Inhibiting 5-hydroxytryptamine receptor 3 alleviates pathological changes of a mouse model of Alzheimer's disease

Extracellular amyloid beta(Aβ) plaques are main pathological feature of Alzheimer’s disease.However,the specific type of neuro ns that produce Aβ peptides in the initial stage of Alzheimer’s disease are unknown.In this study,we found that 5-hydroxytryptamin receptor 3A subunit(HTR3A) was highly expressed in the brain tissue of transgenic amyloid precursor protein and presenilin-1 mice(an Alzheimer’s disease model) and patients with Alzheimer’s disease.To investigate whether HTR3A-positive interneurons are associated with the production of Aβ plaques,we performed double immunostaining and found that HTR3A-positive interneurons were clustered around Aβ plaques in the mouse model.Some amyloid precursor protein-positive or β-site amyloid precursor protein cleaving enzyme-1-positive neurites near Aβ plaques were co-localized with HTR3A interneurons.These results suggest that HTR3A-positive interneurons may partially contribute to the generation of Aβ peptides.We treated 5.0-5.5-month-old model mice with tro pisetron,a HTR3 antagonist,for 8 consecutive weeks.We found that the cognitive deficit of mice was partially reversed,Aβ plaques and neuroinflammation we re remarkably reduced,the expression of HTR3 was remarkably decreased and the calcineurin/nuclear factor of activated T-cell 4 signaling pathway was inhibited in treated model mice.These findings suggest that HTR3A interneurons partly contribute to generation of Aβ peptide at the initial stage of Alzheimer’s disease and inhibiting HTR3 partly reve rses the pathological changes of Alzheimer’s disease.

Effects of 5-hydroxytryptamine Receptor on the Reaction of the Lower Esophageal Sphincter Under the Electrical Field Stimulation

In the first and second parts of this study,5-hydroxytryptamine(5HT)receptors,including 5-HT3 and 5-HT4 with the highest expression level,were found in clasp and sling fibres of the lower esophageal sphincter(LES).Specific 5-HT3 and 5-HT4 receptor agonists can induce the contraction effect of clasp and sling fibres of the LES while specific 5-HT7 receptor agonists showed no effects.In the study of this part,the in-vitro muscle tension measurement technology and EFS methods were used to detect the effect of the selective 5-HT receptor antagonist on the clasp and sling fibres of the in-vitro LES under the electrical field stimulation(EFS),and further to ensure the effect of 5-HT receptor in the LES neuroregulatory pathway,and deeply explore the effect of 5-HT receptor in the systolic and diastolic function regulation of the LES.

Effects of 5-HT2B, 5-HT3 and 5-HT4 receptor antagonists on gastrointestinal motor activity in dogs

AIM:To study the effects of 5-hydroxytryptamine(5-HT)receptor antagonists on normal colonic motor activity in conscious dogs.METHODS:Colonic motor activity was recorded using a strain gauge force transducer in 5 dogs before and after 5-HT2B,5-HT3 and 5-HT4 receptor antagonist administration.The force transducers were implanted on the serosal surfaces of the gastric antrum,terminal ileum,ileocecal sphincter and colon.Test materials or vehicle alone was administered as an intravenous bolus injection during a quiescent period of the whole colon in the interdigestive state.The effects of these receptor antagonists on normal gastrointestinal motor activity were analyzed.RESULTS:5-HT2B,5-HT3 and 5-HT4 receptor antagonists had no contractile effect on the fasting canine terminal ileum.The 5-HT3 and 5-HT4 receptor antagonists inhibited phaseⅢof the interdigestive motor complex of the antrum and significantly inhibited colonic motor activity.In the proximal colon,the inhibitory effect was dose dependent.Dose dependency,however,was not observed in the distal colon.The 5-HT2B receptor antagonist had no contractile effect on normal colonic motor activity.CONCLUSION:The 5-HT3 and 5-HT4 receptor antagonists inhibited normal colonic motor activity.The5-HT2B receptor antagonist had no contractile effect on normal colonic motor activity.

5-HT_(2A)受体拮抗剂治疗神经精神疾病幻觉症状研究进展

帕金森病、阿尔茨海默病和精神分裂症等神经精神疾病在发展过程中会出现幻觉、妄想等精神病症状,这些症状发病率高、治愈难,严重影响患者生活质量。尽管经典抗精神病药物氯丙嗪、舒必利和奋乃静等通过拮抗多巴胺2型(D_(2))受体可治疗相关症状,但也会引发不可控的锥体外系反应和高泌乳素症等不良反应。近年来研究发现,奥氮平、氯氮平、利培酮和匹莫范色林等非经典抗精神病药物通过拮抗5-羟色胺2A(5-HT_(2A))受体或同时拮抗5-HT_(2A)受体(强)和D_(2)受体(弱)治疗神经精神疾病的幻觉症状。非临床研究结果表明,在多种因素诱导的幻觉模型上,非经典抗精神病药物均表现出良好的治疗作用;临床研究进一步证实,该类药物显著改善精神病症状(以幻觉和妄想为主),尤其是匹莫范色林,其对氯氮平、利培酮不敏感或耐受的患者仍能表现出良好的治疗效果。同时,非经典抗精神病药物不良反应的发生率和严重程度较低,总体耐受性较好。本文综述了5-HT_(2A)受体拮抗剂改善神经精神疾病伴随的幻觉症状的研究进展,为设计开发新型神经精神疾病治疗药物提供参考。

Support vector classification for SAR of 5-HT3 receptor antagonists

In this work, support vector classification （SVC） algorithm was used to build structure-activity relationship （SAR） model of the 5-hydroxytryptamine type 3 （5-HT3 ） receptor antagonists with 26 compounds. In a benchmark test, SVC was compared with several techniques of machine learning currently used in the field. The prediction performance of the model was discussed on the basis of the leave-one-out cross-validation. The results show that the accuracy of prediction of SVC model was higher than those of back propagation artificial neural network （BP ANN）, K-nearest neighbor （KNN） and Fisher methods.

5-HT1A受体拮抗剂对七氟烷致老年认知功能障碍模型大鼠突触可塑性的作用及其机制

目的探讨5-HT1A受体拮抗剂对七氟烷致老年认知功能障碍模型大鼠突触可塑性的作用及其机制。方法将30只18月龄Sprague-Dawley大鼠随机分为对照组、模型组以及治疗组。模型组吸入50%空气、氧气混合物(2 L/min)和2%七氟烷4 h后左侧脑室给予生理盐水(5μL),治疗组在吸入50%空气、氧气混合物(2 L/min)和2%七氟烷4 h后左侧脑室给予5-HT1A受体拮抗剂(3μg),对照组仅吸入50%空气、氧气混合物(2 L/min)4 h。水迷宫法检测各组大鼠的学习记忆能力;HE染色法观察各组大鼠海马组织病理变化情况;尼氏染色和高尔基染色观察海马区神经元和突触的病理形态变化;免疫荧光法检测MeCP2、p250GAP、PSD-95、GAP-43与Syn蛋白表达;实时荧光定量PCR检测PKA、CREB1、BDNF mRNA表达水平;Western blotting检测PKA、CREB1、p-CREB1、BDNF蛋白表达水平。结果与对照组比较,模型组大鼠逃避潜伏期显著延长,穿越平台次数显著减少(P<0.05);与模型组比较,治疗组大鼠逃避潜伏期显著缩短,穿越平台次数明显增多(P<0.05)。HE、尼氏和高尔基染色显示,与对照组比较,模型组大鼠海马神经元形态不规则,排列松散,周围组织间隙扩大,细胞核固缩深染,部分神经元内尼氏体减少,树突分支数量以及树突棘密度明显减少;与模型组比较,治疗组大鼠海马神经元形态规则,结构相对完整,排列均匀,神经元内尼氏体数量增多,树突分支数量及树突棘密度显著增加。与对照组比较,模型组大鼠脑组织MeCP2、PSD-95、GAP-43、Syn蛋白,PKA、CREB1、BDNF mRNA和蛋白表达明显减少(P<0.05),p250GAP蛋白表达明显增加(P<0.05)。与模型组比较,治疗组MeCP2、PSD-95、GAP-43、Syn蛋白,PKA、CREB1、BDNF mRNA和蛋白表达明显增加(P<0.05),p250GAP蛋白表达明显减少(P<0.05)。结论5-HT1A受体拮抗剂通过激活CREB/BDNF通路,增强PSD-95、GAP-43、Syn表达,促进突触重塑,保护大鼠海马神经元细胞,从而改善七氟烷致老年认知功能障碍模型大鼠的学习记忆能力。

Role of 5-hydroxytryptamine type 3 receptors in the regulation of anxiety reactions

5-Hydroxytryptamine(5-HT)type 3 receptor(5-HT_(3)R)is the only type of ligand-gated ion channel in the 5-HT receptor family.Through the high permeability of Na+,K+,and Ca2+and activation of subsequent voltage-gated calcium channels(VGCCs),5-HT_(3)R induces a rapid increase of neuronal excitability or the release of neurotransmitters from axon terminals in the central nervous system(CNS).5-HT_(3)Rs are widely expressed in the medial prefrontal cortex(mPFC),amygdala(AMYG),hippocampus(HIP),periaqueductal gray(PAG),and other brain regions closely associated with anxiety reactions.They have a bidirectional regulatory effect on anxiety reactions by acting on different types of cells in different brain regions.5-HT_(3)Rs mediate the activation of the cholecystokinin(CCK)system in the AMYG,and theγ-aminobutyric acid(GABA)“disinhibition”mechanism in the prelimbic area of the mPFC promotes anxiety by the activation of GABAergic intermediate inhibitory neurons(IINs).In contrast,a 5-HT_(3)R-induced GABA“disinhibition”mechanism in the infralimbic area of the mPFC and the ventral HIP produces anxiolytic effects.5-HT_(2)R-mediated regulation of anxiety reactions are also activated by 5-HT_(3)R-activated 5-HT release in the HIP and PAG.This provides a theoretical basis for the treatment of anxiety disorders or the production of anxiolytic drugs by targeting 5-HT_(3)Rs.However,given the circuit specific modulation of 5-HT_(3)Rs on emotion,systemic use of 5-HT_(3)R agonism or antagonism alone seems unlikely to remedy anxiety,which deeply hinders the current clinical application of 5-HT_(3)R drugs.Therefore,the exploitation of circuit targeting methods or a combined drug strategy might be a useful developmental approach in the future.

化疗患者5-羟色胺3受体拮抗剂路径化管理模式的建立与应用

目的建立化疗患者5-羟色胺3受体拮抗剂(5-HT3RA)路径化管理模式,提高化疗患者用药合理性。方法制定5-HT3RA规范化用药管控规则,并借助医疗智能及决策支持(MINDS)系统,以信息抓取结合医嘱前置审核的形式对使用5-HT3RA的化疗患者开展路径化管理,对用药指征、用法用量、疗程等实施全程化干预。通过比较实施路径化管理前后5-HT3RA无指征用药、用法用量不合理、重复用药、疗程不合理的变化情况以及5-HT3RA人均药费变化情况,对干预效果进行分析。结果共纳入9181例患者,实施路径化管理后,无指征用药率降低0.48%,单次剂量、给药频次、重复用药、疗程(化疗结束后3 d仍使用5-HT3RA)的不合理率分别降低10.48%、0.65%、1.33%、0.34%,5-HT3RA人均药费降低13.72元,以上差异均有统计学意义(P<0.05)。结论我院建立的化疗患者5-HT3RA路径化管理模式有效提高了用药合理性,为临床合理用药提供了新思路。

Distribution of serotonin 5-HT_(2A) and 5-HT_7 receptors in the Onuf’s nucleus of the rat spinal cord

BACKGROUND：Motoneurons from the Onuf’s nucleus of the spinal cord, which innervate the striated muscle of the pelvic floor, play an important role in erection, ejaculation, and urine control. Serotonin （5-hydroxytryptamine, 5-HT） regulates motoneuron activity from the Onuf’s nucleus of the spinal cord. However, few studies exist that describe 5-HT receptor distribution in the Onuf’s nucleus. In addition, the nature of the effects of 5-HT receptor on the innervating striated muscle of the pelvic floor is controversial. OBJECTIVE： To investigate the distribution of serotonin 5-HT2A and 5-HT7 receptors in motoneurons of Onuf’s nucleus in the spinal cord of male rats, and to analyze the relationship of 5-HT2A and 5-HT7 receptor to central modulation of urogenital function. DESIGN, TIME AND SETTING： The neural morphology experiment was performed at the Ultramicro-structure Laboratory of Reproductive Medicine, Basic Medical College, Chongqing Medical University, China from April to December 2007. MATERIALS： Ten adult, Sprague Dawley rats （eight males and two females） were randomly divided into gender control group （n = 4, 50% male and 50% female） and a retrograde tracing group （n = 6, 100% male） Recombinant pseudorabies virus （PRV-152） was provided by Professor LW Enquist from Princeton University, USA. Rabbit anti-5-HT2A and 5-HT7 receptor antibodies were purchased from Diasorin, France. METHODS： In the gender control group, the spinal L5-6 segments were harvested, sliced, and then incubate antibodies specific against 5-HT2A or 5-HT7 receptors for immunohistochemical staining. In the retrograde tracing group, PRV-152 was separately injected into the right ischiocavernosus （ischiocavernosus subgroup, n = 3） and the right external urethral sphincter （external urethral sphincter subgroup, n = 3）. Four days after injection, L5-6 segments were harvested, sliced, and incubated with antibodies specific against 5-HT2A or 5-HT7 receptors for double-labeling immunofluorescence staining. MAIN OUTCOME MEASURES： Distribution analysis of 5-HT2A and 5-HT7 receptors in Onuf’s nucleus utilizing optical or laser confocal microscopy. RESULTS： 5-HT2A receptor immunoreactivity was revealed primarily in the medial region of the dorsolateral nucleus of Onuf’s nucleus. 5-HT7 receptor expression was observed in the lateral part of the dorso-lateral nucleus. 5-HT2A and 5-HT7 receptor expressions in the Onuf’s nucleus were significantly greater in male rats, compared to female rats. Double-labeling immunofluorescence demonstrated that 5-HT2A recepto were distributed primarily in the surrounding motoneurons innervating the ischiocavernosus, and 5-HT7 receptors were primarily expressed in motoneurons innervating the external urethral sphincter. CONCLUSION： Motoneurons innervating the ischiocavernosus and external urethral sphincter are located primarily in the medial and lateral region of the dorsolateral nucleus of L5-6 segments. The 5-HT2A receptor-innervating ischiocavernosus may be preferentially involved in the regulation of sexual reflex, and the 5-HT7 receptor-innervating external urethral sphincter may mainly join in regulating micturition reflex.

Medical therapy for clinical benign prostatic hyperplasia:α1 Antagonists,5α reductase inhibitors and their combination

Medical therapy for clinical benign prostatic hyperplasia(BPH)has advanced significantly in the last 2 decades.Many new a1 antagonists and 5a reductase inhibitors(5ARi)are now commercially available.The practicing urologist must decide on the most appropriate medication for his patients,taking into consideration various factors like efficacy,dosing regime,adverse effects,cost,patient’s socioeconomic background,expectations,drug availability and his own clinical experience.The use of combination therapy added further to the complexity in clinical judgment when prescribing.We highlight some of the key points in prescribing a1 antagonists,5ARi and their combination,based on our viewpoints and experience as urologists in an Asian clinical setting.

Predominant mucosal expression of 5-HT_(4(+h)) receptor splice variants in pig stomach and colon

AIM: To investigate cellular 5-HT4(-h/+h) receptor distribution, particularly in the epithelial layer, by laser mi-crodissection and polymerase chain reaction (PCR) in porcine gastrointestinal (GI) tissues. METHODS: A stepwise approach was used to evaluate RNA quality and to study cell-specific 5-HT4 receptor mRNA expression in the porcine gastric fundus and colon descendens. After freezing, staining and laser microdissection and pressure catapulting (LMPC), RNA quality was evaluated by the Experion automated electrophoresis system. 5-HT4 receptor and glyceral-dehyde-3-phosphate dehydrogenase (GAPDH) expressions were examined by endpoint reverse transcription (RT)-PCR in mucosal and muscle-myenteric plexus (MMP) tissue fractions, in mucosal and MMP parts of hematoxylin and eosin (HE) stained tissue sections andin microdissected patches of the epithelial and circular smooth muscle cell layer in these sections. Pig gastric fundus tissue sections were also stained immunohisto-chemically (IHC) for enterochromaffin cells (EC cells; MAB352); these cells were isolated by LMPC and examined by endpoint RT-PCR. RESULTS: After HE staining, the epithelial and circular smooth muscle cell layer of pig colon descendens and the epithelial cell layer of gastric fundus were identified morphologically and isolated by LMPC. EC cells of pig gastric fundus were successfully stained by IHC and isolated by LMPC. Freezing, HE and IHC staining, and LMPC had no influence on RNA quality. 5-HT4 recep-tor and GAPDH mRNA expressions were detected in mucosa and MMP tissue fractions, and in mucosal and MMP parts of HE stained tissue sections of pig colon descendens and gastric fundus. In the mucosa tissue fractions of both GI regions, the expression of h-exon containing receptor [5-HT4(+h) receptor] mRNA was significantly higher (P<0.01) compared to 5-HT4(-h) re-ceptor expression, and a similar trend was obtained in the mucosal part of HE stained tissue sections. Large microdissected patches of the epithelial and circular smooth muscle cell layer of pig colon descendens and of the epithelial cell layer of pig gastric fundus, also showed 5-HT4 receptor and GAPDH mRNA expression. No 5-HT4 receptor mRNA expression was detected in gastric LMPC-isolated EC cells from IHC stained tissues, which cells were positive for GAPDH. CONCLUSION: Porcine GI mucosa predominantly expresses 5-HT4(+h) receptor splice variants, suggesting their contribution to the 5-HT4 receptor-mediated mu-cosal effects of 5-HT.

UFLC‑PDA‑MS/MS Profling of Seven Uncaria Species Integrated with Melatonin/5‑Hydroxytryptamine Receptors Agonistic Assay

Uncariae Ramulus Cum Uncis(Gou-Teng),the dried hook-bearing stems of several Uncaria plants(Rubiaceae),is a wellknown herbal medicine in China.The clinical application of Gou-Teng is bewildered for the morphological and chemical similarity between diferent species.In order to discern their chemical and biological diference,an ultra-fast liquid chromatography equipped with ion trap time-of-fight mass spectrometry(UFLC-IT/TOF-MS)combining with melatonin(MT1 and MT2)and 5-hydroxytryptamine(5-HT1A and 5-HT2C)receptors agonistic assay in vitro was conducted on seven Uncaria species.As a result,57 compounds including 35 indole alkaloids,ten favonoids,fve triterpenoids,fve chlorogenic analogues,and two other compounds were characterized based on their MS/MS patterns and UV absorptions.Specifcally,cadambine-type and corynanthein-type alkaloids were exclusively present in U.rhynchophylla and U.scandens,whereas corynoxine-type alkaloids were commonly detected in all the seven Uncaria plants.Three Uncaria species,U.rhynchophylla,U.macrophylla,and U.yunnanensis showed obviously agnostic activity on four neurotransmitter receptors(MT1,MT2,5-HT1A,and 5-HT_(2C)).This frst-time UFLCMS-IT-TOF analyses integrated with biological assay on seven Uncaria plants will provide scientifc viewpoints for the clinical application of Gou-Teng.

The role of 5-HT_7 Receptor in the pathogenesis of IBS

Objective：To investigate the role of 5-HT7 receptor in the pathogenesis of irritable bowel syndrome（IBS）. Methods：Rat model of D-IBS was established by intracolonic instillation of acetic acid and restraint stress; Rat model of C-IBS was established by stomach irrigated with 0-4℃ cool water daily for 14 d. The content and distribution of 5-HT7 receptor at the brain and bowel was examined by immunohistochemistry and the expression of 5-HT7 receptor mRNA was detected by fluorescence quantitative RT-PCR（Real-time PCR）. Results：Immunocytochemistry result showed the 5-HT7 rceptor positive staining at hippocampus and hypothalamus of both C-IBS and D-IBS group was stronger than that of control group（P 〈 0.01）. The 5-HT7R expression at ileum, proximate colon, distal colon of C-IBS group was significantly stronger than that of control group（P 〈 0.05）. Realtime-PCR analysis results showed the expression level of 5-HT7 receptor at hippocampus and hypothalamus of both C-IBS and D-IBS group was increased than that of control group（P〈 0.05）. At proximal and distal colon of C-IBS group, the 5-HT7 receptor mRNA expression was increased compared with control group（P〈 0.05）. Conclusion：The up-regulated expression of 5-HT7 receptor at brain and colon may play an important role in the pathogenesis of C-IBS.

Herbal medicines for insomnia through regulating 5-hydroxytryptamine receptors:a systematic review

Insomnia is a common sleep disorder without effective therapy and can affect a person's life.The mechanism of the disease is not completely understood.Hence,there is a need to understand the targets related to insomnia,in order to develop innovative therapies and new compounds.Recently,increasing interest has been focused on complementary and alternative medicines for treating or preventing insomnia.Research into their molecular components has revealed that their sedative and sleep-promoting properties rely on the interactions with various neurotransmitter systems in the brain.In this review,the role of 5-hydroxytryptamine(5-HT)in insomnia development is summarized,while a systematic analysis of studies is conducted to assess the mechanisms of herbal medicines on different 5-HT receptors subtypes,in order to provide reference for subsequent research.

GRK5 is an essential co-repressor of the cardiac mineralocorticoid receptor and is selectively induced by finerenone

BACKGROUND In the heart,aldosterone(Aldo)binds the mineralocorticoid receptor(MR)to exert damaging,adverse remodeling-promoting effects.We recently showed that G protein-coupled receptor-kinase(GRK)-5 blocks the cardiac MR by directly phosphorylating it,thereby repressing its transcriptional activity.MR antagonist(MRA)drugs block the cardiac MR reducing morbidity and mortality of advanced human heart failure.Non-steroidal MRAs,such as finerenone,may provide better cardio-protection against Aldo than classic,steroidal MRAs,like spironolactone and eplerenone.AIM To investigate potential differences between finerenone and eplerenone at engaging GRK5-dependent cardiac MR phosphorylation and subsequent blockade.METHODS We used H9c2 cardiomyocytes,which endogenously express the MR and GRK5.RESULTS GRK5 phosphorylates the MR in H9c2 cardiomyocytes in response to finerenone but not to eplerenone.Unlike eplerenone,finerenone alone potently and efficiently suppresses cardiac MR transcriptional activity,thus displaying inverse agonism.GRK5 is necessary for finerenone’s inverse agonism,since GRK5 genetic deletion renders finerenone incapable of blocking cardiac MR transcriptional activity.Eplerenone alone does not fully suppress cardiac MR basal activity regardless of GRK5 expression levels.Finally,GRK5 is necessary for the antiapoptotic,anti-oxidative,and anti-fibrotic effects of both finerenone and eplerenone against Aldo,as well as for the higher efficacy and potency of finerenone at blocking Aldo-induced apoptosis,oxidative stress,and fibrosis.CONCLUSION Finerenone,but not eplerenone,induces GRK5-dependent cardiac MR inhibition,which underlies,at least in part,its higher potency and efficacy,compared to eplerenone,as an MRA in the heart.GRK5 acts as a co-repressor of the cardiac MR and is essential for efficient MR antagonism in the myocardium.

揿针疗法辅助治疗5-羟色胺受体拮抗剂所致便秘的疗效

目的探讨揿针疗法对5-羟色胺受体拮抗剂所致便秘的疗效。方法选择化疗且应用5-羟色胺受体拮抗剂所致便秘患者80例,随机分为观察组与对照组各40例。对照组采用枸橼酸莫沙必利片口服;观察组在对照组基础上加用揿针疗法辅助治疗。比较两组便秘患者首次排便时间、排便持续时间、Wexner便秘评分、Kolcaba舒适状况量表(GCQ)评分、便秘患者生活质量分析量表(PAC-QOL)评分。结果治疗后,两组患者首次排便时间、排便持续时间、Wexner评分及PAC-QOL评分比治疗前改善(P<0.05),且观察组优于对照组(P<0.05)。治疗后,两组患者GCQ评分高于治疗前(P<0.05),且观察组高于对照组(P<0.05)。结论揿针疗法辅助治疗5-羟色胺受体拮抗剂所致的便秘,疗效显著,增加患者的舒适度,提高患者生活质量。

三联方案防治中高度致吐风险化疗药物致急性恶心呕吐疗效的网状Meta分析

目的评价5-羟色胺3(5-HT3)受体拮抗剂、神经激肽-1(NK-1)受体拮抗剂和地塞米松联用方案(以下简称“三联方案”)防治中高度致吐风险化疗药物致急性恶心呕吐的疗效。方法检索PubMed、Embase、Cochrane图书馆、中国期刊全文数据库、万方数据,收集不同三联方案或5-HT3受体拮抗剂联用地塞米松(以下简称“二联方案”)的随机对照试验(RCT),检索时限为建库至2023年5月。筛选文献、提取资料、评价文献质量后,采用Stata16.0软件进行网状Meta分析。结果共纳入59项RCT,共计23418例患者,涉及15种干预措施。网状Meta分析结果显示,急性恶心呕吐控制率方面,以福沙匹坦+帕洛诺司琼+地塞米松(FPD)疗效最优,其次为福沙匹坦+格拉司琼+地塞米松(FGD)和阿瑞匹坦+雷莫司琼+地塞米松(AMD);急性恶心控制率方面,以FPD的疗效最优,其次为阿瑞匹坦+帕洛诺司琼+地塞米松(APD)和FGD;急性呕吐控制率方面,以FPD疗效最优,其次为FGD和APD。结论福沙匹坦+格拉司琼+地塞米松较其他三联方案或二联方案防治中高度致吐风险化疗药物所致急性恶心呕吐的疗效更好。

重复使用5-HT3受体拮抗剂预防多日化疗相关性恶心呕吐的疗效和安全性分析

目的:探讨重复使用第一代5-HT3受体拮抗剂(5-HT3RA)托烷司琼与第二代5-HT3RA帕洛诺司琼预防多日高度催吐风险化疗所致恶心和呕吐(chemotherapy-induced nausea and vomiting,CINV)的疗效和安全性。方法:在接受含有高度催吐风险药物连续多日化疗的患者中,采用随机、交叉自身对照的方法分组,A方案组为:在第1周期化疗中,帕洛诺司琼0.25 mg,静脉滴注,d1、d3(必要时d5)。地塞米松(DXM)10 mg,静脉滴注,d1;5 mg,静脉滴注,d2~d5。第2周期为托烷司琼5 mg,静脉滴注,d1~d3(必要时d4、d5);DXM用法同前。B方案组的止吐方案为第1周期使用托烷司琼,第2周期使用帕洛诺司琼(剂量、用法均同A方案组)。将A方案组第1个周期和B方案组第2个周期的患者归为帕洛诺司琼组,A方案第2个周期和B方案组第1个周期的患者归为托烷司琼组,比较帕洛诺司琼与托烷司琼预防CINV的疗效和不良反应。结果:共计入组91例患者。在d3至d5,帕洛诺司琼组每天恶心发生率分别为28.6%、30.8%和24.2%,托烷司琼组分别为42.8%、47.3%和39.6%,差异均有统计学意义(均P<0.05);在d4至d6,帕洛诺司琼组每天呕吐发生率分别为28.6%、18.7%和5.5%,托烷司琼组则为42.9%、34.1%和14.3%,差异均有统计学意义(均P<0.05);按时间段分析,帕洛诺司琼组在d4~5、d6~7和全程(d1~7)恶心和呕吐发生率均显著低于托烷司琼组(均P<0.05)。帕洛诺司琼组全程(d1~7)解救药使用率为13.2%,低于托烷司琼组的24.2%,但差异无统计学意义(P=0.057)。帕洛诺司琼组与托烷司琼组的止吐药物相关性不良反应发生率的差异均无统计学意义(均P>0.05)。结论:重复使用帕洛诺司琼预防持续多日高度催吐风险化疗相关的延迟性恶心呕吐的疗效优于托烷司琼,两者的安全性良好。

哮喘儿童白三烯受体调节剂临床疗效与白三烯C4合成酶及5-脂氧化酶基因的相关性

目的探讨白三烯C4合成酶(LTC4S)与5-脂氧化酶(ALOX5)基因多态性与白三烯受体拮抗剂临床疗效的关系。方法 2011年6月至2013年6月门诊72例中度持续哮喘患儿分为两组,分别予吸入型糖皮质激素激素(ICS)、ICS联合白三烯受体拮抗剂(LTRA)治疗12周,然后交叉治疗12周;采用聚合酶链反应—限制性片段长度多态性方法(PCRRFLP),对LTC4S RS730012、ALOX5 RS2115819位点进行基因分型;分析患儿治疗前后肺功能及儿童哮喘控制测试问卷(C-ACT)评分与基因多态性的关系。结果经ICS联合LTRA治疗后,LTC4S RS730012基因组中的A/C、C/C基因型患儿的75%肺活量时的用力呼气流速(FEF75)改善率显著优于A/A型,差异均有统计学意义(P<0.01);A/A基因型患儿在治疗前后改善情况的差异无统计学意义。ICS联合LTRA治疗前后,ALOX5 RS2115819基因组中的不同基因型患儿间的肺功能指标差异无统计学意义(P>0.05)。结论 LTC4S RS730012不同基因型患儿在哮喘治疗后小气道功能改善有差异,与LTRA相关。

应用噬菌体展示肽库技术淘选大鼠CCR5膜外第一、二胞外环特异性结合的活性拮抗肽与初步鉴定

目的：利用噬菌体展示肽库技术淘选与大鼠CC趋化因子受体5（CCR5）膜外第一、二胞外环特异性结合的短肽,并鉴定其与CCR5的结合能力。方法：在蛋白质数据库中查得大鼠CCR5第一、二胞外环的氨基酸序列,合成相应的线性短肽作为淘选的靶分子,利用噬菌体展示7肽文库进行3~4轮淘选,用ELISA法鉴定所选肽与靶分子的结合,并测定其与浓度的关系。结果：与CCR5第一、二胞外环特异性结合的噬菌体展示的短肽序列分别为GHWKVWL和HYIDFRW,ELISA鉴定呈阳性反应,且短肽与靶分子的结合具有浓度依赖性和可饱和性。结论：利用噬菌体展示技术成功获得了2条CCR5特异性结合的短肽,并在体外证明其可与CCR5第一、二胞外环具有结合能力。