Pretreatment and analysis techniques development of TKIs in biological samples for pharmacokinetic studies and therapeutic drug monitoring

Tyrosine kinase inhibitors(TKIs)have emerged as the first-line small molecule drugs in many cancer therapies,exerting their effects by impeding aberrant cell growth and proliferation through the modulation of tyrosine kinase-mediated signaling pathways.However,there exists a substantial inter-individual variability in the concentrations of certain TKIs and their metabolites,which may render patients with compromised immune function susceptible to diverse infections despite receiving theoretically efficacious anticancer treatments,alongside other potential side effects or adverse reactions.Therefore,an urgent need exists for an up-to-date review concerning the biological matrices relevant to bioanalysis and the sampling methods,clinical pharmacokinetics,and therapeutic drug monitoring of different TKIs.This paper provides a comprehensive overview of the advancements in pretreatment methods,such as protein precipitation(PPT),liquid-liquid extraction(LLE),solid-phase extraction(SPE),micro-SPE(μ-SPE),magnetic SPE(MSPE),and vortex-assisted dispersive SPE(VA-DSPE)achieved since 2017.It also highlights the latest analysis techniques such as newly developed high performance liquid chromatography(HPLC)and high-resolution mass spectrometry(HRMS)methods,capillary electrophoresis(CE),gas chromatography(GC),supercritical fluid chromatography(SFC)procedures,surface plasmon resonance(SPR)assays as well as novel nanoprobes-based biosensing techniques.In addition,a comparison is made between the advantages and disadvantages of different approaches while presenting critical challenges and prospects in pharmacokinetic studies and therapeutic drug monitoring.

“Blind men and an elephant”:The need for animals in research,drug safety studies,and understanding civilizational diseases

Animal-based research and drug safety studies are essential to understanding the mysteries of nature and the long-term survival of humans.Due to the rapid increase in the global human population,conflict-and economically driven human migration,tourism-related activities,densely populated metropolitan areas,and local policies,humans will be affected by a multitude of novel disease-causing microorganisms and civilizational diseases.Despite disparities among countries,recent and planned changes in regulations concerning animal research and drug safety studies could have detrimental effects on both the animal research community and nations lacking sufficient social support systems.Based on existing scientific literature,I argue that we need animal research encompassing aspects such as animal development,behavior,drug safety studies,and for the understanding of future civilizational diseases.Depending on the nature of the research questions and local challenges,a suitable animal model organism should be made mandatory.

Follow-up Study of Retreatment TB Patients with Sputum Smear and/or Culture Positive Two Years after They were Declared Cured with First-line Anti-TB Drugs in Shandong Province

This study aimed to learn the recurrence rate in the retreatment TB patients with sputum smear and/or culture positive （ss＋ and/or c＋） two years after they were declared cured, and to explore causes of recurrence in order to improve long-time treatment outcome. 5 cities were selected as research locations. Recurrence of TB was judged by chest X-ray examination together with sputum smear and culture examination.

Sex differences in exercise and drug addiction:A mini review of animal studies

Growing literature has demonstrated that exercise may be an effective prevention and treatment option for drug addiction. In the past few years, many studies have suggested that there were sex differences in all phases of drug addiction. However, very limited research has investigated sex differences in the effectiveness of exercise intervention in drug addiction and rehabilitation. In this mini review, we summarize the effect of sex on the results of using exercise to prevent and treat drug addiction. The studies we consider span various animal models and use multiple types of exercise to examine the effectiveness of exercise on the neurobiological mechanism of exercise rehabilitation. We believe that exercise as an adjuvant intervention strategy can be applied better in drug addiction prevention and recovery. Copyright 2014, Shanghai University of Sport. Production and hosting by Elsevier B.V. All rights reserved.

Study on Active Principle and Modernization of Chinese Drugs

The people as a whole cannot live for one day without drug, and the requirement of drugs would never come to an end or stay on the same level. Pharmaceutical industry, being of great significance, has become a new and important one in economic growth in the 21st century. Therefore, the modernization of Chinese drugs has also become a hot spot in public opinion in recent years.

Real world studies are essential for drug therapy in Parkinson's disease

Prospective real-world data from large patient samples, which re- port on the long-term effectiveness of the employed different drug therapies, are rare in Parkinson＇s disease （PD）. The non interven- tional ＂Transdermal Rotigotine User Surveillance Study＂ （TRUST） trial represents such a real-world study. It investigated long-term treatment with different dopamine substituting treatment regimens in 2195 PD patients （Mfiller et al., 2018）. Participation in TRUST meant that the treating neurologists were only asked to document and modify the dopaminergic drug regimen without any prior PD patient selection criteria. Thus this unique trial design reflects the real world of patient maintenance.

The Role of Study Nurses in Clinical Trials of IBD Drugs

Objective: To explore the establishment and roles of study nurses in IBD drug clinical trials. Methods: The management experience of this department’s study nurses in IBD drug clinical trials was retrospectively analyzed. Results: The study nurses played very important roles at all links during the preliminary preparation of IBD drug clinical trials, the whole-process management after project initiation, and the later work of project conclusion. Conclusions: As direct participants in drug clinical trials, study nurses play a very important role in ensuring standardization of the trial process, safeguarding patient’s rights and safety, and assisting investigators in carrying out study works smoothly.

Pharmacological, Microbiological and Derivatographic Studies of the Solid-Dosage Form of the Immunomodulatory Drug Made on the Basis of Bee Products

Pharmacological, derivate and microbiological study of beebread based immunomodulatory drug was conducted. Iimmunomodulating properties of pellets ＂Apimun＂ in the form of antibodies formation in response to the EB antigen were studied. Clear immunostimulatory properties of pellets ＂Apimun＂ were reproduced in mature rats and mice with normal immune status. Pellets ＂Apimun＂ at doses 1.5 and 2.0 g/kg showed increased activity ofphagocytosis and processes of antibody formation inhibition of delayed hypersensitivity reactions. Antimicrobial activity of pellets ＂Apimun＂ was studied. It was proved that it did not have antimicrobial properties. Derivate studies were conducted and showed that the active substance and composition of the IMP was stable at normal temperature. The results of pharmacological, microbiological and derivate studies show the effectiveness of the pellets ＂Apimun＂ and prospects for further research in order to create a product for immune status improvement.

PREDICTION OF THE THERAPEUTIC EFFECTIVENESS OF NEW DRUGS FROM CLINICAL PHARMACOLOGY STUDIES

The development of new drugs for therapeutic purposes has become very expensive and time-consuming in American and European countries.It is estimated that on the average 50 to 100 million dollars and 10 or more years from the time of patenting are required to make a new drug available for general prescription. Every new drug needs to be charac-

Some Hot Spots in the Study of Chinese Drugs in the 21st Century

Mankind has entered the 21st century of high speed development in science and e-conomics. Owing to the alteration of disease modes in the new century, the greatly elevated quality of human life and the arrival of aged society, the modes of medicine have obviously changed from the treatment mode

Contamination of aflatoxins as threat to the safety of herbal Unani drugs: an overview

Unani medicine is an oldest system of traditional medicine,where drugs of animal,mineral and herbal origin are used for centuries to cure diseases.Unani remedies are now available not only in drug stores,but also in food stores and super markets.Therefore the efficacy and safety of these drugs is very crucial.One of the most serious risks associated with these remedies is,consumer assumes that they are natural,so they are safe.But biological contamination(bacterial,fungal and insect)of herbal medicines is a serious concern.The Aspergillus flavus and Aspergillus parasiticus are the fungal species that occur naturally,release aflatoxins and is a threat to the natural drugs.The World Health Organization has recommended determination of aflatoxins in natural drugs(Unani)as one of the parameter of their safety studies as Aflatoxin contamination is concerned significantly with health and economic loss affecting humans,animals,and agriculture.Aflatoxin B1 is categorized as a group 1 carcinogen by The International Agency for Research on Cancer that causes a variety of health issues.Thus keeping in mind the deleterious health effects of aflatoxins,here,in this review we have made an attempt to summarize the aflatoxins with respect to their origin,occurrence,structure and properties to generate the awareness among the people dealing mainly with Unani herbal drugs.Besides these their toxicity and effects on health have also been discussed.The analytical methods for their determination and some measures to prevent their contamination are also suggested to improve the efficacy and safety of Unani herbal drugs.

Management of Multi-Drug Resistant Methicillin Resistant <i>Staphylococcus aureus</i>Induced Pneumonia with New Antibiotic Adjuvant Entity: A Retrospective Study

Aim/Objective: Increase in incidences of pneumonia due to multi-drug resistant methicillin resistant Staphylococcus aureus (MRSA) in both community and health care settings is of great concern globally. Present study aims to retrospectively analyze the efficacy of new fixed dose combination with antibiotic adjuvant entity (FDC) in comparison with vancomycin to treat patients with multi-drug resistant MRSA pneumonia. Materials and Methods: During this retrospective study, case sheets of patients who were treated for MRSA pneumonia with vancomycin or fixed dose combination of vancomycin + ceftriaxone + adjuvant (FDC) between 20 March 2010 to 20 October 2014 at tertiary care center, were analyzed. Various demographic features, antibiotic therapy, length of treatment duration and the resulting efficacy were evaluated. Microbiological success was measured in terms of bacterial eradication, while clinical success was monitored in terms of complete omission of systemic signs and symptoms. Results: Among 136 patients analyzed, 113 cases were having positive culture for MRSA, and hence were further analyzed. Out of these 113 patients, empirical treatment with vancomycin was given in 59 patients and 54 patients were treated with FDC empirically. After initial culture reports, 22 patients showing resistance to vancomycin were shifted to FDC. Amidst all the patients, 24 (64.86%) of 37 from vancomycin group and 62 (81.57%) of 76 from FDC group achieved clinical success. 9 patients out of these failure cases were cured with FDC + colistin combination therapy. Failure rates in FDC treated patients were significantly low (6.57%) as compared to vancomycin group (13.51%). Conclusion: For the treatment of different types of multi-drug resistant MRSA pneumonia, the empirical intravenous FDC therapy was safe and well tolerated with higher efficacy than vancomycin. Most of the vancomycin failure cases responded to FDC therapy and were cured. This retrospective study also concludes that an alternative option of FDC + colistin is safe and effective to treat the patients which fail to respond to FDC monotherapy.

AI-driven drug discovery from natural products

The latest review published in Nature Reviews Drug Discovery by Michael W.Mullowney and co-authors focuses on the use of artificial intelligence techniques,specifically machine learning,in natural product drug discovery.The authors discussed various applications of AI in this field,such as genome and metabolome mining,structural characterization of natural products,and predicting targets and biological activities of these compounds.They also highlighted the challenges associated with creating and managing large datasets for training algorithms,as well as strategies to address these obstacles.Additionally,the authors examine common pitfalls in algorithm training and offer suggestions for avoiding them.

基底膜相关基因在类风湿关节炎不同中医证型中的转录组学分析及药物预测

背景:基底膜基因与类风湿关节炎的发生发展密切相关,但不同中医证型下基底膜相关基因在其发病机制中的作用尚不明确。目的:基底膜基因联合转录组学分析探讨类风湿关节炎5种不同中医证型的发病机制差异,并进行潜在治疗药物预测。方法:基于GEO数据库整理类风湿关节炎相关中医证型芯片数据以及基底膜相关基因,利用R-limma包筛选差异表达基因,Mfuzz包进行表达趋势分析。借助STRING数据库构建PPI网络,UPset筛选关键基因,通过R-clusterProfiler包对差异表达基因进行GSEA及富集分析,同时绘制ROC曲线评估基底膜相关核心靶点对5种证型分别的诊断价值。基于CIBERSORT核心算法计算每种证型的免疫浸润情况。最后,利用SymMap和COREMINE数据库预测可靶向基底膜相关核心基因治疗类风湿关节炎不同证型的潜在中药及小分子药物。结果与结论:①在5种类风湿关节炎中医证型中(风湿痹阻证、寒湿痹阻证、肝肾亏虚证、气血两虚证及血瘀阻络证)分别筛选出67,47,59,57,55个基底膜相关差异表达基因,其中关键靶点分别为5,7,5,3,5个。③各证型中富集最多的为细胞基质黏附、免疫细胞迁移及胶原代谢等生物过程以及细胞外基质受体相互作用、PI3K-Akt、局灶性粘连和Rap1信号通路等。④药物预测结果显示,土茯苓、川乌、绵马贯众及黄精是通过影响基底膜基因治疗5种类风湿关节炎中医证型最具潜力的中药。⑤结果证实,基底膜相关基因的异常表达可能是通过调控细胞附着、免疫细胞迁移及炎症反应等多个途径影响类风湿关节炎的发生和发展,在不同证型中有着差异表现,其中ITGA6可作为5种类风湿关节炎证型中共同的诊断标志物。清热解毒类中药可能是类风湿关节炎不同证型治疗中可以贯穿始终的潜在有效药物。

Preparation and evaluation of nattokinaseloaded self-double-emulsifying drug delivery system

In the present study,we prepared nattokinase-loaded self-double-emulsifying drug delivery system(SDEDDS)and investigated its preliminary pharmacodynamics.The type and concentration of oil phase,inner aqueous phase and emulsifier were screened to prepare optimum nattokinase-loaded SDEDDS.Next,the optimum formulations were characterized based on microstructure,volume-weighted mean droplet size,self-emulsifying rate,yield,storage stability,in vitro release and in vivo pharmacodynamics studies.The water/oil/watermultiple emulsions exhibited typicalmultiple structure,with relatively small volumeweighted mean droplet size 6.0±0.7μm and high self-emulsifying ability(self-emulsifying time<2 min).Encapsulation of nattokinase was up to 86.8±8.2%.The cumulative release of nattokinase within 8 h was about 30%,exhibiting a sustained release effect.The pharmacodynamics study indicated that nattokinase-loaded SDEDDS could significantly prolong the whole blood clotting time in mouse and effectively improve the carrageenan-induced tail thrombosis compared with nattokinase solution.Moreover,we showed that SDEDDS could successfully self-emulsify into water/oil/water multiple emulsions upon dilution in dispersion medium with gentle stirring and effectively protect nattokinase activity in gastric environment.Our findings suggested that SDEDDS could be a promising strategy for peptide and protein drugs by oral administration.

Implantation of a drug delivery system during surgery for patients with primary hepatocarcinoma

BACKGROUND: Postoperative regional chemotherapy is one of the most effective methods to decrease the recurrent rate and improve the prognosis of primary hepatocarcinoma (PHC). This study was undertaken to assess the optimal pathway to implant the drug delivery system (DDS) in the different ways of resecting PHC so as to offer a valuable reference to clinical implantation of the DDS. METHODS: One hundred and ninety cases were divided into two groups according to whether the tumors were resected completely (A) or not (B). Groups A and B were subdivided into three groups a, b and c according to the pathway selected for DDS implantation. The patients in subgroup a received DDS implantation through both the hepatic artery and portal vein (A+P-implanted group), the patients in subgroup b received DDS implantation through the portal vein (P-implanted group), and the patients in subgroup c received DDS implantation through the hepatic artery (A-implanted group). RESULTS: The 1- and 3-year recurrent rates of subgroup c in group A were higher than those of subgroup b, and there was no significant difference between subgroups a and b. Compared with subgroups a and c, the 1- and 3-year survival rates of subgroup b were similar to those of group a but higher than those of group c. The 1- and 3-year survival rates between subgroups a and b in group B were significantly different. The prognosis of subgroup c was lower than that of subgroup a and no significant difference was observed between subgroups b and c. CONCLUSIONS: The DDS should be implanted into the portal vein when PHC is resected completely. It may be better to implant it into both portal vein and hepatic artery if the tumor cannot be completely resected.

Association between Maternal Drug Use and Cytochrome P450 Genetic Polymorphisms and the Risk of Congenital Heart Defects in Offspring

Objective This study aimed to assess the associations between maternal drug use,cytochrome P450(CYP450)genetic polymorphisms,and their interactions with the risk of congenital heart defects(CHDs)in offspring.Methods A case-control study involving 569 mothers of CHD cases and 652 controls was conducted from November 2017 to January 2020.Results After adjusting for potential confounding factors,the results show that mothers who used ovulatory drugs(adjusted odds ratio[a OR]=2.12;95% confidence interval[CI]:1.08-4.16),antidepressants(a OR=2.56;95%CI:1.36-4.82),antiabortifacients(a OR=1.55;95%CI:1.00-2.40),or traditional Chinese drugs(a OR=1.97;95%CI:1.26-3.09)during pregnancy were at a significantly higher risk of CHDs in offspring.Maternal CYP450 genetic polymorphisms at rs1065852(A/T vs.A/A:OR=1.53,95%CI:1.10-2.14;T/T vs.A/A:OR=1.57,95%CI:1.07-2.31)and rs16947(G/G vs.C/C:OR=3.41,95%CI:1.82-6.39)were also significantly associated with the risk of CHDs in offspring.Additionally,significant interactions were observed between the CYP450 genetic variants and drug use on the development of CHDs.Conclusions In those of Chinese descent,ovulatory drugs,antidepressants,antiabortifacients,and traditional Chinese medicines may be associated with the risk of CHDs in offspring.Maternal CYP450 genes may regulate the effects of maternal drug exposure on fetal heart development.

Modern drug discovery for inflammatory bowel disease: The role of computational methods

Inflammatory bowel diseases(IBDs)comprising ulcerative colitis,Crohn’s disease and microscopic colitis are characterized by chronic inflammation of the gastrointestinal tract.IBD has spread around the world and is becoming more prevalent at an alarming rate in developing countries whose societies have become more westernized.Cell therapy,intestinal microecology,apheresis therapy,exosome therapy and small molecules are emerging therapeutic options for IBD.Currently,it is thought that low-molecular-mass substances with good oral bio-availability and the ability to permeate the cell membrane to regulate the action of elements of the inflammatory signaling pathway are effective therapeutic options for the treatment of IBD.Several small molecule inhibitors are being developed as a promising alternative for IBD therapy.The use of highly efficient and time-saving techniques,such as computational methods,is still a viable option for the development of these small molecule drugs.The computeraided(in silico)discovery approach is one drug development technique that has mostly proven efficacy.Computational approaches when combined with traditional drug development methodology dramatically boost the likelihood of drug discovery in a sustainable and cost-effective manner.This review focuses on the modern drug discovery approaches for the design of novel IBD drugs with an emphasis on the role of computational methods.Some computational approaches to IBD genomic studies,target identification,and virtual screening for the discovery of new drugs and in the repurposing of existing drugs are discussed.

Estimation of Metformin Drug for the Diabetes Patients by Simple,Quick and Cheap Techniques within the Formation of Colored Charge Transfer Complexes

Metformin(Met)is a drug developed for the treatment of patients with typeⅡ diabetes.Recently,Met estimation in pharmaceutical formulations and human fluids has gained a growing interest.To extend requisite data that can be used to assessment of Met quantitatively based on charge-transfer(CT)complexation,the present study describes the synthesis and characterization of CT complexes that formed between drug Met and the organicπ-acceptors picric acid(PA),chloranilic acid(CLA),chloranil(CHL),7,7',8,8'-tetracyanoquinodimethane(TCNQ),and dichlorodicyanobenzoquinone(DDQ).The properties of the formed CT complexes were investigated by elemental,spectral(UV-visible,IR,and Raman spectroscopies),thermal(TG)and morphological(SEM)studies.IR results indicated that the complexation of Met with either PA or CLA acceptors occurs through proton transfer interaction,whereas its complexation with CHL,TCNQ,or DDQ acceptors occurs through n→π*interaction.

A qualitative study on the adverse reactions of mass treatment for lymphatic filariasis in Orissa,India

Objective:To describe the perceptions of community members and programme partners regarding severity,management and impact of adverse reactions on mass drug administration (MDA) compliance.Methods:Based on various qualitative data collected from five districts of Orissa,India,where MDA had been implemented during 2002 and 2004.The qualitative surveys included focus group discussions with community members and health workers,and semi-structured interviews with key informants in the community,medical officers at primary health centres,district level health officers and private practitioners.Results:It showed that many people suffered from adverse reactions,though the reactions were not serious.The paper reported different ways of management of adverse reactions at the community level.The impact of adverse reactions on MDA compliance was serious,as many people did not consume the drug due to fear of adverse reactions.The rumours of adverse reactions and news in media deterred people from consuming the tablets.Conclusion:All categories of respondents indicates the need of more information to address the problem of adverse reactions during MDA.The present paper warrants incorporating the messages on adverse reactions during health communication and social mobilization campaigns of MDA.