Synthesis And Utility Of New Polycyclic Compounds As Potential Antimicrobials Based On Chromene Moiety

Objective: The present research aims to synthesize some new polycyclic compounds including chromene moiety and study their antimicrobial activity. Methods: Several new polycyclic systems including chromene scaffold incorporated with pyridine, pyrimidine, imidazopyrimidine, and imidazodiazocine were achieved via condensation reaction of chromene derivative under the proper condition with various reagents namely; cyanothioacetamide, phenyl isothiocyanate, malononitrile, carbon disulfide, benzaldehyde, triethyl orthoformate, and 1,4-dichlorobutane. Moreover, a chlorodiazenyl chromene derivative was reacted with some substances possessing active–CH2-bridge such as ethyl cyanoacetate and malononitrile to end up with hydrazono compounds. Such compounds were eventually cyclized with hydrazine hydrate to form pyrazole and oxopyrazole derivatives. Moreover, compound 1 was treated with benzoyl acetone, and then followed by cyclization with malononitrile to provide the corresponding 2-amino14-(4-methoxyphenyl)-4-methy-5-phenyl-14H-benzo[5,6] chromeno [2,3H][1,6]naphthyridine-3-carbonitrile (20). Results: The results of the antimicrobial screening in vitro revealed that the inhibition zone (mm) of the synthesized compounds 1-3, 5 and 8 implied their optimum antibacterial activity, while the compounds 4, 6 and 9-13, 15 showed a moderate to weak antibacterial activity against multiple species of B. subtilis, S. aureus, E. coli and P. aeruginosa. In contrast, the compounds 1, 6, 11, 15 showed high antifungal activities against different species of A. flavinand C. albicans, while the other compounds exhibit a moderate to poor antifungal activity. Conclusion: It is remarkable that a series of chromene derivatives synthesized by a simple and available method leads to a molecule of promising antimicrobial activity. Further research is recommended to approve the importance of polycyclic systems for various applications.

Believes versus evidence-based regio-orientation in the structure assignment of pyrazolo[1,5-a]pyrimidines

This review aims to focus and highlight the regio-orientation and regioselectivity of the reactions of 3(5)-aminopyrazoleswith 1,3-bielectrophilic reagents that lead to the formation of pyrazolo[1,5-a]pyrimidines. To clarify the significance ofregio-orientation, reactions of 3(5)-aminopyrazoles with symmetric 1,3-bielectrophilic reagents such as acetylacetoneand malononitrile are also included. The comparable nucleophilicity of the exocyclic NH2 group and endocyclicNH in 3(5)-aminopyrazoles is considered as it causes literature controversy associated with regio-orientation of thesubstituents on the pyrimidine ring of pyrazolo[1,5-a]pyrimidine when unsymmetrical 1,3-bielectrophilic reagentreacts with 3(5)-aminopyrazole. To the best of our knowledge, this review would be the first collective and confinedreport to the regio-orientation of pyrazolo[1,5-a]pyrimidines.

Synthesis And Utility Of New Polycyclic Compounds As Potential Antimicrobials Based On Chromene Moiety

Objective: The present research aims to synthesize some new polycyclic compounds including chromene moiety and study their antimicrobial activity. Methods: Several new polycyclic systems including chromene scaffold incorporated with pyridine, pyrimidine, imidazopyrimidine, and imidazodiazocine were achieved via condensation reaction of chromene derivative under the proper condition with various reagents namely; cyanothioacetamide, phenyl isothiocyanate, malononitrile, carbon disulfide, benzaldehyde, triethylorthoformate, and 1,4-dichlorobutane. Moreover, a chlorodiazenyl chromene derivative was reacted with some substances possessing active–CH2-bridge such as ethyl cyanoacetate and malononitrile to end up with hydrazono compounds. Such compounds were eventually cyclized with hydrazine hydrate to form pyrazole and oxopyrazole derivatives. Moreover, compound 1 was treated with benzoyl acetone, and then followed by cyclization with malononitrile to provide the corresponding 2-amino14-(4-methoxyphenyl)-4-methy-5-phenyl-14H-benzo[5,6] chromeno[2,3H][1,6]naphthyridine-3-carbonitrile (20). Results: The results of the antimicrobial screening in vitro revealed that the inhibition zone (mm) of the synthesized compounds 1-3, 5 and 8 implied their optimum antibacterial activity, while the compounds 4, 6 and 9-13, 15 showed a moderate to weak antibacterial activity against multiple species of B. subtilis, S. aureus, E. coli and P. aeruginosa. In contrast, the compounds 1, 6, 11, 15 showed high antifungal activities against different species of A. flavinand C. albicans, while the other compounds exhibit a moderate to poor antifungal activity. Conclusion: It is remarkable that a series of chromene derivatives synthesized by a simple and available method leads to a molecule of promising antimicrobial activity. Further research is recommended to approve the importance of polycyclic systems for various applications.

Preparation and imaging of 18 F-VUIIS1008 targeting TSPO in rheumatoid arthritis model / 中华核医学与分子影像杂志

Objective To synthesize a novel 18 F labeled probe targeting translocator protein ( TSPO) ligand 2-( 5, 7-diethyl-2-( 4-( 2-fluoroethoxy ) phenyl ) pyrazolo [ 1, 5-a ] pyrimidin-3-yl )-N, N-diethylacet-amide (VUIIS1008), and evaluate its biodistribution and imaging in rheumatoid arthritis (RA) model. Methods The tosylate substrate was labeled with 18 F using a tosyloxy for fluorine nucleophilic aliphatic substitution to obtain 18 F-VUIIS1008. The labeling efficiency, radiochemical purity, and stability in vitro were determined. In vitro cellular uptake and competitive binding assay were performed on RAW264.7 mac-rophage cells. Biodistribution and microPET/CT imaging were investigated on RA mice established by Com-plete Freund's Adjuvant. Two-sample t test was used to analyze the data. Results 18 F-VUIIS1008 was syn-thesized with the labeling yield up to (41.00±5.00)％, the radiochemical purity>98.00％, and the specific radioactivity >1. 52 × 108 MBq/mmol. 18 F-VUIIS1008 was highly stable with the radiochemical purity >98. 00％ at 4 h after incubation in mouse serum. In vitro, it also exhibited high specific TSPO binding in RAW264.7 macrophage cells. The uptake ratio was (14.00±0.30)％ at 1 h after incubation, and decreased significantly ((4.00±0.70)％;t=12.894, P<0.05) after adding excessive unlabeled VUIIS1008. The half maximal inhibitory concentration (IC50) of 18F-VUIIS1008 binding to TSPO was 0.05 nmol/L in RAW264.7 macrophage cells. In vivo distribution results showed that the uptake of 18 F-VUIIS1008 in the left arthritic ankles reached the peak value of (1.33±0.02) percentage activity of injection dose per gram of tissue (％ID/g) at 1 h after injection. The radioactivity ratio of left ankle arthritic tissue to blood ( A/B) and to normal muscle ( A/M) was 4.40±0.22 and 1.65±0.07 respectively. MicroPET/CT imaging demonstrated that 18F-VUIIS1008 could specifically target and retained in the inflammation site. Conclusion 18 F-VUIIS1008 can be easily synthe-sized with high radiochemical purity and can clearly visualized in RA imaging with low background, suggesting its potential as a novel promising molecular probe targeting TSPO for RA PET imaging.

Purification and characterization of buffalo liver L-arginase and its kinetic properties with dihydropyrimidine and metal ions.

Arginase (L-arginine amidinohydrolase, EC.3.5.3.1) from animal tissues such as, liver and kidney has been partially characterized by many researchers. In this study, we purified arginase to homogeneity from buffalo liver with about ~2857 purification fold and a 20% recovery by chromatographic and spectroscopic analysis were obtained. The molecular mass determined by gel filtration and SDS-PAGE was found to be 118 kDa and 47 kDa, respectively. The optimal pH and temperature of the arginase was 9.5 and 40°C, respectively. Kinetic parameters (Km and Vmax) showed activation of arginase in the reaction medium with decrease in Km (7.14, 5.26, 4.0 and control 3.22 mM) and Vmax (0.05, 0.035, 0.027 and control 0.021 mg/mL/min), while co-factor activity of arginase was optimized using metal ions like Mn2+ and Mg2+ at 2 mM, which revealed an increase in Vmax values (0.011, 0.013, 0.015 and control 0.010 mg/mL/min) and a decrease in Km values (2.22, 2.12, 1.88 and control 1.66 mM). The kinetic data suggested that the arginase activity is enhanced in the presence of dihydropyrimidine derivative and metal ions, indicating essential mode of activation.

Newer antifungal agents micafungin and voriconazole for fungal infection prevention during hematopoietic cell transplantation: meta-analysis / 中国医师杂志

Objective To compare the newer antifungal agents micafungin and voriconazole for prophylaxis effects on the clinical outcomes.Methods We electronically searched the database of Cochrane Central Register of Controlled Trials,Pubmed,EMbase,China Biology Medicine (CBM),China National Knowledge Infrastructure(CNKI),and relevant database articles (1996.01-2014.12).Comparative studies were carried out on proved fungal infections,mortality,and adverse effects.Meta-analysis was performed by Review Manager 5.3 software.Results We found 1 564 records and 16 studies totaling 4 234patients included in analyses.Pooled comparisons of studies found that antifungal prophylaxis with the new agents did reduce the incidence of invasive fungal infections and transplant related mortality than fluconazole or itraconazole [OR =0.41 (0.21 ～ 0.80) and OR =0.40 (0.24 ～ 0.66),respectively,P ＜ 0.01].Voriconazole had higher rates of liver dysfunction,lower gastrointestinal side effects over fluconazole,and lower rates of nephrotoxic effects than amphotericin B.Voriconazole had significant decrease in adverse events requiring drug discontinuation compared to itraconazole [OR =0.43 (0.27 ～ 0.68),P ＜ 0.01].Conclusions This analysis indicated the 2 agents appear to be well tolerated with manageable side effects and beneficial in the prophylaxis of invasive fungal infection (IFI).

Postoperative fungal endophthalmitis caused by Trichosporon asahii treated with voriconazole / Endoftalmite fúngica pós-operatória causada por Trichosporon asahii tratada com voriconazol

ABSTRACTPostoperative fungal endophthalmitis is a rare but devastating complication of cataract surgery. Vitrectomy and intravitreal amphotericin B injection as well as administration of systemic antifungal agents have been suggested as optimal treatments for fungal endophthalmitis. However, this therapy may fail to eliminate fungal species resistant to current antifungal agents. The saprophytic fungus Trichosporon asahii is frequently observed as a cause of endogenous endophthalmitis in immunosuppressed patients. We report a case of postoperative endophthalmitis caused by T. asahii, resistant to amphotericin B. To the best of our knowledge, this is the first report of T. asahii endophthalmitis successfully treated with intravitreal and systemic voriconazole, pars plana vitrectomy, and removal of the intraocular lens and entire lens capsule.

RESUMOEndoftalmite fúngica pós-operatória é uma complicação rara mas devastadora da cirurgia de catarata. A vitrectomia e injeção intravítrea de anfotericina B, bem como agentes fungicidas sistêmicos, têm sido sugeridos como tratamentos ideais para endoftalmite fúngica. No entanto, esta terapia pode falhar em erradicar as espécies de fungos resistentes aos agentes antifúngicos atuais. Uma dessas espécies de fungos é o fungo saprófita,Trichosporon asahii, que é frequentemente observada, como causa de endoftalmite endógena, em pacientes imunodeprimidos. Relatamos um caso de endoftalmite pós-operatória causada porT. asahii que é resistente a anfotericina B. Ao nosso conhecimento, este é o primeiro relato de endoftalmite porT. asahii tratado com sucesso com voriconazol intravítreo e sistêmico, vitrectomia viapars plana, e remoção da lente intraocular e saco capsular.

Prevention of Pazopanib-Induced Prolonged Cardiac Repolarization and Proarrhythmic Effects / Prevenção da Repolarização Cardíaca Prolongada e dos Efeitos Pró-arrítmicos Induzidos por Pazopanibe

Background: Pazopanib (PZP) may induce prolonged cardiac repolarization and proarrhythmic effects, similarly to other tyrosine kinase inhibitors. Objectives: To demonstrate PZP-induced prolonged cardiac repolarization and proarrhythmic electrophysiological effects and to investigate possible preventive effects of metoprolol and diltiazem on ECG changes (prolonged QT) in an experimental rat model. Methods: Twenty-four Sprague-Dawley adult male rats were randomly assigned to 4 groups (n = 6). The first group (normal group) received 4 mL of tap water and the other groups received 100 mg/kg of PZP (Votrient® tablet) perorally, via orogastric tubes. After 3 hours, the following solutions were intraperitoneally administered to the animals: physiological saline solution (SP), to the normal group and to the second group (control-PZP+SP group); 1 mg/kg metoprolol (Beloc, Ampule, AstraZeneca), to the third group (PZP+metoprolol group); and 1mg/kg diltiazem (Diltiazem, Mustafa Nevzat), to the fourth group (PZP+diltiazem group). One hour after, and under anesthesia, QTc was calculated by recording ECG on lead I. Results: The mean QTc interval values were as follows: normal group, 99.93 ± 3.62 ms; control-PZP+SP group, 131.23 ± 12.21 ms; PZP+metoprolol group, 89.36 ± 3.61 ms; and PZP+diltiazem group, 88.86 ± 4.04 ms. Both PZP+metoprolol and PZP+diltiazem groups had significantly shorter QTc intervals compared to the control-PZP+SP group (p < 0.001). Conclusion: Both metoprolol and diltiazem prevented PZP-induced QT interval prolongation. These drugs may provide a promising prophylactic strategy for the prolonged QTc interval associated with tyrosine kinase inhibitor use. .

Fundamento: Pazopanibe (PZP) pode induzir prolongamento da repolarização cardíaca e efeitos pró-arrítmicos, à semelhança de outros inibidores da tirosina quinase. Objetivos: Demonstrar prolongamento da repolarização cardíaca e efeitos eletrofisiológicos pró-arrítmicos induzidos pelo PZP, assim como investigar possíveis efeitos de metoprolol e diltiazem na prevenção de alterações no ECG (prolongamento do intervalo QT) em um modelo experimental em ratos. Métodos: Ratos Sprague-Dawley adultos machos (24) foram designados de modo aleatório para quatro grupos (n = 6). O primeiro grupo (normal) recebeu 4 ml de água da torneira, enquanto os demais receberam 100 mg/kg de PZP (comprimido de Votrient®) através de sonda orogástrica. Após 3 horas, os animais receberam por via intraperitoneal: solução salina, para o grupo normal e para o segundo grupo (controle-PZP+SP); 1 mg/kg de metoprolol (Beloc, Ampola, AstraZeneca), para o terceiro grupo (PZP+metoprolol); e 1mg/kg de diltiazem (Diltiazem, Mustafa Nevzat), para o quarto grupo (PZP+diltiazem). Uma hora após a administração desses medicamentos, e sob anestesia, calculou-se o intervalo QTc registrando-se o ECG em DI. Resultados: Os valores médios do intervalo QTc foram: grupo normal, 99,93 ± 3,62 ms; grupo controle-PZP+SP, 131,23 ± 12,21 ms; grupo PZP+metoprolol, 89,36 ± 3,61 ms; e grupo PZP+diltiazem, 88,86 ± 4,04 ms. Os grupos PZP+metoprolol e PZP+diltiazem apresentaram intervalos QTc significativamente mais curtos comparados aos do grupo controle-PZP+SP (p < 0,001). Conclusão: Ambos metoprolol e diltiazem evitaram o prolongamento do intervalo QT induzido por PZP. Tais medicamentos podem ser uma promissora estratégia para evitar o prolongamento do intervalo QTc associado ao uso de inibidores da tirosina quinase. .

Clinical research of Zhenqifuzheng granule combined with Tegafur gimeracil oteracil potassim capsule in treating advanced carcinoma of gastric cardia in aged patients / 中华老年医学杂志

Objective To study the clinical effect of Zhenqifuzheng granule combined with Tegafur gimeracil oteracil potassium capsule in treating advanced carcinoma of gastric cardia in aged patients.Methods 52 cases of aged patients with advanced carcinoma of gastric cardia were randomly divided into the observation group and the control group.The observation group was treated with zhenqi fuzheng granule combined with tegafur gimeracil oteracil potassium capsule,and the control group was given Tegafur gimeracil oteracil potassium capsule only.The curative effect,adverse reaction and cellular immune function were evaluated after two treatment cycles.Results There was no statistically significant difference in the objective efficacy rate between observation (46.2％) and control group (50.0％) (P＞0.05).The rate of adverse reaction was higher in the control group than in observation group (P＜0.05).The rate of gastrointestinal adverse reactions in the control group was 50.0％,but 15.4％ in observation group.The rate of bone marrow suppression was 26.9％ in control group,but 11.5％ in observation group.The cellular immune function was better in observation group than in the control group (P＜0.05).Conclusions Zhenqifuzheng granule can improve immune function and reduce toxic side effects when combined with Tegafur gimeracil oteracil potassim capsule in treating advanced carcinoma of gastric cardia in aged patients.

Study on the roles of SDF-1/CXCR4 axis in imatinib resistance of K562 cells co-cultured with the bone marrow stromal cells / 中国医师杂志

Objective To investigate influences of co-culture with the bone marrow stromal cells (BMSCs) on imatinib sensitivity,and the role of stromal cell-derived factor-1 (SDF-1)/chemokine receptor 4 (CXCR4) axis in imatinib resistance of K562 cells in the co-culture model.Methods The model was constructed by co-culturing K562 cells with BMSCs isolated and cultured from the patients with chronic myeloid leukemia.The apoptosis rate and the CXCR4 expressing rate of the K562 cells exposed to 0.5 μmol/L imatinib for 72 hours were detected by fluorescent-activated cell scanning (FACS) machine.The K562 cells were exposed to 0.5 μmol/L imatinib for 4 hours,and labelled by calckin-AM fluorescent labeling sytem.The adhesion rate of the K562 cells co-cultured with BMSCs for 24 hours was calculated with fluorescence intensity.The IC50 value of K562 cells exposed to imatinib was detected by methyl thiazolyl tetrazolium (MTT) assay while the SDF-1/CXCR4 axis was blocked by 10 μg/ml monoclonal antibody of CXCR4.Results The apoptosis rate of K562 cells exposed to 0.5 μmol/L imatinib for 72 hours in co-culture group and suspension culture group was (15.48 ±4.17) ％ and (32.01 ±6.83) ％,respectively.The apoptosis rates of K562 cells in the two groups were significantly different (t =5.587,P =0.001).For the co-culture group,the CXCR4 expressing rates of K562 cells unexposed and exposed to 0.5 μmol/L imatinib for 72 hours were (20.31 ± 3.76) ％ (suspension cultured:11.28％ ± 3.44％) and (53.64 ± 5.35) ％ (suspension cultured:25.34％ ± 3.21％),respectively.Those results showed that co-culture with BMSCs and exposure to imatinib induced the K562 cells to express CXCR4.The adhesion rates of the K562 cells to the BMSCs were elevated from (42.18 ± 6.17) ％ to (68.97 ± 11.08) ％ when the K562 cells were exposed to 0.5 μmol/L imatinib for 4 hours.The IC50 values of block group (the SDF-1/CXCR4 axis was blocked by 10 μg/ml monoclonal antibody of CXCR4) and unblock group were (0.68 ± 0.04) μmol/L and (1.27 ± 0.05) μmol/L,respectively.The IC50 values of two groups were significantly different(t =4.869,P =0.001).Conclusions The K562 cells co-cultured with the BMSCs from the patients with chronic myeloid leukemia can obtain resistance to imatinib,which was related with that co-culture with the BMSCs and exposure to imatinib can induce the K562 cells to express CXCR4.To a certain extent,the imatinib resistance mediated by co-culture with BMSCs can be reversed by monoclonal antibody of CXCR4.

Effects of Rosuvastatin and Losartan on expression of caveolin-1 in cultured human monocyte-macrophage cells induced by oxidized low density lipoprotein / 中国医师杂志

Objective To investigate the effects,mechanisms,and the optimum doses of Rosuvastatin and Losartan on expression of caveolin-1 in cultured human monocyte-macrophage cells which were induced by oxidized low density lipoprotein(ox-LDL).Methods Human-monocyte cells were separated and changed into the human monocyte-macrophage cells.The model of amerosclerosis was set up.These cells were incubated in different doses of Rosuvastatin(0.1,1.0,5.0 μmol/L) and Losartan (10,50,100 μmol/L),and then cultured in combination of two drags (5.0 μmol/L + 100 μmol/L).Expression of caveolin-1 mRNA was determined with real-time fluorescent quantitative polymerase chain reaction (RT-PCR).Results In ox-LDL group,caveolin-1 mRNA was decreased sharply relative to control group [(0.2533 ±0.00973) vs (0.9410 ±0.03677)] in a concentration-dependent manner (P ＜0.01).Compared to ox-LDL group,expressions of Caveolin-1 mRNA were increased gradually in different doses of Rosuvastatin alone and Losartan alone group [(0.5198 ± 0.04840),(0.6183 ± 0.06740),(0.7257 ± 0.03052) vs (0.2533 ± 0.00973) ; (0.3350 ± 0.04177),(0.4428 ± 0.03804),(0.6049 ± 0.02627) vs (0.2533 ± 0.00973)] in a concentration-dependent manner (P ＜ 0.01) ; the summit expressions of caveolin-1 mRNA were emerged in using Rosuvastatin and Losartan together (F =59.119,P ＜ 0.01).Conclusions Rosuvastatin and Losartan may be responsible for the expression of caveolin-1 in human monocyte-macrophage cells that were induced by ox-LDL.The expressions were up-regulated with dose dependent manner of these drugs,and got the crest stage when using optimum doses of Rosuvastatin and Losartan together.

Effects and mechanism of different doses of rosuvastatin on expression of tissue factor in cultured human monocyte-macrophage cells induced by oxidized low density lipoprotein / 中国医师杂志

Objective To investigate the effects and mechanism of different doses of rosuvastatin on expression of tissue factor(TF) in cultured human monocyte-macrophage cells which were induced by oxidized low density lipoprotein (ox-LDL).Methods The human monocyte-macrophage cells were divided into seven groups:control group,ox-LDL group,poly-insine monophosphate group,different doses of rosuvastatin group(0.01 μmol/L,0.1 μmol/L,1 μmol/L,5 μmol/L).The expression of LOX-1 mRNA and TF mRNA was assayed by RT-PCR.The enzyme-linked immunosorbent assay was performed to determine the protein concentration of TF.Results Effects of different doses of rosuvastatin on expressions of LOX-1mRNA,TF mRNA and TF in cultured human monocyte-macrophage cells induced by ox-LDL:comparison among seven groups,the difference was statistically significant (F =91.334,58.833,103.552,P ＜0.05).Compared with control group,the expressions of LOX-1 mRNA,TF mRNA and TF were increased in the ox-LDL group[(3.25156 ± 0.15772) vs (1 ±0) ;(2.522451 ±0.138967) vs (1 ±0) ;(207.7233± 1.154701)ng/L vs (184.8467 ± 0.871799)ng/L],and they were in a concentration-dependent manner (P ＜ 0.05).Compared with the PolyⅠ group and the different doses of rosuvastatin group,the expressions of LOX-1 mRNA,TF mRNA and TF were in the ox-LDL group,and the different doses of rosuvastatin were decreased by dose-dependent manner.It was in a concentration dependent manner (P ＜ 0.05).Different doses of rosuvastatin were compared between groups (between each group P ＜ 0.05),the difference between each two groups was statistically significant (P ＜ 0.05).Conclusions LOX-1 may be responsible for the expression of TF in Human monocyte-macrophage cells induced by ox-LDL.Rosuvastatin by dose dependent manner and by means of ox-LDL reduced monocyte-macrophage LOX-1 mRNA and TF mRNA expressions,which reduced expression of TF.

Determination of serum levels of imatinib mesylate in patients with chronic myeloid leukemia: validation and application of a new analytical method to monitor treatment compliance

OBJECTIVE: The goal of this study was to monitor imatinib mesylate therapeutically in the Tumor Biology Laboratory, Department of Hematology and Hemotherapy, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (USP). A simple and sensitive method to quantify imatinib and its metabolite (CGP74588) in human serum was developed and fully validated in order to monitor treatment compliance. METHODS: The method used to quantify these compounds in serum included protein precipitation extraction followed by instrumental analysis using high performance liquid chromatography coupled with mass spectrometry. The method was validated for several parameters, including selectivity, precision, accuracy, recovery and linearity. RESULTS: The parameters evaluated during the validation stage exhibited satisfactory results based on the Food and Drug Administration and the Brazilian Health Surveillance Agency (ANVISA) guidelines for validating bioanalytical methods. These parameters also showed a linear correlation greater than 0.99 for the concentration range between 0.500 µg/mL and 10.0 µg/mL and a total analysis time of 13 minutes per sample. This study includes results (imatinib serum concentrations) for 308 samples from patients being treated with imatinib mesylate. CONCLUSION: The method developed in this study was successfully validated and is being efficiently used to measure imatinib concentrations in samples from chronic myeloid leukemia patients to check treatment compliance. The imatinib serum levels of patients achieving a major molecular response were significantly higher than those of patients who did not achieve this result. These results are thus consistent with published reports concerning other populations.

Chronic myeloid leukemia BCR/ABL1 mutation clonal evolution and treatment strategies / 中华检验医学杂志

Application of imatinib has made a lot of chronic myeloid leukemia (CML) patients longterm survival,but the CML BCR/ABL1 kinase domain mutations (KDM) will result in drug resistance of imatinib.There are many KDM types.The different types appear randomly.The leukemic clone with different KDM characteristics has a certain evolution.In the period of imatinib treatment,a higher degree of drug resistance mutations in cells likely to develop as the dominant clone.It is suggested that the treatment of imatinib-resistant CML in addition to efforts to develop next-generation tyrosine kinase inhibitors outside,but also consider the use of traditional medicine to help cure.

Effect and mechanism of rosuvastatin on the expression of tissue factor in cultured human monocytemacrophages cell induced by oxidized low density lipoprotein / 中国医师杂志

ObjectiveTo investigate the effects and mechanism of rosuvastatin on the expression of tissue factor in cultured human monocyte-macrophages cells which was induced by oxidized low density lipoprotein(ox-LDL).MethodsThe human monocyte-macrophages cells were divided into four groups:control group,ox-LDL group,Poly-inosine monophosphate (Poly Ⅰ) group,rosuvastatin group.The expression of LOX-1mRNA and TF mRNA was assayed by RT-PCR.The ELISA was performed to determine the protein concentration of TF.ResultsCompared with control group,the expression of LOX-1 mRNA and TF mRNA was increased in the ox-LDL group[ (3.25156±0.15772) vs (1±0) ; (2.522451±0.138967) vs (1±0) ],and it was in a concentration-dependent manner (P＜0.01).Compared with the expression of LOX-1 mRNA in the Poly-inosine monophosphate group and rosuvastatin group,TF mRNA were decreased in the ox-LDL group[ (2.95139±0.157253) vs(3.25156±0.15772) ; (2.877343±0.156558) vs(3.25156±0.15772) ; (1.811956±0.169699) vs (2.522451±0.138967) ; (1.687701±0.174647) vs (2.522451±0.138967)],and it was in a concentration-dependent manner(P＜0.05).Compared with control group,the expression of TF in the ox-LDL group was increased [(207.7233±1.154701) vs (184.8467±0.871799) ],and it was in a concentration-dependent manner (P＜0.01).Compared with the Poly-inosine monophosphate group and rosuvastatin group [(197.8733±1.505003) vs (207.7233±1.154701) ;(202.9567±2.722744)vs(207.7233±1.154701) ],the expression of TF in the ox-LDL group were decreased,and it was in a concentration-dependent manner (P＜0.05).ConclusionsLOX-1 may be responsible for the expression of TF in human monocyte-macrophages cells induced by ox-LDL.Rosuvastatin is able to down-regulate the expression of LOX-1mRNA in human monocyte-macrophages cells through oxLDL,and TF mRNA and TF expression can be reduced.

Imatinib resistance: a review of alternative inhibitors in chronic myeloid leukemia

The development of point mutations in the BCR-ABL kinase domain is the main reason for imatinib resistance in chronic myeloid leukemia. Different detection methods are used in chronic myeloid leukemia monitoring, such as direct sequencing, denaturing high performance liquid chromatography and allele specific polymerase chain reaction. Mutation analysis has become mandatory during patient workup of chronic myeloid leukemia in order for the physician to choose the most suitable tyrosine kinase inhibitor. This article, a review of possible therapies used to overcome imatinib resistance, investigates the current position by searching the PubMed electronic database using the following keywords: imatinib, dasatinib, nilotinib, aurora kinase, SRC kinase, mutation, treatment, drugs and resistance. New tyrosine kinase inhibitors include BCR-ABL kinase selective inhibitors, dual ABL/SRC kinase inhibitors and aurora kinase inhibitors. Awareness of the spectrum of new drugs against mutations, in particular the T315I mutation, makes it possible to properly select the best therapy for each patient.

Importance of monitoring and early switch to second generation tyrosine kinase inhibitors for the prognosis of patients with chronic myeloid leukemia with imatinib resistance or intolerance

Imatinib mesylate was the first BCR-ABL-target agent approved for the treatment of chronic myeloid leukemia. Although most patients respond well to imatinib therapy, the literature shows that one third develops resistance or intolerance. The timing of second-line treatment after failure of initial treatment may have a significant impact on long-term outcome. Thus, appropriate monitoring to identify resistance and/or intolerance is crucial to early intervention with second generation tyrosine kinase inhibitors and attainment of better results.

Dasatinib: clinical trials and management of adverse events in imatinib resistant/intolerant chronic myeloid leukemia

Dasatinib is a highly effective second generation tyrosine kinase inhibitor approved for the treatment of imatinib-resistant or intolerant chronic myeloid leukemia and Philadelphia-positive acute lymphoblastic leukemia. This article reviews the results of phase I, II and III studies and looks at the efficacy and safety of dasatinib. This review also provides practical recommendations for the management of side effects.

Monitoring imatinib plasma concentrations in chronic myeloid leukemia

Imatinib has proved to be effective in the treatment of chronic myeloid leukemia, but plasma levels above 1,000 ng/mL must be achieved to optimize activity. Therapeutic drug monitoring of imatinib is useful for patients that do not present clinical response. There are several analytical methods to measure imatinib in biosamples, which are mainly based on liquid chromatography with mass spectrometric or diode array spectrophotometric detection. The former is preferred due to its lower cost and wider availability. The present manuscript presents a review of the clinical and analytical aspects of the therapeutic drug monitoring of imatinib in the treatment of chronic myeloid leukemia. The review includes references published over the last 10 years. There is evidence that the monitoring of plasmatic levels of imatinib is an useful alternative, especially considering the wide pharmacokinetic variability of this drug.