in all six incidence factors of the SeDeM-ODT diagram. In addition, the comprehensive indices (IGC and IGCB) were higher than 5.0, which indicated that CS could be compressed with DC technique without additional blending with a disintegrant in tablet formulation. The formulation study suggested that CS can be diluted up to 60% in the formulation to compensate for unsatisfactory properties of paracetamol. At this percentage, CS-containing tablets exhibited narrow weight variation (1.5%), low friability (0.43%), acceptable drug content (98%), and rapid disintegration (10 s). The dissolution profile of CS displayed that more than 80% of the drug content was released within 2 min. The functionality of CS was comparable to that of high functionality excipient composite (HFEC), whereas other excipients were unsuccessful in formulating the tablets. These results indicated that CS was a suitable all-in-one excipient for application in DC of tablets. Full article
(This article belongs to the Special Issue Formulation and Evaluation of Tablets of Different Drugs)
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<p>SeDeM-ODT diagrams of CS, PMSS, PGS, and commercial DC excipients, and a SeDeM diagram of paracetamol.</p>
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<p>SeDeM-ODT diagrams of paracetamol formulations containing different types and ratios of directly compressed excipients.</p>
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<p>Drug release profiles of paracetamol tablets formulated using various excipients at pH 1.2 (<b>A</b>) and 5.8 (<b>B</b>), and compiled release profiles of paracetamol-CS formulation at four different pH values along the GI tract (<b>C</b>).</p>
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12 pages, 2993 KiB  
Article
Corylin Ameliorates LPS-Induced Acute Lung Injury via Suppressing the MAPKs and IL-6/STAT3 Signaling Pathways
by I-Chen Chen, Shu-Chi Wang, Yi-Ting Chen, Hsin-Han Tseng, Po-Len Liu, Tzu-Chieh Lin, Hsin-En Wu, Yuan-Ru Chen, Yu-Hsin Tseng, Jong-Hau Hsu, Zen-Kong Dai, Jau-Ling Suen and Chia-Yang Li
Pharmaceuticals 2021, 14(10), 1046; https://doi.org/10.3390/ph14101046 - 14 Oct 2021
Cited by 22 | Viewed by 4378
Abstract
Acute lung injury (ALI) is a high mortality disease with acute inflammation. Corylin is a compound isolated from the whole plant of Psoralea corylifolia L. and has been reported to have anti-inflammatory activities. Herein, we investigated the therapeutic potential of corylin on lipopolysaccharides [...] Read more.
Acute lung injury (ALI) is a high mortality disease with acute inflammation. Corylin is a compound isolated from the whole plant of Psoralea corylifolia L. and has been reported to have anti-inflammatory activities. Herein, we investigated the therapeutic potential of corylin on lipopolysaccharides (LPS)-induced ALI, both in vitro and in vivo. The levels of proinflammatory cytokine secretions were analyzed by ELISA; the expressions of inflammation-associated proteins were detected using Western blot; and the number of immune cell infiltrations in the bronchial alveolar lavage fluid (BALF) were detected by multicolor flow cytometry and lung tissues by hematoxylin and eosin (HE) staining, respectively. Experimental results indicated that corylin attenuated LPS-induced IL-6 production in human bronchial epithelial cells (HBEC3-KT cells). In intratracheal LPS-induced ALI mice, corylin attenuated tissue damage, suppressed inflammatory cell infiltration, and decreased IL-6 and TNF-? secretions in the BALF and serum. Moreover, it further inhibited the phosphorylation of mitogen-activated protein kinases (MAPKs), including p-JNK, p-ERK, p-p38, and repressed the activation of signal transducer and activator of transcription 3 (STAT3) in lungs. Collectively, our results are the first to demonstrate the anti-inflammatory effects of corylin on LPS-induced ALI and suggest corylin has significant potential as a novel therapeutic agent for ALI. Full article
(This article belongs to the Special Issue Lung Injury and Repair)
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<p>The effects of corylin on the cell viability and the production of IL-6 by LPS-induced HBEC3-KT cells. Cells were pre-treated with different concentrations of corylin (0~50 μM) for 1 h following treatment of LPS (1 μg/mL) for 24 h. (<b>A</b>) Cell viability was examined by MTT assay. (<b>B</b>) The concentration of IL-6 in the cell culture supernatant was detected using ELISA. The data are presented as means ± SEM of three independent experiments. Statistical significances are represented as follows: *** <span class="html-italic">p</span> &lt; 0.001 and **** <span class="html-italic">p</span> &lt; 0.0001 vs. LPS alone.</p>
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<p>Effects of corylin on LPS-induced inflammatory cytokine productions in BALF. Mice were intraperitoneally injected with corylin (10 mg/kg or 20 mg/kg) for 1 h following intratracheal administration of LPS for 4 h. The mice were sacrificed and the BALF was collected. The expression levels of (<b>A</b>) TNF-α, (<b>B</b>) IL-6, (<b>C</b>) IL-1β, and (<b>D</b>) IL-12 in BALF were analyzed using ELISA. The data are presented as means ± SEM of three independent experiments. Statistical significances are represented as follows: * <span class="html-italic">p</span> &lt; 0.05, and *** <span class="html-italic">p</span> &lt; 0.001 and **** <span class="html-italic">p</span> &lt; 0.0001 vs. LPS alone.</p>
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<p>Effects of corylin treatment on immune cell infiltration in BALFs in LPS-induced mice. BALFs were collected from LPS and/or corylin-treated mice. (<b>A</b>) The total cell numbers in BALFs. The cell subsets were identified by multi-color flow cytometry, including (<b>B</b>) macrophages, (<b>C</b>) granulocytes, and (<b>D</b>) lymphocytes. Results are shown as mean ± SEM. * <span class="html-italic">p</span> &lt; 0.05, ** <span class="html-italic">p</span> &lt; 0.01, and **** <span class="html-italic">p</span> &lt; 0.0001 vs. LPS alone by one-way ANOVA followed by post hoc Tukey’s test. The numbers of mice are pooled from two independent experiments (<span class="html-italic">n</span> = 8~10).</p>
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<p>Effects of corylin on the expression and phosphorylation of MAPKs and STAT3 in lung tissues. Expressions of phospho-JNK, JNK, phospho-ERK, ERK, phospho-p38 MAPK, p38 MAPK, phospho-STAT3 and STAT3 were analyzed by Western blot. (<b>A</b>) The representative blot of triplicate experiments. Quantitated results of (<b>B</b>) phospho-JNK/JNK ratio (<span class="html-italic">n</span> = 6), (<b>C</b>) phospho-ERK/ERK ratio (<span class="html-italic">n</span> = 6), (<b>D</b>) phospho-p38/p38 ratio (<span class="html-italic">n</span> = 6), and (<b>E</b>) phospho-STAT3/STAT3 ratio (<span class="html-italic">n</span> = 9~10) were shown as mean ± SEM. The relative fold of phosphorylation activity was normalized to untreated samples. (* <span class="html-italic">p</span> &lt; 0.05, ** <span class="html-italic">p</span> &lt; 0.01 and *** <span class="html-italic">p</span> &lt; 0.001 vs. LPS alone).</p>
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<p>Effects of corylin on the expression of IL-6 and TNF-α in serum of LPS-induced mice. The expression levels of (<b>A</b>) IL-6 and (<b>B</b>) TNF-α in serum were measured using ELISA. The data are shown as mean ± SEM (<span class="html-italic">n</span> = 7~9). (* <span class="html-italic">p</span> &lt; 0.05 and *** <span class="html-italic">p</span> &lt; 0.001 vs. LPS alone).</p>
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<p>Effects of corylin on the lung in LPS-challenged mice. (<b>A</b>) Representative photographs of the lung tissues stained with HE. Upper left, control, the representative image PBS control. Upper right, the representative image of LPS administration. Lower left, the representative image of low dose corylin (10 mg/kg) pre-treatment following LPS administration. Lower right, the representative image of high dose corylin (20 mg/kg) pre-treatment following LPS administration. (<b>B</b>) Morphological changes in lung sections were semi-quantified using lung injury score. The results showed a significant reduction in the severity of lung injury in mice treatment with corylin compared to the LPS-induced ALI mice (<span class="html-italic">n</span> = 4~6). The magnification is 400X. The data are shown as mean ± SEM. (*** <span class="html-italic">p</span> &lt; 0.001 and **** <span class="html-italic">p</span> &lt; 0.0001 vs. LPS alone).</p>
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<p>Anti-inflammatory effect of corylin on LPS-induced ALI. The experimental results demonstrated that corylin attenuated the overproduction of IL-6 in LPS-activated human bronchial epithelial cells. In intratracheal LPS-induced ALI mice, corylin attenuated tissue damages, suppressed inflammatory cell infiltration, and decreased secretion of IL-6 and TNF-α in the BALF and serum; moreover, it further inhibited the expression of phosphorylation of mitogen-activated protein kinases (MAPKs), including the expression of p-JNK/JNK, p-ERK/ERK, p-p38/p38, and repressed the activation of signal transducer and activator of transcription 3 (STAT3) in lung. Taken together, our results are the first to demonstrate the anti-inflammatory effects of corylin on LPS-induced ALI and suggest corylin has significant potential as a novel therapeutic agent for ALI.</p>
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18 pages, 9238 KiB  
Article
Pioglitazone Is a Mild Carrier-Dependent Uncoupler of Oxidative Phosphorylation and a Modulator of Mitochondrial Permeability Transition
by Ekaterina S. Kharechkina, Anna B. Nikiforova, Konstantin N. Belosludtsev, Tatyana I. Rokitskaya, Yuri N. Antonenko and Alexey G. Kruglov
Pharmaceuticals 2021, 14(10), 1045; https://doi.org/10.3390/ph14101045 - 14 Oct 2021
Cited by 8 | Viewed by 3562
Abstract
Pioglitazone (PIO) is an insulin-sensitizing antidiabetic drug, which normalizes glucose and lipid metabolism but may provoke heart and liver failure and chronic kidney diseases. Both therapeutic and adverse effects of PIO can be accomplished through mitochondrial targets. Here, we explored the capability of [...] Read more.
Pioglitazone (PIO) is an insulin-sensitizing antidiabetic drug, which normalizes glucose and lipid metabolism but may provoke heart and liver failure and chronic kidney diseases. Both therapeutic and adverse effects of PIO can be accomplished through mitochondrial targets. Here, we explored the capability of PIO to modulate the mitochondrial membrane potential (??m) and the permeability transition pore (mPTP) opening in different models in vitro. ??m was measured using tetraphenylphosphonium and the fluorescent dye rhodamine 123. The coupling of oxidative phosphorylation was estimated polarographically. The transport of ions and solutes across membranes was registered by potentiometric and spectral techniques. We found that PIO decreased ??m in isolated mitochondria and intact thymocytes and the efficiency of ADP phosphorylation, particularly after the addition of Ca2+. The presence of the cytosolic fraction mitigated mitochondrial depolarization but made it sustained. Carboxyatractyloside diminished the PIO-dependent depolarization. PIO activated proton transport in deenergized mitochondria but not in artificial phospholipid vesicles. PIO had no effect on K+ and Ca2+ inward transport but drastically decreased the mitochondrial Ca2+-retention capacity and protective effects of adenine nucleotides against mPTP opening. Thus, PIO is a mild, partly ATP/ADP-translocase-dependent, uncoupler and a modulator of ATP production and mPTP sensitivity to Ca2+ and adenine nucleotides. These properties contribute to both therapeutic and adverse effects of PIO. Full article
(This article belongs to the Special Issue Heterocyclic Compounds and Their Application in Therapy)
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<p>Effect of PIO on ΔΨ<sub>m</sub> and the coupling of mitochondria. (<b>A</b>,<b>B</b>) Assessment of the effect of PIO on ΔΨ<sub>m</sub> using TPP<sup>+</sup> (<b>A</b>) and rhodamine 123 (Rhod 123, (<b>B</b>)). (<b>C</b>,<b>D</b>) Effect of PIO on ΔΨ<sub>m</sub> in mitochondria in the resting state (<b>C</b>) and during the ADP phosphorylation (<b>D</b>). (<b>A</b>) Rat liver mitochondria (RLM) (1 mg prot./mL) were placed in a standard incubation medium supplemented with 5 mM K<sup>+</sup>-succinate, 1 mM EGTA, rotenone (2 µg/mL), and 1 µM TPP<sup>+</sup>. Arrows show the addition of 25 or 100 µM PIO and 500 nM FCCP. (<b>B</b>–<b>D</b>) A mitochondrial suspension (0.75 mg/mL) supplemented with respiratory substrates, 1 mM EGTA, and 330 nM rhodamine 123 was placed in wells with 1% dimethyl sulfoxide (DMSO) (vehicle control) or PIO at indicated concentrations (µM) (<b>B</b>–<b>D</b>), 500 nM FCCP, antimycin A (2.5 µg/mL), and valinomycin (25 ng/mL) (<b>B</b>), and 2 mM ADP (<b>D</b>) just before measurements. Everywhere, except the curve designated “M+P” (5 mM malate + 5 mM pyruvate), the respiratory substrate was 5 mM K<sup>+</sup>-succinate with the addition of rotenone (2 µg/mL). Numbers on curves are the means ± S.E.M. (<span class="html-italic">n</span> = 3) of one representative experiment of three identical experiments. (<b>B</b>) Where indicated, 500 nM FCCP was added to wells with 50, 100, and 200 µM PIO to calibrate the signal. Insert in panel (<b>C</b>) shows a shift in ΔΨ<sub>m</sub> caused by FCCP, DNP, and PIO after 5 min of incubation. Insert in panel (<b>D</b>) shows the effect of PIO on the respiration rate in state 2 and state 3 and the respiratory control (RC) coefficient. In inserts, numbers on curves are the means ± S.E.M. of three independent experiments (<span class="html-italic">n</span> = 9 (<b>C</b>) and 3 (<b>D</b>)).</p>
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<p>PIO increases mitochondrial sensitivity to Ca<sup>2+</sup> and decreases the protective effect of mPTP inhibitors, ATP and ADP. (<b>A</b>–<b>C</b>) Ca<sup>2+</sup>-dependent mitochondrial swelling in the presence of PIO and ATP/ADP. (<b>D</b>) Effect of PIO on the Ca<sup>2+</sup>-retention capacity of mitochondria. (<b>A</b>–<b>C</b>) Mitochondrial suspension (0.75 mg prot./mL) supplemented with 5 mM K<sup>+</sup>-succinate (plus 2 µg/mL rotenone) and, where shown, 2 mM ADP (<b>B</b>) and 2 mM ATP (<b>C</b>) (pH 7.4) were placed in wells with indicated additions: 1 mM EGTA, 1% DMSO, 10–100 µM PIO, and 10 µg/mL oligomycin (Oligo). The arrow shows the addition of 50 µM Ca<sup>2+</sup>. Representative data of three similar experiments are shown. Points on traces are the means ± S.E.M. (<span class="html-italic">n</span> = 3). (<b>D</b>) Ca<sup>2+</sup>-retention capacity equal to 100% corresponds to 210.9 ± 23.45 nmol Ca<sup>2+</sup>/mg protein. Values in columns are means ± S.E.M. (<span class="html-italic">n</span> = 3) of three independent experiments. The asterisk shows the significant difference from the vehicle control (<span class="html-italic">p</span> &lt; 0.05). The insert shows the kinetics of accumulation of 30 µM Ca<sup>2+</sup> in the absence (Control) and in the presence of 100 µM PIO.</p>
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<p>Effect of PIO on the capability of mitochondria to support ATP production in the presence of Ca<sup>2+</sup> (<b>A</b>) and on the level of matrix ATP (<b>B</b>). Mitochondria (0.2 (<b>A</b>) and 0.5 mg prot./mL (<b>B</b>)) were placed in the standard incubation medium, which contained a 20% solution of a luciferin-luciferase reagent, 5 mM K<sup>+</sup>-succinate, 2 µg/mL of rotenone, 10 µM EGTA, and, where indicated, 5–50 µM PIO, 1 µM CATR, and 10 µg/mL oligomycin (Oligo). Vertical dashed lines (<b>A</b>) or arrows (<b>B</b>) show the addition of 500 µM ADP, 50 µM Ca<sup>2+</sup>, and 5 µM ATP standard (to calibrate the chemiluminescent signal). Representative data of three separate experiments are shown. Traces are the means for three wells.</p>
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<p>Mechanism of transmembrane proton transport by PIO. (<b>A</b>) Possible mechanism of proton transport by PIO across the IMM. (<b>B</b>) Comparison of CCCP- and PIO-mediated proton fluxes through liposomes loaded with the pH probe pyranine. The inner liposomal pH value was estimated from the pyranine fluorescence intensity measured at 505 nm upon excitation at 455 nm. Lasalocid A (1 µM) was added approximately at 800 s to equilibrate pH. PIO concentrations were 10 µM, red curve; 50 µM, green curve; 75 µM, blue curve. CCCP concentration was 1 µM (pink curve). Lipid concentration was 20 μg/mL, T = 15 °C. Other conditions: see Materials and Methods Section. The proton flux was initiated by an alkaline pH shift from рН 6 to рН 8, which was caused by the addition of the previously determined aliquot of KOH. In the presence of the protonophores, the pyranine fluorescence gradually increased, indicating the alignment of the pH values inside and outside liposomes due to proton transfer mediated by a protonophore. (<b>C</b>,<b>D</b>) Effect of PIO, palmitic acid, and FCCP on the swelling of deenergized mitochondria in NH<sub>4</sub>NO<sub>3</sub>-based medium. Mitochondria (0.75 mg prot./mL) were added to NH<sub>4</sub>NO<sub>3</sub>-based medium supplemented with rotenone (2.5 mg/mL), and 1 min later, the suspension was placed in the wells of a plate that contained PIO, sodium palmitate (PA), and FCCP at indicated concentrations. (<b>C</b>) Standard curves of mitochondrial swelling. (<b>D</b>) Initial rates of mitochondrial swelling during the first 3 min of incubation. Points are the means ± S.E.M. of three independent experiments (<span class="html-italic">n</span> = 9).</p>
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<p>Effect of inhibitors of ANT and UCPs on the shift in ΔΨ<sub>m</sub> caused by PIO and DNP. Incubation medium contained indicated concentrations of PIO and DNP, and, where shown, 1 mM GDP and 2 µM CATR. (<b>A</b>,<b>B</b>) Dynamics of ΔΨ<sub>m</sub> changes (decrease) in relation to control (1% DMSO). The data of one representative experiment of three similar experiments are shown. Values on traces are the means for three wells. (<b>C</b>) Effect of GDP and CATR on the average PIO-dependent shift in ΔΨ<sub>m</sub>. Each point on the curves is an average ΔΨ<sub>m</sub> shift defined as a mean ± S.E.M. for 60 points of experimental curves (such as in Panel (<b>A</b>)) for three individual experiments (<span class="html-italic">n</span> = 180). (<b>D</b>) Changes in the DNP-dependent ΔΨ<sub>m</sub> shift caused by CATR and GDP in relation to DNP alone (Control).</p>
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<p>PIO decreases ΔΨ<sub>m</sub> in isolated intact thymocytes. (<b>A</b>–<b>D</b>) Typical plots obtained in the absence of additions (<b>A</b>, Control), in the presence of 50 (<b>B</b>) and 200 µM PIO (<b>C</b>), and 500 nM FCCP (<b>D</b>). (<b>E</b>) The portion of depolarized cells in different experimental groups (means ± SEM, <span class="html-italic">n</span> = 3). * Statistically significant (<span class="html-italic">p</span> &lt; 0.05) differences from control (without PIO).</p>
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<p>Effect of a cytosolic fraction (RLH) on PIO-dependent changes in ΔΨ<sub>m</sub>. Just before measurements, mitochondria alone (RLM) (0.75 mg prot./mL) (<b>A</b>,<b>D</b>) or in combination with 5 (<b>B</b>,<b>D</b>) and 15 mg prot./mL (<b>C</b>,<b>D</b>) of RLH were added to a standard incubation medium supplemented with 5 mM K<sup>+</sup>-succinate, 1 mM EGTA, rotenone (2.5 µg/mL), and 330 nM rhodamine 123, and then transferred to the wells of a 96-well plate, which contained 1% DMSO (Control), 10–200 µM PIO, or 500 nM FCCP, antimycin A (2.5 µg/mL), and valinomycin (25 ng/mL). Traces are the differences in ΔΨ<sub>m</sub> between PIO- and DMSO-containing samples in one representative experiment of three similar experiments.</p>
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<p>Contribution of uncoupling and mPTP-modulating effects of PIO to its healing and harmful action in the cell and the organism. CVD: cardiovascular disease.</p>
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16 pages, 2600 KiB  
Article
Esculetin Provides Neuroprotection against Mutant Huntingtin-Induced Toxicity in Huntington’s Disease Models
by Letizia Pruccoli, Carlo Breda, Gabriella Teti, Mirella Falconi, Flaviano Giorgini and Andrea Tarozzi
Pharmaceuticals 2021, 14(10), 1044; https://doi.org/10.3390/ph14101044 - 13 Oct 2021
Cited by 7 | Viewed by 2968
Abstract
Huntington’s disease (HD) is a neurodegenerative disorder caused by an abnormal CAG trinucleotide repeat expansion within exon 1 of the huntingtin (HTT) gene. This mutation leads to the production of mutant HTT (mHTT) protein which triggers neuronal death through several mechanisms. Here, we [...] Read more.
Huntington’s disease (HD) is a neurodegenerative disorder caused by an abnormal CAG trinucleotide repeat expansion within exon 1 of the huntingtin (HTT) gene. This mutation leads to the production of mutant HTT (mHTT) protein which triggers neuronal death through several mechanisms. Here, we investigated the neuroprotective effects of esculetin (ESC), a bioactive phenolic compound, in an inducible PC12 model and a transgenic Drosophila melanogaster model of HD, both of which express mHTT fragments. ESC partially inhibited the progression of mHTT aggregation and reduced neuronal death through its ability to counteract the oxidative stress and mitochondria impairment elicited by mHTT in the PC12 model. The ability of ESC to counteract neuronal death was also confirmed in the transgenic Drosophila model. Although ESC did not modify the lifespan of the transgenic Drosophila, it still seemed to have a positive impact on the HD phenotype of this model. Based on our findings, ESC may be further studied as a potential neuroprotective agent in a rodent transgenic model of HD. Full article
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<p>Neurotoxicity onset upon induction of mHTT in HD-Q74 cells. (<b>A</b>,<b>C</b>) HD-Q23 and HD-Q74 cells were incubated with DOX (1 µg/mL) for different times (1, 2, 3 and 6 days) and the cell proliferation was evaluated using eosin as described in the Materials and Methods. Data are expressed as numbers of total cells and reported as the mean ± SEM of at least three independent experiments (* <span class="html-italic">p</span> &lt; 0.05 vs. HD-Q74 (−DOX) at one-way ANOVA with Bonferroni post hoc test); (<b>B</b>,<b>D</b>) HD-Q23 and HD-Q74 cells were incubated with DOX (1 µg/mL) for 3 days and neuronal death was evaluated using eosin as described in the Materials and Methods. Data are expressed as percentages of neuronal death and reported as the mean ± SEM of at least three independent experiments (*** <span class="html-italic">p</span> &lt; 0.001 vs. HD-Q74 (−DOX) at Student’s <span class="html-italic">t</span>-test); (<b>E</b>,<b>F</b>) HD-Q23 and HD-Q74 cells were incubated with DOX (1 µg/mL) for 3 days and TH protein levels were evaluated by western blotting as described in the Materials and Methods. Data are expressed as TH/β-Actin and reported as the mean ± SEM of at least three independent experiments (** <span class="html-italic">p</span> &lt; 0.01 vs. HD-Q74 (−DOX) at one-way ANOVA with Bonferroni post hoc test).</p>
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<p>Impairment of cellular redox status upon induction of mHTT in HD-Q74 cells. The cellular redox status in terms of cytosolic ROS (<b>A</b>) and GSH (<b>B</b>) levels were evaluated in HD-Q23 and HD-Q74 cells after 3 days of incubation with DOX (1 µg/mL). At the end of incubation, ROS formation and GSH levels were evaluated using the fluorescent probes H<sub>2</sub>DCF-DA and MCB, respectively, as described in the Materials and Methods. Data are expressed as AUF and reported as the mean ± SEM of at least three independent experiments (*** <span class="html-italic">p</span> &lt; 0.001 vs. HD-Q74 (−DOX) at one-way ANOVA with Bonferroni post hoc test).</p>
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<p>ESC inhibits mHTT aggregation in HD-Q74 cells. (<b>A</b>,<b>B</b>) HD-Q23 and HD-Q74 cells were incubated with DOX (1 µg/mL) for 3 days and ESC (5 µM) was added during the last 24 h of incubation with DOX. The fluorescence of both EGFP-tagged HTT23Q and HTT74Q aggregates was measured as described in the Materials and Methods. Data are expressed as AUF and reported as the mean ± SEM of at least three independent experiments (*** <span class="html-italic">p</span> &lt; 0.001 vs. HD-Q23 (−DOX) and *** <span class="html-italic">p</span> &lt; 0.001 vs. HD-Q74 (−DOX) at one-way ANOVA with Bonferroni post hoc test); (<b>C</b>) HD-Q74 cells were incubated with DOX (1 µg/mL) for 3 days and ESC (5 µM) was added during the last 24 h of incubation with DOX. The area of the fluorescent EGFP-tagged HTT74Q aggregates was measured using an inverted fluorescence microscope as described in the Materials and Methods. Data are expressed as area and reported as mean ± SEM of at least three independent experiments (** <span class="html-italic">p</span> &lt; 0.01 vs. HD-Q74 (+DOX) at Student’s <span class="html-italic">t</span>-test); (<b>D</b>) Representative images of HTT74Q aggregates after treatment with ESC (scale bars: 100 µm).</p>
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<p>Neuroprotective effects of ESC against mHTT neurotoxicity in HD-Q74 cells. HD-Q23 and HD-Q74 cells were incubated with DOX (1 µg/mL) for 3 days and ESC (5 µM) was added during the last 24 h of incubation with DOX. Neurotoxicity, in terms of cytostatic effects (<b>A</b>,<b>B</b>) and neuronal death (<b>C</b>,<b>D</b>), was assessed using eosin as described in the Materials and Methods. Data are expressed as numbers of total cells and percentages of neuronal death and are reported as the mean ± SEM of at least three independent experiments (* <span class="html-italic">p</span> &lt; 0.05 and ** <span class="html-italic">p</span> &lt; 0.01 vs. HD-Q74 (−DOX), § <span class="html-italic">p</span> &lt; 0.05 and §§ <span class="html-italic">p</span> &lt; 0.01 vs. HD-Q74 (+DOX) at one-way ANOVA with Bonferroni post hoc test).</p>
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<p>Effects of ESC on TH levels upon induction of mHTT in HD-Q74 cells. HD-Q74 cells were incubated with DOX (1 µg/mL) for 3 days and ESC (5 µM) was added during the last 24 h of incubation with DOX. TH protein levels (<b>A</b>) and gene expression (<b>B</b>) were evaluated by western blotting and RT–PCR, respectively, as described in the Materials and Methods. Data are expressed as TH protein levels and relative normalized gene expression and are reported as the mean ± SEM of at least three independent experiments (*** <span class="html-italic">p</span> &lt; 0.001 vs. HD-Q74 (−DOX) and § <span class="html-italic">p</span> &lt; 0.05 vs. HD-Q74 (+DOX) at one-way ANOVA with Bonferroni post hoc test).</p>
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<p>Effects of ESC on mitochondrial activity in HD-Q74 cells. Cells were incubated with DOX (1 µg/mL) for 3 days and ESC (5 µM) was added during the last 24 h of incubation with DOX. The mitochondrial area (<b>A</b>) and mitochondrial efficiency (<b>B</b>) were determined as described in the Materials and Methods. Data are reported as the mean ± SEM of at least three independent experiments (*** <span class="html-italic">p</span> &lt; 0.001 vs. HD-Q74 (−DOX), §§ &lt; 0.01 and §§§ <span class="html-italic">p</span> &lt; 0.001 vs. HD-Q74 (+DOX) at one-way ANOVA with Bonferroni post hoc test). (<b>C</b>) Ultrastructural TEM image of untreated HD-Q74 cells (−DOX). Mitochondria showed a tubular shape with dense matrixes and regular cristae (scale bar: 1000 nm). (<b>D</b>) Ultrastructural TEM image of HD-Q74 cells induced with DOX (+DOX). Several mitochondria showed a round shaped morphology, extracted matrixes and swollen cristae (scale bar: 1000 nm). (<b>E</b>) Ultrastructural TEM image of HD-Q74 cells induced with DOX and treated with ESC (+DOX/ESC). Mitochondria showed a tubular shape, with dense matrixes and regular cristae (scale bar: 1000 nm).</p>
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<p>ESC improves the cellular redox status altered by mHTT in HD-Q74 cells. HD-Q74 cells were incubated with DOX (1 µg/mL) for 3 days and ESC (5 µM) was added during the last 24 h of incubation with DOX. ROS formation (<b>A</b>) and intracellular GSH levels (<b>B</b>) were evaluated using the fluorescent probes H<sub>2</sub>DCF-DA and MCB, respectively, as described in the Materials and Methods; (<b>C</b>) <span class="html-italic">GCLC</span> gene expression was evaluated by RT–PCR. Data are reported as the mean ± SEM of at least three independent experiments (** <span class="html-italic">p</span> &lt; 0.01 and *** <span class="html-italic">p</span> &lt; 0.001 vs. HD-Q74 (−DOX), § <span class="html-italic">p</span> &lt; 0.05 vs. HD-Q74 (+DOX) at one-way ANOVA with Bonferroni post hoc test).</p>
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<p>ESC ameliorates neurodegeneration in transgenic HTT93Q flies. (<b>A</b>) <span class="html-italic">Drosophila</span> expressing HTT93Q exon 1 pan-neuronally were fed with ESC at different concentrations during development and as adults. Rhabdomeres were scored via the pseudopupil assay at day 0 (newly emerged flies) and at day 7 (adult flies) post eclosion as described in the Materials and Methods. Data are expressed as the mean rhabdomere count per ommatidium ± SEM (<span class="html-italic">n</span> = 12 per condition) (*** <span class="html-italic">p</span> &lt; 0.001 vs. HTT93Q flies untreated at one-way ANOVA with Newman–Keuls post hoc test). (<b>B</b>) Crosses were set up in food containing either 10 or 100 µM of ESC. The number of adult females and males emerging from the pupal case was scored using eclosion analysis as described in the materials and methods. Data are expressed as mean ± SEM (<span class="html-italic">n</span> = 100 per condition) (* <span class="html-italic">p</span> &lt; 0.05 vs. HTT93Q flies untreated at one-way ANOVA with Newman–Keuls post hoc test). (<b>C</b>) Crosses were carried out to obtain the desired genotype and ESC was mixed in fly food at different concentrations for growing adult flies as described in the materials and methods. Data are expressed as mean ± SEM (<span class="html-italic">n</span> = 100 per condition).</p>
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<p>Chemical structure of ESC.</p>
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25 pages, 6443 KiB  
Review
Recent Developments in the Synthesis of ?-Diketones
by Gonzalo de Gonzalo and Andrés R. Alcántara
Pharmaceuticals 2021, 14(10), 1043; https://doi.org/10.3390/ph14101043 - 13 Oct 2021
Cited by 29 | Viewed by 7901
Abstract
Apart from being one of the most important intermediates in chemical synthesis, broadly used in the formation of C–C bonds among other processes, the ?-dicarbonyl structure is present in a huge number of biologically and pharmaceutically active compounds. In fact, mainly derived from [...] Read more.
Apart from being one of the most important intermediates in chemical synthesis, broadly used in the formation of C–C bonds among other processes, the ?-dicarbonyl structure is present in a huge number of biologically and pharmaceutically active compounds. In fact, mainly derived from the well-known antioxidant capability associated with the corresponding enol tautomer, ?-diketones are valuable compounds in the treatment of many pathological disorders, such as cardiovascular and liver diseases, hypertension, obesity, diabetes, neurological disorders, inflammation, skin diseases, fibrosis, or arthritis; therefore, the synthesis of these structures is an area of overwhelming interest for organic chemists. This paper is devoted to the advances achieved in the last ten years for the preparation of 1,3-diketones, using different chemical (Claisen, hydration of alkynones, decarboxylative coupling) or catalytic (biocatalysis, organocatalytic, metal-based catalysis) methodologies: Additionally, the preparation of branched ?-dicarbonyl compounds by means of ?-functionalization of non-substituted 1,3-diketones are also discussed. Full article
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Scheme 1

Scheme 1
<p>Some linear 1,3-diketones possessing biological activity.</p>
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<p>Keto-enol structures of linear and cyclic 1,3-diketones with antioxidant activity.</p>
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<p>Some examples of β-ketoesters with antioxidant activity.</p>
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<p>Some linear and cyclic β-diketones possessing different biological activity.</p>
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<p>Some 1,3-diketone-metal complexes with antimicrobial activity.</p>
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<p>Synthesis of biologically active heterocycles starting from 1,3-dicarbonyl compounds. (<b>a</b>) flavonoid type (<b>33</b>) and pyrazol type (<b>34</b>) compounds with antioxidant and anti-inflammatory activity; (<b>b</b>) biologically active <span class="html-italic">N</span>-arylpyrazolyl diketones (<b>35</b>); (<b>c</b>) biologically active <span class="html-italic">N</span>-arylpyrazolyl oxoesters (<b>36</b>); (<b>d</b>) biologically active pyrazolyl oxoamides (<b>37</b>).</p>
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<p>Synthesis of 1,3-diketones through classical Claisen condensation: (<b>a</b>) by acylating alkyl aryl ketones (<b>39</b>) with alkanoic acids (<b>38</b>); (<b>b</b>) by the reaction of the ferrocenyl esters (<b>41</b>) with different ferrocenyl ketones (<b>42</b>); (<b>c</b>) by condensation of 4-methylbenzoate methylenpyran (<b>44</b>) with different ketones.</p>
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<p>Preparation of valuable β-diketones using the Baker–Venkataraman transposition: (<b>a</b>) by treating of carbazole esters (<b>50</b>) with KOH in the presence of pyridine; (<b>b</b>) by treating diester <b>54</b> with NaOH/DMSO.</p>
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<p>Preparation of halogenated 1,3-diketones via Claisen condensation: (<b>a</b>) via condensation of fluoroketones (<b>57</b> or <b>59</b>) with perfluoro alkylesters (<b>58</b> or <b>60</b>); (<b>b</b>) by condensation between 2-acetylthiophene (<b>62</b>) and fluorinated esters (<b>63</b>); (<b>c</b>) by acetal acylation with trichloroacetyl chloride.</p>
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<p>Preparation of 1,3-diketones using soft enolates methodologies: (<b>a</b>) by using acid chlorides (<b>68</b>) as electrophiles; (<b>b</b>) by using acid chlorides and β,γ-unsaturated ketones (<b>73</b>); (<b>c</b>) starting from β–phenylpropionic acids (<b>75</b>).</p>
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<p>Preparation of 1,3-diketones by hydration of alkynones (<b>78</b>): (<b>a</b>) by treating with benzaldehyde oxime (<b>79</b>); (<b>b</b>) by gold(I)-catalyzed regioselective hydration.</p>
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<p>Preparation of β-diketones by decarboxylative coupling reactions: (<b>a</b>) cross-coupling between potassium 2-oxo-phenylacetate (<b>81</b>) and 2-bromo-1-phenylethanone (<b>82</b>); (<b>b</b>) decarboxylate coupling between <b>82</b> and methyl 2-oxo-2-phenylacetate (<b>83</b>).</p>
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<p>Different synthetic methodologies for the preparation of β-diketones: (<b>a</b>) 1,4-addition of bis(iodozincio)methane onto α.β-unsaturated ketones <b>85</b>; (<b>b</b>) via a multicomponent process; (<b>c</b>) by oxidation of β-hydroxyketones (<b>91</b>) with o-iodoxybenzoic acid (IBX).</p>
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<p>Preparation of a set of 1,3-diketones by a biocatalytic approach employing <span class="html-italic">Yp</span>YerE.</p>
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<p>Preparation of symmetrical and asymmetrical 1,3-diketones by using acetylacetoin synthase.</p>
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<p>Organocatalyzed synthesis of 1,3-diketones employing <span class="html-italic">N</span>-heterocyclic carbenes.</p>
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<p>Metal-based catalytic preparation 1,3-diketones in presence of a palladium complex.</p>
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<p>Synthesis of novel β-diketones by functionalization at the α-position of other 1,3-diketones: (<b>a</b>) preparation of chiral ferrocene-containing 1,3-diketones (<b>105</b>); (<b>b</b>) preparation of the preparation of 2-(2,2,2-trifluoroethylidene)- and (2,2-difluoroethyl)-1,3-dicarbonyl compounds (<b>107</b>).</p>
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10 pages, 1799 KiB  
Article
Ten-Year Outcomes of Intravitreal Bevacizumab for Myopic Choroidal Neovascularization: Analysis of Prognostic Factors
by Fabiana Mallone, Rosalia Giustolisi, Federica Franzone, Marco Marenco, Rocco Plateroti, Marcella Nebbioso, Alessandro Lambiase and Magda Gharbiya
Pharmaceuticals 2021, 14(10), 1042; https://doi.org/10.3390/ph14101042 - 13 Oct 2021
Cited by 6 | Viewed by 3602
Abstract
The current standard treatment of myopic choroidal neovascularisation (mCNV) is intravitreal injection of VEGF antagonists. This study was proposed to assess efficacy and safety of intravitreal bevacizumab (IVB) for the treatment of mCNV across a 10-year follow-up. Thirty eyes of thirty patients with [...] Read more.
The current standard treatment of myopic choroidal neovascularisation (mCNV) is intravitreal injection of VEGF antagonists. This study was proposed to assess efficacy and safety of intravitreal bevacizumab (IVB) for the treatment of mCNV across a 10-year follow-up. Thirty eyes of thirty patients with treatment-naïve mCNV who underwent IVB and were followed up with for a minimum of ten years were recruited for the present retrospective cohort study. All participants were treated with three monthly IVB at baseline and then evaluated and treated under pro re nata (PRN) schedule. Outcome measures were to determine BCVA changes over years and identify the predictive factors of both final visual outcome and need for retreatment. Analysis of the main involved prognostic factors with correlations among variables is reported. Visual acuity remained stable at 10-year follow-up (p = 0.001) with the greatest improvement at 2 years (p < 0.0001) in all CNV locations. Baseline BCVA correlated positively with final BCVA (? = 0.88, p < 0.0001, R2: 0.75). No predictive factors for the need of additional injections were identified. Retinal and choroidal thickness significantly reduced over time but without correlation with the number of injections. CNV max height and area significantly decreased at 10 years (p < 0.0001 and p = 0.003, respectively), with complete regression of mCNV lesion in 40% of subjects. Intravitreal bevacizumab resulted as long-term effective and safe therapy for mCNV with sustained results at 10 years. Full article
(This article belongs to the Special Issue Advances in Ocular Pharmacology)
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Figure 1
<p>Spectral domain optical coherence tomography (SD-OCT) consecutive images (<b>A</b>–<b>C</b>) referring to baseline, 5-year and 10-year follow-up times of a 49-year-old female patient suffering from mCNV and treated with IVB (radial 20°, six lines scan protocol centred on the fovea). (<b>A</b>) Baseline scan showing an active juxtafoveal type 2 mCNV with macular thickening and minimal subretinal fluid. (<b>B</b>) Year 5 scan showing a residual highly reflective subretinal scar lesion with no associated fluid. (<b>C</b>) Year 10 scan showing complete regression of the mCNV lesion.</p>
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19 pages, 769 KiB  
Review
Plasma Rich in Growth Factors in the Treatment of Endodontic Periapical Lesions in Adult Patients: A Narrative Review
by Agata Zoltowska, Katarzyna Machut, Elzbieta Pawlowska and Marcin Derwich
Pharmaceuticals 2021, 14(10), 1041; https://doi.org/10.3390/ph14101041 - 13 Oct 2021
Cited by 11 | Viewed by 4523
Abstract
Platelet concentrates have been widely used in regenerative medicine, including endodontics. The aim of this manuscript was to assess critically the efficacy of PRF in the treatment of endodontic periapical lesions in adult patients on the basis of the literature. The PICO approach [...] Read more.
Platelet concentrates have been widely used in regenerative medicine, including endodontics. The aim of this manuscript was to assess critically the efficacy of PRF in the treatment of endodontic periapical lesions in adult patients on the basis of the literature. The PICO approach was used to properly develop literature search strategies. The PubMed database was analyzed with the keywords: “((PRP) OR (PRF) OR (PRGF) OR (CGF)) AND (endodontic) AND ((treatment) OR (therapy))”. After screening of 155 results, 14 articles were included in this review. Different types of platelet concentrates are able to stimulate the processes of proliferation and differentiation of mesenchymal stem cells. Platelet rich fibrin (PRF) releases growth factors for at least 7 days at the application site. Growth factors and released cytokines stimulate the activity of osteoblasts. Moreover, the release of growth factors accelerates tissue regeneration by increasing the migration of fibroblasts. It was not possible to assess the efficacy of PRF supplementation in the treatment of endodontic periapical lesions in permanent, mature teeth with closed apexes, due to the lack of well-designed scientific research. Further studies are needed to analyze the effect of PRF on the healing processes in the periapical region. Full article
(This article belongs to the Section Pharmacology)
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<p>PRISMA flow diagram for review of the literature.</p>
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19 pages, 3358 KiB  
Article
Inhibition of 11?-HSD1 Ameliorates Cognition and Molecular Detrimental Changes after Chronic Mild Stress in SAMP8 Mice
by Dolors Puigoriol-Illamola, Júlia Companys-Alemany, Kris McGuire, Natalie Z. M. Homer, Rosana Leiva, Santiago Vázquez, Damian J. Mole, Christian Griñán-Ferré and Mercè Pallàs
Pharmaceuticals 2021, 14(10), 1040; https://doi.org/10.3390/ph14101040 - 13 Oct 2021
Cited by 6 | Viewed by 3239
Abstract
Impaired glucocorticoid (GC) signaling is a significant factor in aging, stress, and neurodegenerative diseases such as Alzheimer’s disease. Therefore, the study of GC-mediated stress responses to chronic moderately stressful situations, which occur in daily life, is of huge interest for the design of [...] Read more.
Impaired glucocorticoid (GC) signaling is a significant factor in aging, stress, and neurodegenerative diseases such as Alzheimer’s disease. Therefore, the study of GC-mediated stress responses to chronic moderately stressful situations, which occur in daily life, is of huge interest for the design of pharmacological strategies toward the prevention of neurodegeneration. To address this issue, SAMP8 mice were exposed to the chronic mild stress (CMS) paradigm for 4 weeks and treated with RL-118, an 11?-hydroxysteroid dehydrogenase type 1 (11?-HSD1) inhibitor. The inhibition of this enzyme is linked with a reduction in GC levels and cognitive improvement, while CMS exposure has been associated with reduced cognitive performance. The aim of this project was to assess whether RL-118 treatment could reverse the deleterious effects of CMS on cognition and behavioral abilities and to evaluate the molecular mechanisms that compromise healthy aging in SAMP8 mice. First, we confirmed the target engagement between RL-118 and 11?-HSD1. Additionally, we showed that DNA methylation, hydroxymethylation, and histone phosphorylation were decreased by CMS induction, and increased by RL-118 treatment. In addition, CMS exposure caused the accumulation of reactive oxygen species (ROS)-induced damage and increased pro-oxidant enzymes—as well as pro-inflammatory mediators—through the NF-?B pathway and astrogliosis markers, such as GFAP. Of note, these modifications were reversed by 11?-HSD1 inhibition. Remarkably, although CMS altered mTORC1 signaling, autophagy was increased in the SAMP8 RL-118-treated mice. We also showed an increase in amyloidogenic processes and a decrease in synaptic plasticity and neuronal remodeling markers in mice under CMS, which were consequently modified by RL-118 treatment. In conclusion, 11?-HSD1 inhibition through RL-118 ameliorated the detrimental effects induced by CMS, including epigenetic and cognitive disturbances, indicating that GC-excess attenuation shows potential as a therapeutic strategy for age-related cognitive decline and AD. Full article
(This article belongs to the Special Issue Stress, Neurotransmitters and Neurodegeneration)
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Figure 1
<p>TAPS Assay results showing the peak area per cell. Values are the mean ± standard error of the mean (SEM) (<span class="html-italic">n</span> = 3), *** <span class="html-italic">p</span> &lt; 0.0001. ** <span class="html-italic">p</span> &lt; 0.01 +/− x protein interaction; *** <span class="html-italic">p</span> &lt; 0.001 +/− main effect; **** <span class="html-italic">p</span> &lt; 0.0001 protein main effect. The Y-axis represents the peak area obtained in LC-MS divided by the number of cells evaluated after lysis (see methodology for details).</p>
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<p>Representative results from epigenetic marks. Global 5-methylated cytosine (<b>A</b>) and 5-hydroxymethylated cytosine levels (<b>B</b>). Relative gene expression of <span class="html-italic">Dnmt1</span> (<b>C</b>), <span class="html-italic">Tet2</span> (<b>D</b>), and <span class="html-italic">Hdac2</span> (<b>E</b>). Representative Western blot for the ratio of Lys12 acetylated H4 protein levels and quantification (<b>F</b>), the ratio of Lys9 acetylated H3 protein levels and quantification (<b>G</b>), and the ratio of H3K9me2 protein levels and quantification (<b>H</b>). Gene expression levels were determined by real-time PCR. Western blot values in bar graphs are adjusted to 100% for protein levels of SAMP8 Control (Control). Values are mean ± standard error of the mean (SEM) (<span class="html-italic">n</span> = 6 for each group). 11β-HSD1 and CMS main effects as well as interactions were determined. * <span class="html-italic">p</span> &lt; 0.05; ** <span class="html-italic">p</span> &lt; 0.01; *** <span class="html-italic">p</span> &lt; 0.001.</p>
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<p>Representative results from pro-oxidant vs antioxidant mechanism imbalances. Representative ROS accumulation was measured by the hydrogen peroxide concentration in homogenates of hippocampus tissue (<b>A</b>). Representative Western blot for the ratio of nuclear/cytoplasmic NRF2 protein levels and quantification (<b>B</b>). Relative gene expression of <span class="html-italic">Aox1</span> (<b>C</b>) and <span class="html-italic">iNOS</span> (<b>D</b>). Western blot values in bar graphs are adjusted to 100% for protein levels of SAMP8 Control (Control). Gene expression levels were determined by real-time PCR. Values are mean ± standard error of the mean (SEM) (<span class="html-italic">n</span> = 6 for each group). 11β-HSD1 and CMS main effects as well as interactions were determined. * <span class="html-italic">p</span> &lt; 0.05; ** <span class="html-italic">p</span> &lt; 0.01.</p>
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<p>Representative results from inflammatory pathways. Representative Western blot for NF-κB protein levels and quantification (<b>A</b>). Relative gene expression of <span class="html-italic">Il-1β</span> (<b>B</b>), <span class="html-italic">Cxcl2</span> (<b>C</b>), <span class="html-italic">Tnf-α</span> (<b>D</b>), and <span class="html-italic">Gfap</span> (<b>E</b>). Western blot values in bar graphs are adjusted to 100% for protein levels of SAMP8 Control (Control). Gene expression levels were determined by real-time PCR. Values are mean ± standard error of the mean (SEM) (<span class="html-italic">n</span> = 6 for each group). 11β-HSD1 and CMS main effects as well as interactions were determined. * <span class="html-italic">p</span> &lt; 0.05; ** <span class="html-italic">p</span> &lt; 0.01.</p>
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<p>Representative results from the evaluation of the autophagy process. Representative Western blot for Beclin1 protein levels and quantification (<b>A</b>), p-TORC1 (Ser 151) protein levels and quantification (<b>B</b>), and the ratio of LC3 protein levels and quantification (<b>C</b>). Values in bar graphs are adjusted to 100% for protein levels of SAMP8 Control (Control). Values are mean ± standard error of the mean (SEM) (<span class="html-italic">n</span> = 4 for each group). 11β-HSD1 and CMS main effects as well as interactions were determined. * <span class="html-italic">p</span> &lt; 0.05; ** <span class="html-italic">p</span> &lt; 0.01.</p>
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<p>Representative results from APP processing pathways. Relative gene expression of <span class="html-italic">Adam10</span> (<b>A</b>), <span class="html-italic">Bace1</span> (<b>B</b>), <span class="html-italic">Aβ-precursor</span> (<b>C</b>), and <span class="html-italic">Neprilisin12</span> (<b>D</b>). Gene expression levels were determined by real-time PCR. Values are mean ± standard error of the mean (SEM) (<span class="html-italic">n</span> = 6 for each group). 11β-HSD1 and CMS main effects as well as interactions were determined. * <span class="html-italic">p</span> &lt; 0.05; ** <span class="html-italic">p</span> &lt; 0.01.</p>
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<p>Representative results from neuroplasticity modulators. Relative gene expression of <span class="html-italic">Creb</span> (<b>A</b>). Representative Western blot for the ratio of p-CREB protein levels and quantification (<b>B</b>), PSD95 protein levels and quantification (<b>C</b>), and synaptophysin protein levels and quantification (<b>D</b>). Gene expression levels were determined by real-time PCR. Western blot values in bar graphs are adjusted to 100% for protein levels of SAMP8 Control (Control). Values are mean ± standard error of the mean (SEM) (<span class="html-italic">n</span> = 6 for each group). 11β-HSD1 and CMS main effects as well as interactions were determined. * <span class="html-italic">p</span> &lt; 0.05; ** <span class="html-italic">p</span> &lt; 0.01; **** <span class="html-italic">p</span> &lt; 0.0001.</p>
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<p>Behavioral test results from NORT and MWM respectively. Summary of DI from 2 and 24 h after familiarization phase (<b>A</b>,<b>B</b>), MWM learning curve (<b>C</b>), distance to reach the platform (<b>D</b>), number of entries (<b>E</b>), and time in the platform (<b>F</b>). Values are mean ± standard error of the mean (SEM) (<span class="html-italic">n</span> = 12 for each group). 11β-HSD1 and CMS main effects as well as interactions were determined. * <span class="html-italic">p</span> &lt; 0.05; **** <span class="html-italic">p</span> &lt; 0.0001.</p>
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<p>Representative scheme of the molecular pathways altered after RL-118 treatment in SAMP8 mice under chronic mild stress. Authors should discuss the results and how they can be interpreted from the perspective of previous studies and of the working hypotheses. The findings and their implications should be discussed in the broadest context possible. Future research directions may also be highlighted.</p>
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12 pages, 1149 KiB  
Systematic Review
Somatostatin Analogue Therapy in MEN1-Related Pancreatic Neuroendocrine Tumors from Evidence to Clinical Practice: A Systematic Review
by Anna La Salvia, Franz Sesti, Chiara Grinzato, Rossella Mazzilli, Maria Grazia Tarsitano, Elisa Giannetta and Antongiulio Faggiano
Pharmaceuticals 2021, 14(10), 1039; https://doi.org/10.3390/ph14101039 - 12 Oct 2021
Cited by 7 | Viewed by 3140
Abstract
Neuroendocrine neoplasms (NENs) are relatively rare and complex tumors that can be sporadic or hereditary, as in the context of multiple endocrine neoplasia type 1 (MEN1) where patients display a 70% lifelong risk of developing a pancreatic NENs (pNENs). To date, specific personalized [...] Read more.
Neuroendocrine neoplasms (NENs) are relatively rare and complex tumors that can be sporadic or hereditary, as in the context of multiple endocrine neoplasia type 1 (MEN1) where patients display a 70% lifelong risk of developing a pancreatic NENs (pNENs). To date, specific personalized treatment for pNENs in patients with MEN1 are lacking. The aim of this study was to systematically analyze the efficacy and safety of somatostatin analogue (SSA) treatment in patients affected by MEN1-related pNENs. We performed a systematic review of the literature, searching for peer-reviewed articles on SSA (octreotide or lanreotide) treatment in MEN1 associated with pNENs. We selected 20 studies with a pooled population of 105 MEN1 patients with pNENs. Females were 58.5%, median age was 44 years (18–73). TNM stage at diagnosis was stage I–II in 84.8% and stage IV in 15.2%. The overall response rate (SD+PR+CR) was achieved in 88.3% of cases, with stable disease in 75.6% and objective response in 12.7% of patients. The safety profile was favorable with both SSA agents. SSAs appear to be an effective and safe treatment option for MEN1-related pNEN, either at localized or advanced stages. Full article
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<p>PRISMA flow diagram.</p>
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<p>Hot topic: pNENs in MEN1 patients (abbreviations: MEN1 = multiple endocrine neoplasia type 1; pNEN = pancreatic neuroendocrine neoplasm; SSAs = somatostatin analogues).</p>
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<p>Mechanism of action of SSA in patients with MEN-1. Abbreviations: AKT, protein kinase B; cAMP, cyclic adenosine monophosphate; Erk, extracellular signal-regulated kinase; Ca<sup>2+</sup>, calcium; K+, potassium; MEK, mitogen-activated extracellular signal-regulated kinase; mTOR, mammalian target of rapamycin; PI3K, phosphoinositide 3-kinase; Src, proto-oncogene tyrosine protein kinase Src; SSA, somatostatin analogue; SSTR, somatostatin receptors; TSC, tuberous sclerosis complex.</p>
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19 pages, 5042 KiB  
Article
Engineered Bacteriophage as a Delivery Vehicle for Antibacterial Protein, SASP
by James Cass, Anne Barnard and Heather Fairhead
Pharmaceuticals 2021, 14(10), 1038; https://doi.org/10.3390/ph14101038 - 12 Oct 2021
Cited by 13 | Viewed by 3749
Abstract
The difficulties in developing novel classes of antibacterials is leading to a resurgence of interest in bacteriophages as therapeutic agents, and in particular engineered phages that can be optimally designed. Here, pre-clinical microbiology assessment is presented of a Staphylococcus aureus phage engineered to [...] Read more.
The difficulties in developing novel classes of antibacterials is leading to a resurgence of interest in bacteriophages as therapeutic agents, and in particular engineered phages that can be optimally designed. Here, pre-clinical microbiology assessment is presented of a Staphylococcus aureus phage engineered to deliver a gene encoding an antibacterial small acid soluble spore protein (SASP) and further, rendered non-lytic to give product SASPject PT1.2. PT1.2 has been developed initially for nasal decolonisation of S. aureus, including methicillin-resistant S. aureus. Time-kill curve assays were conducted with PT1.2 against a range of staphylococcal species, and serial passaging experiments were conducted to investigate the potential for resistance to develop. SASPject PT1.2 demonstrates activity against 100% of 225 geographically diverse S. aureus isolates, exquisite specificity for S. aureus, and a rapid speed of kill. The kinetics of S. aureus/PT1.2 interaction is examined together with demonstrating that PT1.2 activity is unaffected by the presence of human serum albumin. SASPject PT1.2 shows a low propensity for resistance to develop with no consistent shift in sensitivity in S. aureus cells passaged for up to 42 days. SASPject PT1.2 shows promise as a novel first-in-class antibacterial agent and demonstrates potential for the SASPject platform. Full article
(This article belongs to the Special Issue Bacteriophages as Therapeutic Delivery Vehicles)
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<p>Mechanism of action of SASPject PT1.2 and SASP.</p>
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<p>Modification of phi11 genome (<b>A</b>) showing holin and amidase genes (<b>B</b>) and creation of SASPject PT1.2 by deletion of holin gene and promoter driving holin and amidase genes by insertion of SASP-C gene under the control of native <span class="html-italic">S. aureus</span> promoter, <span class="html-italic">fbaA</span> and, selectable marker, cadmium resistance gene (<b>C</b>). Phi11 genome visualized using CGView [<a href="#B21-pharmaceuticals-14-01038" class="html-bibr">21</a>].</p>
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<p>Time-kill curve assay showing efficacy of SASPject PT1.2 in mixed <span class="html-italic">S. aureus</span> MSSA/MRSA (strains 100085/88048 respectively) cultures. Viable cells counts are shown for the strain written in bold letters. Results of a representative experiment are shown.</p>
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<p>Time-kill curve assay showing efficacy of SASPject PT1.2 in mixed <span class="html-italic">S. aureus</span> MSSA/MRSA (strains 100085/17046 respectively) cultures. Viable cells counts are shown for the strain written in bold letters. Results of a representative experiment are shown.</p>
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<p>Time-kill curve assay showing efficacy of SASPject PT1.2 in mixed cultures of MRSA strain 88048 and <span class="html-italic">S. epidermidis</span> 7,020 (abbreviated to “S.e.” in the chart legend). Viable cell counts are shown for the strain written in bold letters. Results of a representative experiment are shown.</p>
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<p>Time-kill curve assay showing efficacy of SASPject PT1.2 in mixed cultures of MRSA and <span class="html-italic">S. haemolyticus</span> 133034 (abbreviated to “S.h.” in the chart legend). Viable cell counts are shown for the strain written in bold letters. Results of a representative experiment are shown.</p>
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<p>Time-kill curve assay of SASPject PT1.2 activity against <span class="html-italic">S. aureus</span> USA 300 over 1 h. Results of a representative experiment are shown.</p>
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<p>Time-kill curve analysis of SASPject PT1.2 activity, at concentrations ranging 10<sup>6</sup> to 10<sup>8</sup> pfu/mL, against EMRSA-15 strain 02ST4127 treated over 24 h. Data plotted are the means of 2 or 3 (10<sup>7</sup> pfu/mL only) replicates. Error bars represent 1 standard deviation.</p>
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<p>Time-kill curve analysis of SASPject PT1.2 activity against EMRSA-15 strain 02ST4127, at viable cell concentrations of 10<sup>3</sup>, 10<sup>5</sup>, and 10<sup>7</sup> cfu/mL, over 6 h. The means of duplicate samples are plotted. Error bars represent 1 standard deviation.</p>
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<p>Time-kill curve assay showing the efficacy of SASPject PT1.2 against <span class="html-italic">S. aureus</span> MRSA USA300 and EMRSA-16 in the presence and absence of human serum albumin (HSA) at 50 g/L. Data points represent the mean of 2 replicates and error bars represent 1 standard deviation.</p>
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<p>Assessment of resistance development in serially passaged EMRSA strain O2ST4285 by time-kill curve assay of cells from passage day 52 (3 and 6 × 10<sup>4</sup> pfu/mL passaged cultures) and passage day 46 (1.5 × 10<sup>4</sup> pfu/mL passaged cultures) exposed to SASPject PT1.2. Passaging was carried out in triplicate, and time-kill curve assays were carried out in singlicate on each of the triplicate cultures. Cells that were passaged in singlicate in the absence of PT1.2 for 52 days were exposed to PT1.2 as a control (Control). The mean number of viable cells for each passaging condition following time-kill curve assay with PT1.2 is plotted. Error bars for the passaged conditions represent 1 standard deviation.</p>
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<p>Assessment of resistance development in serially passaged MRSA USA300 by exposing passaged cells to PT1.2 at passage days 7, 14, and 21, and incubating with PT1.2 for 4 h before assessing viable cell count. Triplicate cultures were set up for each of the phage concentrations, and each culture was assessed via the kill experiment in singlicate. Results shown are the mean viable cell counts for the three cultures passaged with each PT1.2 concentration, following kill experiment analysis. Error bars represent 1 standard deviation. The control was MRSA USA300 simultaneously passaged for the same lengths of time in the absence of PT1.2, prior to assessment of viable cell count after exposure to PT1.2 for 4 h.</p>
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17 pages, 2861 KiB  
Article
Thermodynamic Study of Oxidovanadium(IV) with Kojic Acid Derivatives: A Multi-Technique Approach
by Rosita Cappai, Guido Crisponi, Daniele Sanna, Valeria Ugone, Andrea Melchior, Eugenio Garribba, Massimiliano Peana, Maria Antonietta Zoroddu and Valeria Marina Nurchi
Pharmaceuticals 2021, 14(10), 1037; https://doi.org/10.3390/ph14101037 - 12 Oct 2021
Cited by 6 | Viewed by 2612
Abstract
The good chelating properties of hydroxypyrone (HPO) derivatives towards oxidovanadium(IV) cation, VIVO2+, constitute the precondition for the development of new insulin-mimetic and anticancer compounds. In the present work, we examined the VIVO2+ complex formation equilibria of [...] Read more.
The good chelating properties of hydroxypyrone (HPO) derivatives towards oxidovanadium(IV) cation, VIVO2+, constitute the precondition for the development of new insulin-mimetic and anticancer compounds. In the present work, we examined the VIVO2+ complex formation equilibria of two kojic acid (KA) derivatives, L4 and L9, structurally constituted by two kojic acid units linked in position 6 through methylene diamine and diethyl-ethylenediamine, respectively. These chemical systems have been characterized in solution by the combined use of various complementary techniques, as UV-vis spectrophotometry, potentiometry, NMR and EPR spectroscopy, ESI-MS spectrometry, and DFT calculations. The thermodynamic approach allowed proposing a chemical coordination model and the calculation of the complex formation constants. Both ligands L4 and L9 form 1:1 binuclear complexes at acidic and physiological pHs, with various protonation degrees in which two KA units coordinate each VIVO2+ ion. The joined use of different techniques allowed reaching a coherent vision of the complexation models of the two ligands toward oxidovanadium(IV) ion in aqueous solution. The high stability of the formed species and the binuclear structure may favor their biological action, and represent a good starting point toward the design of new pharmacologically active vanadium species. Full article
(This article belongs to the Special Issue Applications of Medicinal Bioinorganic Chemistry)
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<p>Molecular structure of L4 and L9 ligands.</p>
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<p>Speciation plots of V<sup>IV</sup>O<sup>2+</sup>-ligand systems (L4 on the left and L9 on the right), calculated with Hyss program [<a href="#B55-pharmaceuticals-14-01037" class="html-bibr">55</a>]. Top: conditions of spectrophotometric titrations, 1:1 V<sup>IV</sup>O<sup>2+</sup>:ligand molar ratio at ligand concentration 3 × 10<sup>−4</sup> M. Bottom: conditions of EPR measurements 1:2 V<sup>IV</sup>O<sup>2+</sup>:ligand molar ratio at ligand concentration 4 mM. V stands for V<sup>IV</sup>O<sup>2+</sup>, and L for L4 or L9; charges are omitted for simplicity.</p>
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<p>Representative spectra of V<sup>IV</sup>O<sup>2+</sup>-L4 (<b>A</b>) and V<sup>IV</sup>O<sup>2+</sup>-L9 (<b>B</b>) both at 1:1 molar ratio collected between 200 and 400 nm, l = 0.2 cm at 25 °C, 0.1 M NaCl ionic strength and ligand concentration 3 × 10<sup>−4</sup> M.</p>
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<p>ESI-MS(+) spectrum recorded on the system V<sup>IV</sup>O<sup>2+</sup>-L4 at 1:1 molar ratio (top) and ESI-MS(+) spectrum recorded on the system V<sup>IV</sup>O<sup>2+</sup>-L9 (bottom) at 1:1 molar ratio (LC-MS H<sub>2</sub>O, ligand concentration 50 µM).</p>
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<p>High-field region of the anisotropic X-band EPR spectra recorded on frozen solutions (120 K) of V<sup>IV</sup>O<sup>2+</sup>-L9 system at 1:1 (<b>A</b>) and 1:2 (<b>B</b>) molar ratio at V<sup>IV</sup>O<sup>2+</sup> concentration 2 mM at different pH.</p>
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<p>High-field region of the anisotropic X-band EPR spectra recorded on frozen solutions (120 K) of V<sup>IV</sup>O<sup>2+</sup>-L4 at 1:2 molar ratio and V<sup>IV</sup>O<sup>2+</sup> concentration 2 mM at different pH.</p>
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<p>1D <sup>1</sup>H NMR spectra of L4-V<sup>IV</sup>O<sup>2+</sup> system in D<sub>2</sub>O at different molar ratios.</p>
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<p>1D <sup>1</sup>H NMR spectra of L9-V<sup>IV</sup>O<sup>2+</sup> system in MeOD at different L9:V<sup>IV</sup>O<sup>2+</sup> ratios.</p>
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<p>Comparison of 2D <sup>1</sup>H-<sup>1</sup>H NMR COSY spectra of L9 free (blue) and L9-V<sup>IV</sup>O<sup>2+</sup> (red) systems in MeOD solution.</p>
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<p>DFT optimized structure of [(V<sup>IV</sup>O)<sub>2</sub>(L4)<sub>2</sub>(H<sub>2</sub>O)<sub>2</sub>]. The V<b>⋯</b>V distance is 8.88 Å. The two V<sup>IV</sup>O<sup>2+</sup> centers are indicated with <b>1</b> and <b>2</b>. The hydrogen atoms are omitted for clarity.</p>
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<p>Experimental (top) and simulated (bottom) EPR spectrum of [(V<sup>IV</sup>O)<sub>2</sub>(L4)<sub>2</sub>(H<sub>2</sub>O)<sub>2</sub>] (V<sup>IV</sup>O<sup>2+</sup>-L4 1:1, V<sup>IV</sup>O<sup>2+</sup> concentration 1 mM, pH 5.1). The spectrum was simulated with EasySpin software, considering two V<sup>IV</sup>O ions with S = 1/2 coupled with <span class="html-italic">J</span> = 0.11 cm<sup>−1</sup>. For each V<sup>IV</sup> center g<sub>x,y,z</sub> = {1.979, 1.979, 1.943} and A<sub>x,y,z</sub>= {52.5, 52.5, 170.1} × 10<sup>−4</sup> cm<sup>−1</sup> were used. Gaussian and Lorentzian broadening were set to 1.4 and 1.4 mT.</p>
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10 pages, 1097 KiB  
Article
Folium Sennae Increased the Bioavailability of Methotrexate through Modulation on MRP 2 and BCRP
by Chung-Ping Yu, Yu-Hsuan Peng, Ching-Ya Huang, Yow-Wen Hsieh, Yu-Chi Hou and Shiuan-Pey Lin
Pharmaceuticals 2021, 14(10), 1036; https://doi.org/10.3390/ph14101036 - 12 Oct 2021
Cited by 3 | Viewed by 2393
Abstract
Folium Sennae (FS), a popular laxative (Senna), contains polyphenolic anthranoids, whose conjugation metabolites are probable modulators of multidrug resistance-associated proteins (MRPs) and breast cancer resistance protein (BCRP). We suspected that the combined use of FS might alter the pharmacokinetics of various medicines transported [...] Read more.
Folium Sennae (FS), a popular laxative (Senna), contains polyphenolic anthranoids, whose conjugation metabolites are probable modulators of multidrug resistance-associated proteins (MRPs) and breast cancer resistance protein (BCRP). We suspected that the combined use of FS might alter the pharmacokinetics of various medicines transported by MRPs or BCRP. This study investigated the effect of FS on the pharmacokinetics of methotrexate (MTX), an anticancer drug and a probe substrate of MRPs/BCRP. Rats were orally administered MTX alone and with two dosage regimens of FS in a parallel design. The results show that 5.0 g/kg of FS significantly increased the AUC0–2880, AUC720–2880 and MRT of MTX by 45%, 102% and 42%, and the seventh dose of 2.5 g/kg of FS significantly enhanced the AUC720–2880 and MRT by 78% and 42%, respectively. Mechanism studies indicated that the metabolites of FS (FSM) inhibited MRP 2 and BCRP. In conclusion, the combined use of FS increased the systemic exposure and MRT of MTX through inhibition on MRP 2 and BCRP. Full article
(This article belongs to the Section Pharmacology)
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<p>Mean (±S.E.) serum concentration-time profiles of MTX after oral MTX alone (5.0 mg/kg, ○) and with single dose of FS (5 g/kg, ●), and the 7<sup>th</sup> dose of FS (2.5 g/kg, ▼) (<span class="html-italic">n</span> = 5 in each group).</p>
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<p>Effects of FS (1.0 and 2.5 mg/mL) and Ko143 (0.5 μM) on the intracellular accumulation of MXR in MDCKII-BCRP cells. ** <span class="html-italic">p</span> &lt; 0.01 and *** <span class="html-italic">p</span> &lt; 0.001.</p>
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<p>Effects of FSM (1/4 and 1/2-fold serum concentrations), rhein (R, μM) and Ko143 (0.5 μM) on the intracellular accumulation of MXR in MDCKII-BCRP cells. * <span class="html-italic">p</span> &lt; 0.05 and ** <span class="html-italic">p</span> &lt; 0.01.</p>
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<p>Effects of FSM at 1/4 and 1/2-fold serum concentrations, rhein (R, μM) and MK571 (10 μM) on the intracellular accumulation of GSMF in MDCK II cells. ** <span class="html-italic">p</span> &lt; 0.01 and *** <span class="html-italic">p</span> &lt; 0.001.</p>
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20 pages, 13804 KiB  
Article
Growth Inhibition of Triple-Negative Breast Cancer: The Role of Spatiotemporal Delivery of Neoadjuvant Doxorubicin and Cisplatin
by Dominick Salerno and Stavroula Sofou
Pharmaceuticals 2021, 14(10), 1035; https://doi.org/10.3390/ph14101035 - 12 Oct 2021
Cited by 2 | Viewed by 2669
Abstract
Combinations of platinum-based compounds with doxorubicin in free and/or in liposomal form for improved safety are currently being evaluated in the neoadjuvant setting on patients with advanced triple-negative breast cancer (TNBC). However, TNBC may likely be driven by chemotherapy-resistant cells. Additionally, established TNBC [...] Read more.
Combinations of platinum-based compounds with doxorubicin in free and/or in liposomal form for improved safety are currently being evaluated in the neoadjuvant setting on patients with advanced triple-negative breast cancer (TNBC). However, TNBC may likely be driven by chemotherapy-resistant cells. Additionally, established TNBC tumors may also exhibit diffusion-limited transport, resulting in heterogeneous intratumoral delivery of the administered therapeutics; this limits therapeutic efficacy in vivo. We studied TNBC cells with variable chemosensitivities, in the absence (on monolayers) and presence (in 3D multicellular spheroids) of transport barriers; we compared the combined killing effect of free doxorubicin and free cisplatin to the killing effect (1) of conventional liposomal forms of the two chemotherapeutics, and (2) of tumor-responsive lipid nanoparticles (NP), specifically engineered to result in more uniform spatiotemporal microdistributions of the agents within solid tumors. This was enabled by the NP properties of interstitial release, cell binding/internalization, and/or adhesion to the tumors’ extracellular matrix. The synergistic cell kill by combinations of the agents (in all forms), compared to the killing effect of each agent alone, was validated on monolayers of cells. Especially for spheroids formed by cells exhibiting resistance to doxorubicin combination treatments with both agents in free and/or in tumor-responsive NP-forms were comparably effective; we not only observed greater inhibition of outgrowth compared to the single agent(s) but also compared to the conventional liposome forms of the combined agents. We correlated this finding to more uniform spatiotemporal microdistributions of agents by the tumor-responsive NP. Our study shows that combinations of NP with properties specifically optimized to improve the spatiotemporal uniformity of the delivery of their corresponding therapeutic cargo can improve treatment efficacy while keeping favorable safety profiles. Full article
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<p>Illustration depicting the properties of NP types. Conventional non-responsive NP (conventional liposomes) retain their contents both in circulation and at the tumor site. Responsive DXR-NP were designed to release their contents only in the acidic tumor interstitium, as well as to form patches of HER2 targeting peptide-ligands (blue triangles) that allow for the targeting of single HER2 receptors on TNBC cells. Responsive CDDP-NP were similarly designed to retain their contents and to exhibit neutral charge in circulation at neutral pH, but when exposed to the decreased pH in the acidic tumor interstitium, to release their contents and gain a positive charge on the free ends of PEG chains, allowing them to adhere to the negatively charged tumor extracellular matrix (ECM) slowing their clearance from tumors. Nanoparticles—NP; cisplatin—CDDP; doxorubicin—DXR; triple-negative breast cancer—TNBC.</p>
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<p>(<b>A</b>–<b>D</b>). MDA-MB-231 and DXR-Res-231 cell lines. Concentrations of free agents alone and in combination required to kill 50% of cell population (IC<sub>50</sub>), of free DXR and free CDDP introduced alone and in combination on MDA-MB-231 (<b>A</b>,<b>B</b>) and the DXR-resistant DXR-Res-231 (<b>C</b>,<b>D</b>) cell lines at pH 7.4 (left column; (<b>A</b>,<b>C</b>)) and pH 6.5 (right column; (<b>B</b>,<b>D</b>)) across a range of different CDDP–DXR mass ratios following a 6 h incubation. The dotted lines serve as guide to the eye connecting the single-agent IC<sub>50</sub> values and illustrate a purely additive relationship between the two agents. If a point falls above (below) this line, it indicates antagonism (synergism) between the two agents. Error bars correspond to standard deviation of <span class="html-italic">n</span> = 3 independent measurements (<b>E</b>,<b>F</b>). Combination Index (CI) of free DXR and free CDDP on MDA-MB-231 (filled symbols) and DXR-Res-231 cell lines (open symbols) at extracellular pH 7.4 (<b>E</b>) and pH 6.5 (<b>F</b>). The CI is defined as the sum of the normalized IC<sub>50</sub> values at each ratio CI = ((IC<sub>50</sub> of free CDDP in combination treatment)/(IC<sub>50</sub> of free CDDP alone)) + ((IC<sub>50</sub> of free DXR in combination treatment)/(IC<sub>50</sub> of free DXR alone)). The horizontal dashed line connects the single-agent combination indices (defined as CI = 1) and illustrates a purely additive relationship between the two agents. If the CI is greater (lower) than 1, it indicates antagonism (synergism) between the two agents. Lines connecting the data points serve as guides to the eye. Error bars correspond to standard deviation of <span class="html-italic">n</span> = 3 independent measurements.</p>
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<p>(<b>A</b>–<b>D</b>). MDA-MB-231 and DXR-Res-231 cell lines. Concentrations of agents delivered by responsive NP alone and in combination required to kill 50% of cell population (IC<sub>50</sub>), of responsive DXR-NP and of responsive CDDP-NP given in combination on MDA-MB-231 (<b>A</b>,<b>B</b>) and DXR-Res-231 (<b>C</b>,<b>D</b>) cell lines at pH 7.4 (left column; (<b>A</b>,<b>C</b>)) and pH 6.5 (right column; (<b>B</b>,<b>D</b>)) across a range of different encapsulated CDDP–DXR mass ratios following a 6 h incubation. The dotted lines serve as guide to the eye connecting the single-agent IC<sub>50</sub> values and illustrate a purely additive relationship between the two therapeutics. If a point falls above (below) this line, it indicates antagonism (synergism) between the two agents. Error bars correspond to standard deviation of <span class="html-italic">n</span> = 3 independent measurements. (<b>E</b>,<b>F</b>) Combination Index (CI) of DXR- and CDDP-responsive NP on MDA-MB-231 (filled symbols) and DXR-Res-231 (open symbols) cell lines. The CI is defined as the sum of the normalized IC<sub>50</sub> values at each ratio CI = ((IC<sub>50</sub> of responsive CDDP-NP in combination treatment)/(IC<sub>50</sub> of responsive CDDP-NP alone)) + ((IC<sub>50</sub> of responsive DXR-NP in combination treatment)/(IC<sub>50</sub> of responsive DXR-NP alone)). The horizontal dashed line connects the single-agent combination indices (defined as CI = 1) and illustrates a purely additive relationship between the two agents. If the CI is greater (lower) than 1, it indicates antagonism (synergism) between the two agents. Lines connecting the data points serve as guides to the eye. Error bars correspond to the standard deviation of <span class="html-italic">n</span> = 3 independent.</p>
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<p>(<b>A</b>–<b>D</b>). MDA-MB-231 cell line. Concentrations of agents delivered by non-responsive NP compared to the concentrations of same agents delivered by responsive NP, alone and in combination, required to kill 50% of cell population (IC<sub>50</sub>). DXR and CDDP delivered by non-responsive NP (<b>A</b>,<b>B</b>), and DXR and CDDP delivered by responsive NP (<b>C</b>,<b>D</b>) given in combination on the MDA-MB-231 cell line at pH 7.4 (left column; (<b>A</b>,<b>C</b>)) and pH 6.5 (right column; (<b>B</b>,<b>D</b>)) across a range of different mass ratios of encapsulated CDDP–DXR. The dotted lines serve as guide to the eye connecting the single drug IC<sub>50</sub> values and illustrate a purely additive relationship between the two therapeutics. If a point falls above (below) this line, it indicates antagonism (synergism) between the two agents. Error bars correspond to standard deviation of <span class="html-italic">n</span> = 3 independent measurements. (<b>E</b>,<b>F</b>). Combination Index (CI) of DXR- and CDDP-non-responsive NP on MDA-MB-231 cell line. The CI is defined as the sum of the normalized IC<sub>50</sub> values at each ratio CI = ((IC<sub>50</sub> of non-responsive CDDP-NP in combination treatment)/(IC<sub>50</sub> of non-responsive CDDP-NP alone)) + ((IC<sub>50</sub> of non-responsive DXR-NP in combination treatment)/(IC<sub>50</sub> of non-responsive DXR-NP alone)). The horizontal dashed line connects the single-agent combination indices (defined as CI = 1) and illustrates a purely additive relationship between the two agents. If the CI is greater (lower) than 1, it indicates antagonism (synergism) between the two agents. Lines connecting the data points serve as guides to the eye. Error bars correspond to standard deviation of <span class="html-italic">n</span> = 2 independent measurements.</p>
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<p>Extent of inhibiting spheroid outgrowth by agents in combination and as a single treatment. Spheroids formed by MDA-MB-231 cells (<b>A</b>) and by the doxorubicin-resistant DXR-Res-231 cells (<b>B</b>) were treated with 18 or 4.5 µg/mL CDDP combined with 18 or 4.5 µg/mL DXR (1:1, blue bars), respectively. The spheroid outgrowth by the combined treatments was compared to the outgrowth by the corresponding single treatments (<b>C</b>,<b>D</b>) of 18 or 4.5 µg/mL CDDP (1:0, black bars) and/or 18 or 4.5 µg/mL DXR (0:1, grey bars), respectively, in free and/or NP-form as indicated on the plot. Arrows indicate the treatment schedule: spheroids were incubated with free CDDP for one hour, with free DXR for 20 min, and with all NP forms for 24 h, to model their representative blood clearance kinetics as discussed in the main text. Error bars correspond to standard deviation of <span class="html-italic">n</span> = 3 independent measurements (<span class="html-italic">n</span> = 6 spheroids per measurement). * indicates <span class="html-italic">p</span>-values &lt; 0.05, ** <span class="html-italic">p</span>-values &lt; 0.01.</p>
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<p>(<b>A</b>) Spatiotemporal profiles of the fluorescent drug surrogate CFDA-SE delivered by different NP forms. CFDA-SE was treated as a surrogate of CDDP and of DXR and was loaded in the corresponding responsive and non-responsive NP; compositions for responsive CDDP-NP (black symbols), for responsive DXR-NP (grey symbols), and for non-responsive NP (white symbols). The time-integrated radial concentrations were calculated using the trapezoid rule that integrated the radial spatial microdistributions shown in <a href="#app1-pharmaceuticals-14-01035" class="html-app">Supplemental Figures S12 and S13</a>. Error bars correspond to the standard deviation of <span class="html-italic">n</span> = 3 spheroids per sampled time point. (<b>B</b>) Snapshots of the spatial microdistributions of the fluorescent drug surrogate CFDA-SE in spheroids in free and/or in NP form. Microdistributions of CFDA-SE (used as a surrogate for CDDP and for DXR) in different forms (free and/or in NP) at the relevant end time points of incubation for each form that was scaled to the agents’ blood circulation times. Error bars correspond to standard deviation of <span class="html-italic">n</span> = 3 spheroids.</p>
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11 pages, 1994 KiB  
Article
The Extract of Corydalis yanhusuo Prevents Morphine Tolerance and Dependence
by Lamees Alhassen, Khawla Nuseir, Allyssa Ha, Warren Phan, Ilias Marmouzi, Shalini Shah and Olivier Civelli
Pharmaceuticals 2021, 14(10), 1034; https://doi.org/10.3390/ph14101034 - 12 Oct 2021
Cited by 9 | Viewed by 9833
Abstract
The opioid epidemic was triggered by an overprescription of opioid analgesics. In the treatment of chronic pain, repeated opioid administrations are required which ultimately lead to tolerance, physical dependence, and addiction. A possible way to overcome this conundrum consists of a co-medication that [...] Read more.
The opioid epidemic was triggered by an overprescription of opioid analgesics. In the treatment of chronic pain, repeated opioid administrations are required which ultimately lead to tolerance, physical dependence, and addiction. A possible way to overcome this conundrum consists of a co-medication that maintains the analgesic benefits of opioids while preventing their adverse liabilities. YHS, the extract of the plant Corydalis yanhusuo, has been used as analgesic in traditional Chinese medicine for centuries. More recently, it has been shown to promote analgesia in animal models of acute, inflammatory, and neuropathic pain. It acts, at least in part, by inhibiting the dopamine D2 receptor, suggesting that it may be advantageous to manage addiction. We first show that, in animals, YHS can increase the efficacy of morphine antinociceptive and, as such, decrease the need of the opioid. We then show that YHS, when coadministered with morphine, inhibits morphine tolerance, dependence, and addiction. Finally, we show that, in animals treated for several days with morphine, YHS can reverse morphine dependence and addiction. Together, these data indicate that YHS may be useful as a co-medication in morphine therapies to limit adverse morphine effects. Because YHS is readily available and safe, it may have an immediate positive impact to curb the opioid epidemic. Full article
(This article belongs to the Section Natural Products)
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<p>YHS increases morphine antinociception. <b>A:</b> Foot withdrawal latency (FWL) of mice injected with saline, morphine (2.5 mg/kg), YHS (250 mg/kg), or the combination of morphine and YHS (2.5 mg and 250 mg/kg, respectively) at 30, 60, and 120 min after i.p. administration (n = 10). The black dots correlate to the number of animals used in each experiment. Two-way ANOVA revealed significant drug effects F (3, 288) = 332.8 <span class="html-italic">p</span> &lt; 0.0001, time effect F (4, 288) = 217.5 <span class="html-italic">p</span> &lt; 0.0001, and drug x interaction time F (12, 288) = 55.29 <span class="html-italic">p</span> &lt; 0.0001, followed by Tukey’s multiple comparison test *** <span class="html-italic">p</span> &lt; 0.001 compared with M2.5 mg/kg, <span>$</span><span>$</span><span>$</span> <span class="html-italic">p</span> &lt; 0.0001 compared with saline, ### <span class="html-italic">p</span> &lt; 0.0001 compared with M5 mg/kg. <b>B:</b> FWL at 30 min after morphine (2.5 mg/kg, 5 mg/kg, 10 mg/kg), YHS (125 mg/kg, 250 mg/kg, 500 mg/kg),or morphine + YHS (n = 9–10) i.p. administration. One-way ANOVA revealed significant drug effects F = 247.2, <span class="html-italic">p</span> &lt; 0.0001, followed by Tukey’s multiple comparison test *** <span class="html-italic">p</span> &lt; 0.001 compared with saline, ## <span class="html-italic">p</span> &lt; 0.01, ### <span class="html-italic">p</span> &lt; 0.001 compared with M2.5 mg/kg. YHS prevents morphine tolerance.</p>
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<p>YHS inhibits morphine tolerance. <b>A:</b> FWL at 30 min after morphine 2.5 mg/kg (M2.5), YHS (250 mg/kg), and morphine +YHS (M2.5+YHS) (i.p. administration) over a period of 7 days (n = 7–11) to display tolerance. The black dots correlate to the number of animals used in each experiment. The gradient color for each figure shows the time-dependent change. One-way ANOVA followed by Tukey’s test revealed significant drug tolerance over 7 days F = 33.59, <span class="html-italic">p</span> &lt; 0.0001, D1 *** <span class="html-italic">p</span> &lt; 0.001 compared with D2-D7, D2 ### <span class="html-italic">p</span> &lt; 0.0001, ## <span class="html-italic">p</span> &lt; 0.01 compared with D4-D7, D3 <span>$</span><span>$</span> <span class="html-italic">p</span> &lt; 0.01, <span>$</span> <span class="html-italic">p</span> &lt; 0.05 compared with D6 and D7 in the morphine (2.5 mg/kg) group. One-way ANOVA followed by Tukey’s test revealed no significant drug tolerance over 7 days for YHS (250 mg/kg) group, D3 # <span class="html-italic">p</span> &lt; 0.05 compared with D7. One-way ANOVA followed by Tukey’s test revealed no significant drug tolerance over 7 days for the combination group. <b>B:</b> Comparison of FWL at day 1 and day 7 30 min after i.p. administration of morphine, YHS, and morphine + YHS (n = 10). Two-way ANOVA revealed significant tolerance amongst all morphine doses (2.5, 5, 10 mg/kg) F(9, 180) = 291.3 <span class="html-italic">p</span> &lt; 0.0001, followed by Tukey’s multiple comparison test, ### <span class="html-italic">p</span> &lt; 0.001. Two-way ANOVA revealed significant analgesic effects between saline and all other groups on Day 1, F(9, 180) = 291.3 followed by Tukey’s multiple comparison test *** <span class="html-italic">p</span> &lt; 0.001 compared with saline, <span class="html-italic">p</span> &lt; 0.05 compared with saline. YHS prevents morphine dependence.</p>
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<p>YHS inhibits morphine physical dependence after i.p. administration. Jumping, writhing, head shakes, genital licking, body grooming, face wiping, teeth chattering, dysphoria, rearing, chewing, diarrhea, and sniffing after naloxone injection (n = 8). One-way ANOVA revealed significant percentage of jumping, writhing, head shakes, genital licking, body grooming, face wiping, teeth chattering, dysphoria, rearing, chewing, and diarrhea in both morphine groups, F = 65.51 <span class="html-italic">p</span> &lt; 0.0001, followed by Tukey’s multiple comparison test M2.5 *** <span class="html-italic">p</span> &lt; 0.0001 compared with saline, M5, YHS 250, and M2.5YHS250; M5 ### <span class="html-italic">p</span> &lt; 0.0001 compared with saline, M2.5, YHS 250, and M2.5 YHS250. YHS inhibits the rewarding properties of morphine.</p>
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<p>Morphine-induced CPP is inhibited by YHS after i.p. administration. Preference scores calculated based on animal’s time spent in the drug-paired chamber vs. the non-drug-paired chamber during the pre- and post-preference periods (n = 8–11). The black dots correlate to the number of animals used in each experiment. One-way ANOVA revealed significant drug addiction in all morphine groups and a reduction in the combination groups F = 62.50 <span class="html-italic">p</span> &lt; 0.0001, followed by Tukey’s multiple comparison test, *** <span class="html-italic">p</span> &lt; 0.0001 compared with M2.5, M5, and M5 YHS250, ### <span class="html-italic">p</span> &lt; 0.0001 compared with M2.5, M5, and M5 YHS250, <span>$</span><span>$</span><span>$</span> <span class="html-italic">p</span> &lt; 0.0001 compared with M5 and M2.5 YHS 250. YHS reverses morphine tolerance and dependence.</p>
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<p>YHS reverses morphine tolerance. Analgesic response after 3 days (D) of Morphine, followed by 4 D of either YHS (250 mg/kg) or M2.5-M2.5+YHS (n = 10) (i.p. administration). Two-way ANOVA revealed significant drug effects F (6, 168) = 205.9 <span class="html-italic">p</span> &lt; 0.0001, followed by Tukey’s multiple comparison test, *** <span class="html-italic">p</span> &lt; 0.0001 M2.5 compared with M2.5-YHS and M2.5-M2.5-YHS on D4-7, <span>$</span><span>$</span><span>$</span> <span class="html-italic">p</span> &lt; 0.0001 compared M2.5-YHS with M2.5-M2.5-YHS on D4-7.</p>
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<p>YHS reverses morphine-induced CPP. CPP responses for the following groups: 14 days of Sal injections (Sal–Sal), 7 days of Sal followed by 7 days of M2.5 injections (Sal-M2.5), 14 days of M2.5 injections (M2.5-M2.5), 7 days of M2.5 followed by 7 days of YHS (250 mg/kg) or M2.5-YHS injections (i.p. administration). (n = 7–11). The black dots correlate to the number of animals used in each experiment. One-way ANOVA revealed significant drug preference F = 8.131 <span class="html-italic">p</span> &lt; 0.0001, followed by Tukey’s multiple comparison test, *** <span class="html-italic">p</span> &lt; 0.0001 compared with Sal and M2.5-YHS, <span>$</span><span>$</span><span>$</span> <span class="html-italic">p</span> &lt; 0.0001 compared with Sal-Sal, M2.5-YHS, and M2.5-M2.5+YHS.</p>
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