A Convenient Synthesis of the Substituted 2,3-Diarylindole the Potent Selective COX-2 Inhibitors

Phenyl sulfone-containing 2, 3-diarylindole derivatives were designed and identified to be selective COX-2 inhibitors. A convenient synthetic route was also developed for the synthesis of the novel inhibitors.

Selective COX-2 inhibitor,NS-398,suppresses cellular proliferation in human hepatocellular carcinoma cell lines via cell cycle arrest

AIM: To investigate the growth inhibitory mechanism of NS-398, a selective cyclooxygenase-2 (COX-2) inhibitor, in two hepatocellular carcinoma (HCC) cell lines (HepG2 and Huh7). METHODS: HepG2 and Huh7 cells were treated with NS-398. Its effects on cell viability, cell proliferation, cell cycles, and gene expression were respectively evaluated by water-soluble tetrazolium salt (WST-1) assay, 4’-6-diamidino-2-phenylindole (DAPI) staining, flow cytometer analysis, and Western blotting, with dimethyl sulfoxide (DMSO) as positive control. RESULTS: NS-398 showed dose- and time-dependent growth-inhibitory effects on the two cell lines. Proliferating cell nuclear antigen (PCNA) expressions in HepG2 and Huh7 cells, particularly in Huh7 cells were inhibited in a time- and dose-independent manner. NS-398 caused cell cycle arrest in the G1 phase with cell accumulation in the sub-G1 phase in HepG2 and Huh7 cell lines. No evidence of apoptosis was observed in two cell lines. CONCLUSION: NS-398 reduces cell proliferation by inducing cell cycle arrest in HepG2 and Huh7 cell lines, and COX-2 inhibitors may have potent chemoprevention effects on human hepatocellular carcinoma.

Specific COX-2 inhibitor NS398 induces apoptosis in human liver cancer cell line HepG2 through BCL-2

AIM: To evaluate the effects of NS-398, a cyclooxygenase2 (COX-2) inhibitor, on the proliferation and apoptosis of HepG2 cells.METHODS: The effects of NS-398 on the proliferation of HepG2 cells were evaluated by MTT. DNA fragmentation gel analysis was used to analyze the apoptotic cells. DNA ploidy and apoptotic cell percentage were calculated by flow cytometry.The expression of COX-2 and Bcl-2 mRNA was identified by competitive RT-PCR. Furthermore, expression level of Bcl-2 was detected using Western blot in HepG2 after treated with NS-398.RESULTS: NS-398 inhibited cell proliferation and induced apoptosis of HepG2 cells in a concentration-dependent manner. DNA ploidy analysis showed that S phase cells were significantly decreased with increase of NS-398 concentration.The quiescent G0/G1 phase was accumulated with decrease of Bcl-2 mRNA. Whereas NS-398 had no effect on the expression of COX-2 mRNA, and no correlations were found between COX-2 mRNA and HepG2 cell proliferation and apoptosis induced by NS-398 (r = 0.056 and r= 0.119,respectively). Bcl-2 protein level was inhibited after treated with NS-398.CONCLUSION: NS-398 significantly inhibits the proliferation and induces apoptosis of HepG2 cells. Mechanisms involved may be accumulation of quiescent G0/G1 phase and decrease of Bcl-2 expression.

Anti-cancer effects of COX-2 inhibitors and their correlation wit angiogenesis and invasion in gastric cancer

AIM- To observe the anti-cancer effects of COX-2 inhibitors and investigate the relationship between COX-2 inhibitors and angiogenesis, infiltration or metastasis in SGC7901 cancer xenografts.METHODS: Thirty athymic mice xenograft models with human stomach cancer cell SGC7901 were established and divided randomly into 3 groups of 10 each. Sulindac, one non-specific COX inhibitor belonging to non-steroidal antiinflammatory drugs (a series of COX inhibitors known as NSAIDs) and celecoxib, one selective COX-2 inhibitor (known as SCIs) were orally administered to mice of treatment groups. Immunohistochemistry was used to examine the expression of PCNA, CD44v6 and microvessel density (MVD).Apoptosis was detected by using TUNEL assay.RESULTS: Tumors in sulindac and celecoxib groups were significantly smaller than those in control group from the second week after drug administration (P<0.01). In treatment group, the cell proliferation index was lower (P<0.05) and apoptosis index was higher (P<0.05) than those in control groups. Compared with the controls,microvessel density was reduced (P<0.01) and expression of CD44v6 on tumor cells was weakened (P<0.05) in treatment groups.CONCLUSION: COX-2 inhibitors have anticancer effects on gastric cancer. They play important roles in angiogenesis and infiltration or metastasis of stomach carcinoma. The anticancer effects of COX-2 inhibitors may include inducing apoptosis, suppressing proliferation, reducing angiogenesis and weakening invasiveness.

Clinical benefit of COX-2 inhibitors in the adjuvant chemotherapy of advanced non-small cell lung cancer: A systematic review and metaanalysis

BACKGROUND Lung cancer is a major cause of death among patients,and non-small cell lung cancer(NSCLC)accounts for more than 80%of all lung cancers in many countries.AIM To evaluate the clinical benefit(CB)of COX-2 inhibitors in patients with advanced NSCLC using systematic review.METHODS We searched the six electronic databases up until December 9,2019 for studies that examined the efficacy and safety of the addition of COX-2 inhibitors to chemotherapy for NSCLC.Overall survival(OS),progression free survival(PFS),1-year survival rate(SR),overall response rate(ORR),CB,complete response(CR),partial response(PR),stable disease(SD),and toxicities were measured with more than one outcome as their endpoints.Fixed and random effects models were used to calculate risk estimates in a meta-analysis.Potential publication bias was calculated using Egger’s linear regression test.Data analysis was performed using R software.RESULTS The COX-2 inhibitors combined with chemotherapy were not found to be more effective than chemotherapy alone in OS,progression free survival,1-year SR,CB,CR,and SD.However,there was a difference in overall response rate for patients with advanced NSCLC.In a subgroup analysis,significantly increased ORR results were found for celecoxib,rofecoxib,first-line treatment,and PR.For adverse events,the increase in COX-2 inhibitor was positively correlated with the increase in grade 3 and 4 toxicity of leukopenia,thrombocytopenia,and cardiovascular events.CONCLUSION COX-2 inhibitor combined with chemotherapy increased the total effective rate of advanced NSCLC with the possible increased risk of blood toxicity and cardiovascular events and had no effect on survival index.

Health Related Quality of Life among Osteoarthritis Patients: A Comparison of Traditional Non-Steroidal Anti-Inflammatory Drugs and Selective COX-2 Inhibitors in the United Arab Emirates Using the SF-36

Objectives: Osteoarthritis (OA) has a dramatic impact on patients’ health related quality of life (HRQoL). Chronic use of analgesics and anti-inflammatory medications for pain management may improve symptoms but on long term may affect HRQoL negatively. The objective of the present study was to compare the impact of two different classes of analgesics, traditional non-steroidal anti-inflammatory drugs (NSAIDs) and selective cyclo-oxygenase-2 (COX-2) inhibitors on HRQoL among osteoarthritis patients using the SF-36 questionnaire. Methods: Clinic based cross-sectional study conducted at Al-Qassimi Hospital, Sharjah, United Arab Emirates (UAE), over a period of six months. Ethical Approval was obtained from the ethics committee at Al-Qassimi Clinical Research Center. Total of 200 osteoarthritis patients fulfilling the inclusion and exclusion criteria were involved in the study. Patients’ demographics were collected from their medical records. The Medical Outcome Study Short-Form 36 (SF-36) questionnaire was used to measure patients’ HRQoL. SF-36 data were scored using health outcomes scoring software 4.5. Results: Mean age of the subjects was 62.19 ± 9.81 years with females constituting 151 (75.5%) of the patients. In general, females scored lower in most of the HRQoL domains compared to males and there was significant difference between the two groups in the mental health (p = 0.005) & mental component (p = 0.042) domains. Compared to selective COX-2 inhibitors, patients on NSAIDs scored higher on all domains of SF-36 except physical functioning. There was significant difference in mental health domain for patients treated with NSAIDs (p = 0.02). Celecoxib was only better than NSAIDs in osteoarthritis patients with more than one musculoskeletal disorders in the domain of bodily pain (p = 0.009). Conclusion: NSAIDs-treated patients did not differ significantly from celecoxib-treated patients in all domains of the SF-36 except for the mental health domain.

NSAIDs and the Gastrointestinal Tract： will COX-2 Inhibitors Make this a thing of the Past？

Aspirin has been marketed for just over 100 years and for, an evolving set of clinical indications, has been the world's first and most successful mass marketed pharmaceutical compound. However, by 1937 it was clear that aspirin could cause acute gastric erosions and chronic ulcers. Attempts to develop aspirin like compounds that would avoid of aspirin's topical toxicity did not result in avoidance of the same side effects. This is probably because aspirin and non-aspirin NSAIDs inhibit prostaglandin synthesis, a central component of both their therapeutic and toxic activity.

选择性COX-2抑制剂引起心血管风险的研究进展

非甾体抗炎药(non-steroid anti-inflammatory drugs,NSAIDs)是一种有效的、广泛使用的抗炎镇痛药物,其对环氧合酶(cyclo-oxygenase,COX)亚型(COX-1、COX-2)的抑制作用将引起不同的反应,选择性COX-2抑制剂将显著增加不良心血管事件的风险,随着此类药物使用的增加和临床循证证据的积累,其带来的心血管风险引起了越来越多学者的关注。笔者通过归纳分析最新发表文献对选择性COX-2抑制剂引起心血管风险的研究进行综述,以期辅助临床合理用药,减少不良反应,提高用药安全性。

次苷酸查尔酮对LPS诱导的RAW264.7细胞iNOS和COX-2表达的影响

补骨脂为豆科植物补骨脂(Psoraleacorylifolia L.)果实,具有温肾助阳、温脾止泻的功效[1],临床上被用于治疗皮肤病、肾炎、骨折等[2-3]。次苷酸查尔酮(corylifol A,CYA)是中药补骨脂的活性成分之一,是一种异黄酮类化合物,具有抗炎、抗菌、抗氧化、抗骨质疏松的特性[4-5]。有研究表明,CYA能明显抑制破骨细胞的分化,且能明显降低LPS诱导的巨噬细胞一氧化氮(NO)的生成[6-7]。

Enhanced macrophage polarization induced by COX-2 inhibitor-loaded Pd octahedral nanozymes for treatment of atherosclerosis

Inhibition of foam cell formation is considered a promising treatment method for atherosclerosis,the leading cause of cardiovascular diseases worldwide.However,currently available therapeutic strategies have shown unsatisfactory clinical outcomes.Thus,herein,we design aloperine(ALO)-loaded and hyaluronic acid(HA)-modified palladium(Pd)octahedral nanozymes(Pd@HA/ALO)that can synergistically scavenge reactive oxygen species(ROS)and downregulate cyclooxygenase-2(COX-2)expression to induce macrophage polarization,thus inhibiting foam cell formation to attenuate atherosclerosis.Due to the targeted effect of HA on stabilin-2 and CD44,which are overexpressed in atherosclerotic plaques,Pd@HA/ALO can actively accumulate in atherosclerotic plaques.Subsequently,the antioxidative effects of Pd octahedral nanozymes are mediated by their intrinsic superoxide dismutase-and catalase-like activities capable of effective scavenging of ROS.In addition,anti-inflammatory effects are mediated by controlled,on-demand near-infrared-triggered ALO release leading to inhibition of COX-2 expression.Importantly,the combined therapy can promote the polarization of macrophages to the M2 subtype by upregulating Arg-1 and CD206 expression and downregulating expression of TNF-α,IL-1βand IL-6,thereby inhibiting atherosclerosis-related foam cell formation.In conclusion,the presented in vitro and in vivo data demonstrate that Pd@HA/ALO enhanced macrophage polarization to reduce plaque formation,identifying an attractive treatment strategy for cardiovascular disease.

Clinical Use of COX-2 Inhibitors Containing Quinoline Heterocycle as a Selective Therapeutic Agents for Complementary Medicine

Inflammation represents an initial response of immune system and is involved in a number of biochemical inci-dents.Such incidents may multiply and further develop the provocative response.Over the past 15 years,various classes of secondary metabolites that were isolated from plant and marine sources have been described as natural cyclooxygenase(COX)inhibitors.The majority of natural COX inhibitors could be used as a selective therapeutic agent for complementary medicine and clinical applications.Currently,the inflammation is commonly treated by non-steroidal anti-inflammatory drugs(NSAIDs),several medications of which,however,have been linked to renal and gastrointestinal side effects.A variety of inhibitors of COX-2 that are selective(celecoxib,rofecoxib,valdecoxib and others)have been designed as NSAIDs mostly with enhanced stomach safety profiles.This helps to improve the compliance and functions in the geriatric patients as they have so many complications and problems associated with the diseases.The use of complementary medicine in combination with clinical therapy might give better results than medicine alone.Some disease condition like cancer which shows the COX-2 expressions could also have treatment related problems in such cases the selective inhibitors used as a complementary medicine.On the other hand,elevated cardiovascular risks have brought increasing worries about the safety of using specific inhibitors of COX-2.This current review focuses on how quinoline heterocycle was used for creation of inhibitors of COX-2 since 2009 along with its clinical significance in complementary medicine.These agents included the variety of substituents on the ring or ring attached to other heterocycles.As a result,the quinoline heterocycle will be used for creating and finding anti-inflammatory COX-2 medicines.

黑逍遥散调控p38MAPK/ATF2/COX-2信号通路对阿尔茨海默病大鼠神经炎症的影响

目的 观察黑逍遥散对Aβ_(1-42)所致阿尔茨海默病(AD)大鼠学习记忆能力的影响,并从p38MAPK/ATF2/COX-2信号通路介导的炎症级联反应探讨其作用机制。方法 双侧海马注射1μL Aβ_(1-42)溶液复刻AD大鼠模型。筛选造模成功的大鼠50只,随机分为模型组、盐酸多奈哌齐组(0.5 mg/kg)和黑逍遥散低、中、高剂量组(4.25、8.5、17 g/kg),连续给药42 d。Morris水迷宫实验检测定位航行与空间探索能力,HE染色观察海马神经元病理结构改变,ELISA法检测海马组织Aβ_(1-42)、iNOS、PGE_(2)表达,RT-qPCR法检测海马组织p38、ATF2、COX-2 mRNA表达,Western blot法检测海马组织p-p38、p-ATF2、COX-2蛋白表达。结果 与模型组比较,黑逍遥散中、高剂量组和盐酸多奈哌齐组逃避潜伏期缩短(P<0.01),有效区域运动距离、目标象限滞留时间百分比增加(P<0.01),海马CA1区神经元排列有序,胞体清晰,凋亡细胞减少,海马组织Aβ_(1-42)、iNOS、PGE_(2)水平降低(P<0.05,P<0.01),p38、COX-2 mRNA表达降低(P<0.05,P<0.01),p38、p-p38、p-ATF2、COX-2蛋白表达降低(P<0.01)。结论 黑逍遥散可改善Aβ_(1-42)所致AD大鼠的认知能力,其机制可能与阻断p38MAPK/ATF2/COX-2信号通路传导,进而减轻炎症反应有关。

肉桂提取物调控COX-2的表达改善大鼠良性前列腺增生

目的研究肉桂乙醇提取物(Cinnamomum cassia Prsel ethanol extract,CE)对良性前列腺增生(benign prostatic hyperplasa,BPH)的治疗作用及其可能的作用机制。方法分子对接初步推测CE中3种化合物对环氧合酶-2(cyclooxygenase-2,COX-2)和5-脂氧合酶(5-lipoxygenase,5-LOX)的结合能力。考察前列腺湿重(prostate weight,PW)、前列腺指数(prostate index,PI),并采用苏木精-伊红染色(hematoxylin-esion staining,HE)观察大鼠前列腺组织的形态变化;Western-blot和q-PCR检测大鼠前列腺组织中COX-2和5-LOX的蛋白、mRNA表达水平。结果分子对接结果表明,CE中3种主要活性单体化合物与COX-2及5-LOX蛋白模型均有较好的结合能;Western-blot和q-PCR结果显示,CE能同时降低COX-2及5-LOX在蛋白和mRNA水平上的表达,对COX-2的下调具有显著性;PW、PI及组织病理学切片均表明肉桂能改善BPH。结论CE能够有效改善BPH,其机制可能与下调花生四烯酸代谢网络中的COX-2的表达相关。

PGE2、COX-2表达与牙槽骨成骨活性、内氧水平的关系

目的:探讨前列腺素E2(prostaglandin E2,PGE2)、环氧合酶2(cyclooxygenase-2,COX-2)表达与牙槽骨成骨活性、内氧水平的关系。方法:选择2021年3月—2023年3月收治的56例慢性牙周炎且牙槽骨感染的患者为试验(牙周炎)组,同一时段53例健康牙槽骨为对照组。采用组织块培养法进行成骨细胞培养,采用改良Kaplow碱性磷酸酶(alkaline phosphatase,ALP)染色鉴定细胞,利用ELISA试剂盒检测COX-2、PGE2、破骨细胞抑制因子(osteoclastogenesis inhibitory factor,OPG)和核因子κB受体活化因子配体(receptor activator of nuclear factor-κb ligand,RANKL)等的表达,比较2组患者PGE2、COX-2、OPG、内氧水平、ALP和RANKL的表达水平,并分析其相关性。采用SPSS 27.0软件包对数据进行统计学分析。结果:牙周炎组的PGE2、COX-2、RANKL显著高于对照组,而OPG、内氧水平、ALP显著低于对照组(P<0.05)。PGE2、COX2呈高度正相关,与OPG、内氧水平和ALP呈高度负相关,但与RANKL呈高度正相关(P<0.05)。结论:PGE2、COX-2表达与ALP、内氧水平呈高度负相关,可考虑通过增加内氧水平,加大氧分压,并通过药物调节ALP水平,改变牙周炎或其他类似疾病的炎症状况。

宣痹汤通过调控COX-2信号通路抑制大鼠急性痛风性关节炎炎症反应的机制研究

目的:探究宣痹汤抑制环氧合酶-2(COX-2)通路对急性痛风性关节炎(GA)大鼠炎症的影响。方法:SD大鼠60只,随机分为对照组、模型组、塞来昔布组(20 mg/kg)、宣痹汤低剂量组(5 g/kg)、宣痹汤中剂量组(10 g/kg)、宣痹汤高剂量组(20 g/kg),每组10只。采用Coderre经典方法建立大鼠痛风模型,对各组大鼠一般情况进行观察,步态分析,评估关节肿胀程度;利用HE染色技术对大鼠踝关节滑膜组织进行观察;ELISA测定大鼠关节液中炎症因子IL-1β、TNF-α、PGE_(2)、LTB_(4)水平;免疫印迹法检测大鼠踝关节滑膜组织PGE受体2(EP2)和LTB受体1(BLT1)的表达情况;qRT-PCR测定COX-2、5-脂氧合酶(5-LOX)mRNA表达的影响。结果:模型组大鼠关节肿胀、跛足、毛发暗淡、精神萎靡;塞来昔布组、宣痹汤低、中、高剂量组的大鼠症状明显改善;相比于对照组,模型组大鼠步态评价、关节肿胀程度、组织病理学改变、IL-1β、TNF-α、PGE_(2)、LTB_(4)、COX-2、5-LOX、EP2、BLT1水平显著升高(P<0.05);与COX-2抑制剂塞来昔布组相比,宣痹汤(20 g/kg)在接受MSU晶体处理的大鼠中表现出更好的抗关节炎特性,同时伴有IL-1β、TNF-α、PGE_(2)、LTB_(4)、COX-2、5-LOX、EP2、BLT1表达的减少。结论:宣痹汤抑制GA大鼠中COX-2、5-LOX来改善MSU晶体诱导的炎症,并可能作为一种治疗GA新策略。

High-throughput computational screening and in vitro evaluation identifies 5-(4-oxo-4H-3,1-benzoxazin-2-yl)-2-[3-(4-oxo-4H-3,1-benzoxazin-2-yl)phenyl]-1H-isoindole-1,3(2H)-dione(C3),as a novel EGFR—HER2 dual inhibitor in gastric tumors

Gastric cancers are caused primarily due to the activation and amplification of the EGFR or HER2 kinases resulting in cell proliferation,adhesion,angiogenesis,and metastasis.Conventional therapies are ineffective due to the intra-tumoral heterogeneity and concomitant genetic mutations.Hence,dual inhibition strategies are recommended to increase potency and reduce cytotoxicity.In this study,we have conducted computational high-throughput screening of the ChemBridge library followed by in vitro assays and identified novel selective inhibitors that have a dual impediment of EGFR/HER2 kinase activities.Diversity-based High-throughput Virtual Screening(D-HTVS)was used to screen the whole ChemBridge small molecular library against EGFR and HER2.The atomistic molecular dynamic simulation was conducted to understand the dynamics and stability of the protein-ligand complexes.EGFR/HER2 kinase enzymes,KATOIII,and Snu-5 cells were used for in vitro validations.The atomistic Molecular Dynamics simulations followed by solvent-based Gibbs binding free energy calculation of top molecules,identified compound C3(5-(4-oxo-4H-3,1-benzoxazin-2-yl)-2-[3-(4-oxo-4H-3,1-benzoxazin-2-yl)phenyl]-1H-isoindole-1,3(2H)-dione)to have a good affinity for both EGFR and HER2.The predicted compound,C3,was promising with better binding energy,good binding pose,and optimum interactions with the EGFR and HER2 residues.C3 inhibited EGFR and HER2 kinases with IC50 values of 37.24 and 45.83 nM,respectively.The GI50 values of C3 to inhibit KATOIII and Snu-5 cells were 84.76 and 48.26 nM,respectively.Based on these findings,we conclude that the identified compound C3 showed a conceivable dual inhibitory activity on EGFR/HER2 kinase,and therefore can be considered as a plausible lead-like molecule for treating gastric cancers with minimal side effects,though testing in higher models with pharmacokinetic approach is required.

Sodium glucose cotransporter-2 inhibitors and heart disease:Current perspectives

Sodium glucose cotransporter-2 inhibitors(SGLT-2i)are antidiabetic medications with remarkable cardiovascular(CV)benefits proven by multiple randomised controlled trials and real-world data.These drugs are also useful in the prevention of CV disease(CVD)in patients with diabetes mellitus(DM).Although DM as such is a huge risk factor for CVD,the CV benefits of SGLT-2i are not just because of antidiabetic effects.These molecules have proven beneficial roles in prevention and management of nondiabetic CVD and renal disease as well.There are various molecular mechanisms for the organ protective effects of SGLT-2i which are still being elucidated.Proper understanding of the role of SGLT-2i in prevention and management of CVD is important not only for the cardiologists but also for other specialists caring for various illnesses which can directly or indirectly impact care of heart diseases.This clinical review compiles the current evidence on the rational use of SGLT-2i in clinical practice.

Comparative efficacy of sodium glucose cotransporter-2 inhibitors in the management of type 2 diabetes mellitus:A real-world experience

BACKGROUND Sodium glucose cotransporter-2 inhibitors(SGLT-2i)are a class of drugs with modest antidiabetic efficacy,weight loss effect,and cardiovascular benefits as proven by multiple randomised controlled trials(RCTs).However,real-world data on the comparative efficacy and safety of individual SGLT-2i medications is sparse.AIM To study the comparative efficacy and safety of SGLT-2i using real-world clinical data.METHODS We evaluated the comparative efficacy data of 3 SGLT-2i drugs(dapagliflozin,canagliflozin,and empagliflozin)used for treating patients with type 2 diabetes mellitus.Data on the reduction of glycated hemoglobin(HbA1c),body weight,blood pressure(BP),urine albumin creatinine ratio(ACR),and adverse effects were recorded retrospectively.RESULTS Data from 467 patients with a median age of 64(14.8)years,294(62.96%)males and 375(80.5%)Caucasians were analysed.Median diabetes duration was 16.0(9.0)years,and the duration of SGLT-2i use was 3.6(2.1)years.SGLT-2i molecules used were dapagliflozin 10 mg(n=227;48.6%),canagliflozin 300 mg(n=160;34.3%),and empagliflozin 25 mg(n=80;17.1).Baseline median(interquartile range)HbA1c in mmol/mol were:dapagliflozin-78.0(25.3),canagliflozin-80.0(25.5),and empagliflozin-75.0(23.5)respectively.The respective median HbA1c reduction at 12 months and the latest review(just prior to the study)were:66.5(22.8)&69.0(24.0),67.0(16.3)&66.0(28.0),and 67.0(22.5)&66.5(25.8)respectively(P<0.001 for all comparisons from baseline).Significant improvements in body weight(in kilograms)from baseline to study end were noticed with dapagliflozin-101(29.5)to 92.2(25.6),and canagliflozin 100(28.3)to 95.3(27.5)only.Significant reductions in median systolic and diastolic BP,from 144(21)mmHg to 139(23)mmHg;(P=0.015),and from 82(16)mmHg to 78(19)mmHg;(P<0.001)respectively were also observed.A significant reduction of microalbuminuria was observed with canagliflozin only[ACR 14.6(42.6)at baseline to 8.9(23.7)at the study end;P=0.043].Adverse effects of SGLT-2i were as follows:genital thrush and urinary infection-20(8.8%)&17(7.5%)with dapagliflozin;9(5.6%)&5(3.13%)with canagliflozin;and 4(5%)&4(5%)with empagliflozin.Diabetic ketoacidosis was observed in 4(1.8%)with dapagliflozin and 1(0.63%)with canagliflozin.CONCLUSION Treatment of patients with SGLT-2i is associated with statistically significant reductions in HbA1c,body weight,and better than those reported in RCTs,with low side effect profiles.A review of large-scale real-world data is needed to inform better clinical practice decision making.

Long noncoding RNAs HAND2-AS1 ultrasound microbubbles suppress hepatocellular carcinoma progression by regulating the miR-873-5p/tissue inhibitor of matrix metalloproteinase-2 axis

BACKGROUND Increasing data indicated that long noncoding RNAs(lncRNAs)were directly or indirectly involved in the occurrence and development of tumors,including hepatocellular carcinoma(HCC).Recent studies had found that the expression of lncRNA HAND2-AS1 was downregulated in HCC tissues,but its role in HCC progression is unclear.Ultrasound targeted microbubble destruction mediated gene transfection is a new method to overexpress genes.AIM To study the role of ultrasound microbubbles(UTMBs)mediated HAND2-AS1 in the progression of HCC,in order to provide a new reference for the treatment of HCC.METHODS In vitro,we transfected HAND2-AS1 siRNA into HepG2 cells by UTMBs,and detected cell proliferation,apoptosis,invasion and epithelial-mesenchymal transition(EMT)by cell counting kit-8 assay,flow cytometry,Transwell invasion assay and Western blotting,respectively.In addition,we transfected miR-837-5p mimic into UTMBs treated cells and observed the changes of cell behavior.Next,the UTMBs treated HepG2 cells were transfected together with miR-837-5p mimic and tissue inhibitor of matrix metalloproteinase-2(TIMP2)overexpression vector,and we detected cell proliferation,apoptosis,invasion and EMT.In vivo,we established a mouse model of subcutaneous transplantation of HepG2 cells and observed the effect of HAND2-AS1 silencing on tumor formation ability.RESULTS We found that UTMBs carrying HAND2-AS1 restricted cell proliferation,invasion,and EMT,encouraged apoptosis,and HAND2-AS1 silencing eliminated the effect of UTMBs.Additionally,miR-873-5p targets the gene HAND2-AS1,which also targets the 3’UTR of TIMP2.And miR-873-5p mimic counteracted the impact of HAND2-AS1.Further,miR-873-5p mimic solely or in combination with pcDNA-TIMP2 had been transformed into HepG2 cells exposed to UTMBs.We discovered that TIMP2 reversed the effect of miR-873-5p mimic caused by the blocked signalling cascade for matrix metalloproteinase(MMP)2/MMP9.In vivo results showed that HAND2-AS1 silencing significantly inhibited tumor formation in mice.CONCLUSION LncRNA HAND2-AS1 promotes TIMP2 expression by targeting miR-873-5p to inhibit HepG2 cell growth and delay HCC progression.

Sodium-glucose cotransporter-2 inhibitors protect tissues via cellular and mitochondrial pathways:Experimental and clinical evidence

Mitochondrial dysfunction is a key driver of cardiovascular disease(CVD)in metabolic syndrome and diabetes.This dysfunction promotes the production of reactive oxygen species(ROS),which cause oxidative stress and inflammation.Angiotensin II,the main mediator of the renin-angiotensin-aldosterone system,also contributes to CVD by promoting ROS production.Reduced activity of sirtuins(SIRTs),a family of proteins that regulate cellular metabolism,also worsens oxidative stress.Reduction of energy production by mitochondria is a common feature of all metabolic disorders.High SIRT levels and 5’adenosine monophosphate-activated protein kinase signaling stimulate hypoxia-inducible factor 1 beta,which promotes ketosis.Ketosis,in turn,increases autophagy and mitophagy,processes that clear cells of debris and protect against damage.Sodiumglucose cotransporter-2 inhibitors(SGLT2i),a class of drugs used to treat type 2 diabetes,have a beneficial effect on these mechanisms.Randomized clinical trials have shown that SGLT2i improves cardiac function and reduces the rate of cardiovascular and renal events.SGLT2i also increase mitochondrial efficiency,reduce oxidative stress and inflammation,and strengthen tissues.These findings suggest that SGLT2i hold great potential for the treatment of CVD.Furthermore,they are proposed as anti-aging drugs;however,rigorous research is needed to validate these preliminary findings.