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1.
Expert Opin Drug Discov ; : 1-27, 2024 Jul 14.
Article in English | MEDLINE | ID: mdl-39004919

ABSTRACT

INTRODUCTION: Small molecules often bind to multiple targets, a behavior termed polypharmacology. Anticipating polypharmacology is essential for drug discovery since unknown off-targets can modulate safety and efficacy - profoundly affecting drug discovery success. Unfortunately, experimental methods to assess selectivity present significant limitations and drugs still fail in the clinic due to unanticipated off-targets. Computational methods are a cost-effective, complementary approach to predict polypharmacology. AREAS COVERED: This review aims to provide a comprehensive overview of the state of polypharmacology prediction and discuss its strengths and limitations, covering both classical cheminformatics methods and bioinformatic approaches. The authors review available data sources, paying close attention to their different coverage. The authors then discuss major algorithms grouped by the types of data that they exploit using selected examples. EXPERT OPINION: Polypharmacology prediction has made impressive progress over the last decades and contributed to identify many off-targets. However, data incompleteness currently limits most approaches to comprehensively predict selectivity. Moreover, our limited agreement on model assessment challenges the identification of the best algorithms - which at present show modest performance in prospective real-world applications. Despite these limitations, the exponential increase of multidisciplinary Big Data and AI hold much potential to better polypharmacology prediction and de-risk drug discovery.

2.
Clin Transl Med ; 14(4): e1657, 2024 04.
Article in English | MEDLINE | ID: mdl-38629623

ABSTRACT

PURPOSE: Systematic repurposing of approved medicines for another indication may accelerate drug development in oncology. We present a strategy combining biomarker testing with drug repurposing to identify new treatments for patients with advanced cancer. METHODS: Tumours were sequenced with the Illumina TruSight Oncology 500 (TSO-500) platform or the FoundationOne CDx panel. Mutations were screened by two medical oncologists and pathogenic mutations were categorised referencing literature. Variants of unknown significance were classified as potentially pathogenic using plausible mechanisms and computational prediction of pathogenicity. Gain of function (GOF) mutations were evaluated through repurposing databases Probe Miner (PM), Broad Institute Drug Repurposing Hub (Broad Institute DRH) and TOPOGRAPH. GOF mutations were repurposing events if identified in PM, not indexed in TOPOGRAPH and excluding mutations with a known Food and Drug Administration (FDA)-approved biomarker. The computational repurposing approach was validated by evaluating its ability to identify FDA-approved biomarkers. The total repurposable genome was identified by evaluating all possible gene-FDA drug-approved combinations in the PM dataset. RESULTS: The computational repurposing approach was accurate at identifying FDA therapies with known biomarkers (94%). Using next-generation sequencing molecular reports (n = 94), a meaningful percentage of patients (14%) could have an off-label therapeutic identified. The frequency of theoretical drug repurposing events in The Cancer Genome Atlas pan-cancer dataset was 73% of the samples in the cohort. CONCLUSION: A computational drug repurposing approach may assist in identifying novel repurposing events in cancer patients with no access to standard therapies. Further validation is needed to confirm a precision oncology approach using drug repurposing.


Subject(s)
Neoplasms , Humans , Neoplasms/drug therapy , Neoplasms/genetics , Drug Repositioning , Precision Medicine , Pharmaceutical Preparations , Biomarkers
3.
Cell Chem Biol ; 31(5): 973-988.e4, 2024 May 16.
Article in English | MEDLINE | ID: mdl-38335967

ABSTRACT

The (poly)pharmacology of drug metabolites is seldom comprehensively characterized in drug discovery. However, some drug metabolites can reach high plasma concentrations and display in vivo activity. Here, we use computational and experimental methods to comprehensively characterize the kinase polypharmacology of M324, the major metabolite of the PARP1 inhibitor rucaparib. We demonstrate that M324 displays unique PLK2 inhibition at clinical concentrations. This kinase activity could have implications for the efficacy and safety of rucaparib and therefore warrants further clinical investigation. Importantly, we identify synergy between the drug and the metabolite in prostate cancer models and a complete reduction of α-synuclein accumulation in Parkinson's disease models. These activities could be harnessed in the clinic or open new drug discovery opportunities. The study reported here highlights the importance of characterizing the activity of drug metabolites to comprehensively understand drug response in the clinic and exploit our current drug arsenal in precision medicine.


Subject(s)
Indoles , Poly(ADP-ribose) Polymerase Inhibitors , Humans , Poly(ADP-ribose) Polymerase Inhibitors/pharmacology , Poly(ADP-ribose) Polymerase Inhibitors/chemistry , Poly(ADP-ribose) Polymerase Inhibitors/metabolism , Indoles/pharmacology , Indoles/chemistry , Indoles/metabolism , Animals , Male , Mice , Drug Synergism , Cell Line, Tumor , Prostatic Neoplasms/drug therapy , Prostatic Neoplasms/metabolism , Prostatic Neoplasms/pathology
4.
Sci Total Environ ; 912: 169301, 2024 Feb 20.
Article in English | MEDLINE | ID: mdl-38103609

ABSTRACT

The current view is that environmental levels of nicotine and cotinine, commonly in the ng/L range, are safe for aquatic organisms. In this study, 7 days post-fertilization zebrafish embryos have been exposed for 24 h to a range of environmental concentrations of nicotine (2.0 ng/L-2.5 µg/L) and cotinine (50 pg/L-10 µg/L), as well as to a binary mixture of these emerging pollutants. Nicotine exposure led to hyperactivity, decreased vibrational startle response and increased non-associative learning. However, the more consistent effect found for both nicotine and cotinine was a significant increase in light-off visual motor response (VMR). The effect of both pollutants on this behavior occurred through a similar mode of action, as the joint effects of the binary mixture of both chemicals were consistent with the concentration addition concept predictions. The results from docking studies suggest that the effect of nicotine and cotinine on light-off VMR could be mediated by zebrafish α7 nAChR expressed in retina. The results presented in this study emphasize the need to revisit the environmental risk assessment of chemicals including additional ecologically relevant sublethal endpoints.


Subject(s)
Environmental Pollutants , Nicotine , Animals , Nicotine/toxicity , Cotinine , Zebrafish , Larva
5.
bioRxiv ; 2023 Oct 10.
Article in English | MEDLINE | ID: mdl-37873470

ABSTRACT

The Mechanism of Action (MoA) of a drug is generally represented as a small, non-tissue-specific repertoire of high-affinity binding targets. Yet, drug activity and polypharmacology are increasingly associated with a broad range of off-target and tissue-specific effector proteins. To address this challenge, we have implemented an efficient integrative experimental and computational framework leveraging the systematic generation and analysis of drug perturbational profiles representing >700 FDA-approved and experimental oncology drugs, in cell lines selected as high-fidelity models of 23 aggressive tumor subtypes. Protein activity-based analyses revealed highly reproducible, drug-mediated modulation of tissue-specific targets, leading to generation of a proteome-wide polypharmacology map, characterization of MoA-related drug clusters and off-target effects, and identification and experimental validation of novel, tissue-specific inhibitors of undruggable oncoproteins. The proposed framework, which is easily extended to elucidating the MoA of novel small-molecule libraries, could help support more systematic and quantitative approaches to precision oncology.

6.
Cell Chem Biol ; 30(12): 1634-1651.e6, 2023 12 21.
Article in English | MEDLINE | ID: mdl-37797617

ABSTRACT

Drug-induced phospholipidosis (DIPL), characterized by excessive accumulation of phospholipids in lysosomes, can lead to clinical adverse effects. It may also alter phenotypic responses in functional studies using chemical probes. Therefore, robust methods are needed to predict and quantify phospholipidosis (PL) early in drug discovery and in chemical probe characterization. Here, we present a versatile high-content live-cell imaging approach, which was used to evaluate a chemogenomic and a lysosomal modulation library. We trained and evaluated several machine learning models using the most comprehensive set of publicly available compounds and interpreted the best model using SHapley Additive exPlanations (SHAP). Analysis of high-quality chemical probes extracted from the Chemical Probes Portal using our algorithm revealed that closely related molecules, such as chemical probes and their matched negative controls can differ in their ability to induce PL, highlighting the importance of identifying PL for robust target validation in chemical biology.


Subject(s)
Lipidoses , Lysosomal Storage Diseases , Humans , Lipidoses/chemically induced , Phospholipids , Machine Learning , Drug Discovery
7.
RSC Med Chem ; 14(6): 1002-1011, 2023 Jun 22.
Article in English | MEDLINE | ID: mdl-37360399

ABSTRACT

Target 2035, an international federation of biomedical scientists from the public and private sectors, is leveraging 'open' principles to develop a pharmacological tool for every human protein. These tools are important reagents for scientists studying human health and disease and will facilitate the development of new medicines. It is therefore not surprising that pharmaceutical companies are joining Target 2035, contributing both knowledge and reagents to study novel proteins. Here, we present a brief progress update on Target 2035 and highlight some of industry's contributions.

8.
Nucleic Acids Res ; 51(D1): D1212-D1219, 2023 01 06.
Article in English | MEDLINE | ID: mdl-36624665

ABSTRACT

canSAR (https://cansar.ai) is the largest public cancer drug discovery and translational research knowledgebase. Now hosted in its new home at MD Anderson Cancer Center, canSAR integrates billions of experimental measurements from across molecular profiling, pharmacology, chemistry, structural and systems biology. Moreover, canSAR applies a unique suite of machine learning algorithms designed to inform drug discovery. Here, we describe the latest updates to the knowledgebase, including a focus on significant novel data. These include canSAR's ligandability assessment of AlphaFold; mapping of fragment-based screening data; and new chemical bioactivity data for novel targets. We also describe enhancements to the data and interface.


Subject(s)
Antineoplastic Agents , Drug Discovery , Knowledge Bases , Translational Research, Biomedical , Humans , Algorithms , Neoplasms/drug therapy , Neoplasms/genetics
9.
Nucleic Acids Res ; 51(D1): D1492-D1502, 2023 01 06.
Article in English | MEDLINE | ID: mdl-36268860

ABSTRACT

We describe the Chemical Probes Portal (https://www.chemicalprobes.org/), an expert review-based public resource to empower chemical probe assessment, selection and use. Chemical probes are high-quality small-molecule reagents, often inhibitors, that are important for exploring protein function and biological mechanisms, and for validating targets for drug discovery. The publication, dissemination and use of chemical probes provide an important means to accelerate the functional annotation of proteins, the study of proteins in cell biology, physiology, and disease pathology, and to inform and enable subsequent pioneering drug discovery and development efforts. However, the widespread use of small-molecule compounds that are claimed as chemical probes but are lacking sufficient quality, especially being inadequately selective for the desired target or even broadly promiscuous in behaviour, has resulted in many erroneous conclusions in the biomedical literature. The Chemical Probes Portal was established as a public resource to aid the selection and best-practice use of chemical probes in basic and translational biomedical research. We describe the background, principles and content of the Portal and its technical development, as well as examples of its applications and use. The Chemical Probes Portal is a community resource and we therefore describe how researchers can be involved in its content and development.


Subject(s)
Molecular Probes , Proteins , Drug Discovery , Proteins/chemistry , Proteins/metabolism , Databases, Chemical
10.
J Cheminform ; 14(1): 28, 2022 May 28.
Article in English | MEDLINE | ID: mdl-35643512

ABSTRACT

BACKGROUND: Integration of medicinal chemistry data from numerous public resources is an increasingly important part of academic drug discovery and translational research because it can bring a wealth of important knowledge related to compounds in one place. However, different data sources can report the same or related compounds in various forms (e.g., tautomers, racemates, etc.), thus highlighting the need of organising related compounds in hierarchies that alert the user on important bioactivity data that may be relevant. To generate these compound hierarchies, we have developed and implemented canSARchem, a new compound registration and standardization pipeline as part of the canSAR public knowledgebase. canSARchem builds on previously developed ChEMBL and PubChem pipelines and is developed using KNIME. We describe the pipeline which we make publicly available, and we provide examples on the strengths and limitations of the use of hierarchies for bioactivity data exploration. Finally, we identify canonicalization enrichment in FDA-approved drugs, illustrating the benefits of our approach. RESULTS: We created a chemical registration and standardization pipeline in KNIME and made it freely available to the research community. The pipeline consists of five steps to register the compounds and create the compounds' hierarchy: 1. Structure checker, 2. Standardization, 3. Generation of canonical tautomers and representative structures, 4. Salt strip, and 5. Generation of abstract structure to generate the compound hierarchy. Unlike ChEMBL's RDKit pipeline, we carry out compound canonicalization ahead of getting the parent structure, similar to PubChem's OpenEye pipeline. canSARchem has a lower rejection rate compared to both PubChem and ChEMBL. We use our pipeline to assess the impact of grouping the compounds in hierarchies for bioactivity data exploration. We find that FDA-approved drugs show statistically significant sensitivity to canonicalization compared to the majority of bioactive compounds which demonstrates the importance of this step. CONCLUSIONS: We use canSARchem to standardize all the compounds uploaded in canSAR (> 3 million) enabling efficient data integration and the rapid identification of alternative compound forms with useful bioactivity data. Comparison with PubChem and ChEMBL pipelines evidenced comparable performances in compound standardization, but only PubChem and canSAR canonicalize tautomers and canSAR has a slightly lower rejection rate. Our results highlight the importance of compound hierarchies for bioactivity data exploration. We make canSARchem available under a Creative Commons Attribution-ShareAlike 4.0 International License (CC BY-SA 4.0) at https://gitlab.icr.ac.uk/cansar-public/compound-registration-pipeline .

11.
RSC Med Chem ; 13(1): 13-21, 2022 Jan 27.
Article in English | MEDLINE | ID: mdl-35211674

ABSTRACT

Twenty years after the publication of the first draft of the human genome, our knowledge of the human proteome is still fragmented. The challenge of translating the wealth of new knowledge from genomics into new medicines is that proteins, and not genes, are the primary executers of biological function. Therefore, much of how biology works in health and disease must be understood through the lens of protein function. Accordingly, a subset of human proteins has been at the heart of research interests of scientists over the centuries, and we have accumulated varying degrees of knowledge about approximately 65% of the human proteome. Nevertheless, a large proportion of proteins in the human proteome (∼35%) remains uncharacterized, and less than 5% of the human proteome has been successfully targeted for drug discovery. This highlights the profound disconnect between our abilities to obtain genetic information and subsequent development of effective medicines. Target 2035 is an international federation of biomedical scientists from the public and private sectors, which aims to address this gap by developing and applying new technologies to create by year 2035 chemogenomic libraries, chemical probes, and/or biological probes for the entire human proteome.

12.
Circ Genom Precis Med ; 15(1): e003391, 2022 02.
Article in English | MEDLINE | ID: mdl-35113648

ABSTRACT

BACKGROUND: Acquired long QT syndrome (aLQTS) is a serious unpredictable adverse drug reaction. Pharmacogenomic markers may predict risk. METHODS: Among 153 aLQTS patients (mean age 58 years [range, 14-88], 98.7% White, 85.6% symptomatic), computational methods identified proteins interacting most significantly with 216 QT-prolonging drugs. All cases underwent sequencing of 31 candidate genes arising from this analysis or associating with congenital LQTS. Variants were filtered using a minor allele frequency <1% and classified for susceptibility for aLQTS. Gene-burden analyses were then performed comparing the primary cohort to control exomes (n=452) and an independent replication aLQTS exome sequencing cohort. RESULTS: In 25.5% of cases, at least one rare variant was identified: 22.2% of cases carried a rare variant in a gene associated with congenital LQTS, and in 4% of cases that variant was known to be pathogenic or likely pathogenic for congenital LQTS; 7.8% cases carried a cytochrome-P450 (CYP) gene variant. Of 12 identified CYP variants, 11 (92%) were in an enzyme known to metabolize at least one culprit drug to which the subject had been exposed. Drug-drug interactions that affected culprit drug metabolism were found in 19% of cases. More than one congenital LQTS variant, CYP gene variant, or drug interaction was present in 7.8% of cases. Gene-burden analyses of the primary cohort compared to control exomes (n=452), and an independent replication aLQTS exome sequencing cohort (n=67) and drug-tolerant controls (n=148) demonstrated an increased burden of rare (minor allele frequency<0.01) variants in CYP genes but not LQTS genes. CONCLUSIONS: Rare susceptibility variants in CYP genes are emerging as potentially important pharmacogenomic risk markers for aLQTS and could form part of personalized medicine approaches in the future.


Subject(s)
Genetic Predisposition to Disease , Long QT Syndrome , Exome/genetics , Gene Frequency , Genetic Testing , Humans , Long QT Syndrome/genetics , Middle Aged
13.
Br J Clin Pharmacol ; 88(2): 742-752, 2022 02.
Article in English | MEDLINE | ID: mdl-34327724

ABSTRACT

AIMS: The aim of this study was to determine the differences and potential mechanistic rationale for observed adverse drug reactions (ADRs) between four approved PARP inhibitors (PARPi). METHODS: The Medicines and Healthcare products Regulatory Authority (MHRA) Yellow Card drug analysis profiles and NHS secondary care medicines database enabled the identification of suspected ADRs associated with the PARPi in the UK from launch to 2020. The polypharmacology of the PARPi were data-mined from several public data sources. RESULTS: The overall ADRs per 100 000 Rx identified across the four PARPi are statistically significant (χ2 test, P < .001). Rucaparib has the greatest relative suspected ADRs, which can be explained by its least clean kinome and physicochemical properties. The suspected gastrointestinal ADRs of rucaparib and niraparib can be ascribed to their kinase polypharmacology. Suspected blood and lymphatic system ADRs of PARPi can be linked to their high volume of distribution (Vd ). The thrombocytopenia rate of niraparib > rucaparib > olaparib tracked with the Vd trend. Hypertension is only associated with niraparib and could be explained by the therapeutically achievable inhibition of DYRK1A and/or transporters. Arrhythmia cases are potentially linked to the structural features of hERG ion-channel inhibition found in rucaparib and niraparib. Enhanced psychiatric/nervous disorders associated with niraparib can be interpreted from the diverse neurotransporter off-targets reported. CONCLUSIONS: Despite their similar mode of action, the differential polypharmacology of PARP inhibitors influences their ADR profile.


Subject(s)
Drug-Related Side Effects and Adverse Reactions , Poly(ADP-ribose) Polymerase Inhibitors , Humans , Poly(ADP-ribose) Polymerase Inhibitors/adverse effects , Polypharmacology
14.
PLoS Biol ; 19(10): e3001415, 2021 10.
Article in English | MEDLINE | ID: mdl-34669692

ABSTRACT

Michaelis constants (Km) are essential to predict the catalytic rate of enzymes, but are not widely available. A new study in PLOS Biology uses artificial intelligence (AI) to accurately predict Km on a proteome-wide scale, paving the way for dynamic, genome-wide modeling of metabolism.


Subject(s)
Artificial Intelligence
15.
Emergencias (Sant Vicenç dels Horts) ; 33(5): 361-367, oct. 2021. tab
Article in Spanish | IBECS | ID: ibc-216292

ABSTRACT

Objetivo: Determinar si el infratriaje tiene impacto pronóstico en pacientes que requieren ingreso desde urgencias en cuidados intensivos por enfermedad médica e identificar factores asociados. Método: Revisión retrospectiva de pacientes atendidos durante 2018 por enfermedades médicas con ingreso directo en cuidados intensivos desde urgencias. Se clasificaron en dos grupos en función del nivel de triaje asignado y se consideró infratriaje un nivel de triaje $ III. Las variables independientes incluyeron datos demográficos, epidemiológicos e indicadores de gravedad en urgencias. Se registró la mortalidad a los 30 días (objetivo primario), así como la mortalidad hospitalaria, el ingreso prolongado en cuidados intensivos o el ingreso prolongado hospitalario (objetivos secundarios). Resultados: Se incluyeron 470 pacientes [edad 68 años (rango 57-78), 61,1% hombres] de los que 151 (32,1%) formaban el grupo con infratriaje. Los factores relacionados con el infratriaje fueron la edad (OR = 1,017; IC 95% 1,003-1,032), indicador qSOFA 0-1 (OR = 1,761; IC 95% 1,038-2,988), índice SpO2/FiO2 > 300 (OR = 2,447; IC 95% 1,418-4,223) y el diagnóstico de infección (OR = 5,003; IC 95% 2,727-9,188), respiratorio (OR = 3,993; IC 95% 1,919-8,310) u otro (OR = 1,980; IC 95% 1,036-3,785) respecto al diagnóstico cardiovascular, mientras que la admisión en horario de tarde (OR = 0,512; IC 95% 0,306-0,856) o el traslado en ambulancia (OR = 0,373; IC 95% 0,232-0,600) se relacionaron de forma inversa con el infratriaje. El evento mortalidad a 30 días tuvo lugar en 90 pacientes (19,1%). El infratriaje no se relacionó con la mortalidad a 30 días ni con el resto de los objetivos analizados. (AU)


Objectives: To determine whether undertriage affects the outcome for patients requiring direct admission to the intensive care unit (ICU) from the emergency department due to a medical condition. To identify factors associated with undertriage. Material and methods: Retrospective review of patients treated in 2018 for medical emergencies requiring direct admission to the ICU from the emergency department. The cases were classified in 2 groups according to the assigned triage level. Underestimation was defined as a triage level of III or more. Independent variables were demographic and epidemiologic data and indicators of severity recorded in the emergency department. The main outcome was 30-day mortality. Secondary outcomes were in-hospital mortality, prolonged ICU stay, and prolonged hospital stay. Results: We included 470 patients with a median age of 68 years (first-third quartile range, 57-78 years); 61.1% were men, and 151 (32.1%) were undertriaged. Factors directly related to undertriage according to odds ratios (ORs) were age (OR = 1.017; 95% CI, 1.003-1.032), Quick Sequential Organ Failure Assessment score of 0 or 1 (OR = 1.761; 95% CI, 1.038-2.988), ratio of oxygen saturation to fraction of inspired oxygen greater than 300 (OR = 2.447; 95% CI, 1.418-4.223), a diagnosis of infection (OR = 5.003, 95% CI 2.727-9.188) whether respiratory (OR = 3.993, 95% CI 1.919-8.310) or other (OR = 1.980, 95% CI, 1.036-3.785) versus a diagnosis of cardiovascular disease. Factors inversely related to undertriage were admission during the afternoon (OR = 0.512, 95% CI, 0.306-0.856) and ambulance transfer (OR = 0.373; 95% CI, 0.232-0.600). Ninety patients (19.1%) died within 30 days. Undertriage was not related to 30-day mortality or the other outcomes analyzed. (AU)


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Triage , Emergency Service, Hospital , Retrospective Studies , Critical Care , Aging
16.
Emergencias ; 33(5): 361-367, 2021 10.
Article in English, Spanish | MEDLINE | ID: mdl-34581529

ABSTRACT

OBJECTIVES: To determine whether undertriage affects the outcome for patients requiring direct admission to the intensive care unit (ICU) from the emergency department due to a medical condition. To identify factors associated with undertriage. MATERIAL AND METHODS: Retrospective review of patients treated in 2018 for medical emergencies requiring direct admission to the ICU from the emergency department. The cases were classified in 2 groups according to the assigned triage level. Underestimation was defined as a triage level of III or more. Independent variables were demographic and epidemiologic data and indicators of severity recorded in the emergency department. The main outcome was 30-day mortality. Secondary outcomes were in-hospital mortality, prolonged ICU stay, and prolonged hospital stay. RESULTS: We included 470 patients with a median age of 68 years (first-third quartile range, 57-78 years); 61.1% were men, and 151 (32.1%) were undertriaged. Factors directly related to undertriage according to odds ratios (ORs) were age (OR = 1.017; 95% CI, 1.003-1.032), Quick Sequential Organ Failure Assessment score of 0 or 1 (OR = 1.761; 95% CI, 1.038-2.988), ratio of oxygen saturation to fraction of inspired oxygen greater than 300 (OR = 2.447; 95% CI, 1.418-4.223), a diagnosis of infection (OR = 5.003, 95% CI 2.727-9.188) whether respiratory (OR = 3.993, 95% CI 1.919-8.310) or other (OR = 1.980, 95% CI, 1.036-3.785) versus a diagnosis of cardiovascular disease. Factors inversely related to undertriage were admission during the afternoon (OR = 0.512, 95% CI, 0.306-0.856) and ambulance transfer (OR = 0.373; 95% CI, 0.232-0.600). Ninety patients (19.1%) died within 30 days. Undertriage was not related to 30-day mortality or the other outcomes analyzed. CONCLUSION: Undertriage was not associated with a worse outcome in patients requiring direct admission to the ICU for a medical emergency. The factors we found to be associated with undertriage, such as patient age and time of day admitted, merit special attention given that these factors should not be affecting the triage process.


OBJETIVO: Determinar si el infratriaje tiene impacto pronóstico en pacientes que requieren ingreso desde urgencias en cuidados intensivos por enfermedad médica e identificar factores asociados. METODO: Revisión retrospectiva de pacientes atendidos durante 2018 por enfermedades médicas con ingreso directo en cuidados intensivos desde urgencias. Se clasificaron en dos grupos en función del nivel de triaje asignado y se consideró infratriaje un nivel de triaje III. Las variables independientes incluyeron datos demográficos, epidemiológicos e indicadores de gravedad en urgencias. Se registró la mortalidad a los 30 días (objetivo primario), así como la mortalidad hospitalaria, el ingreso prolongado en cuidados intensivos o el ingreso prolongado hospitalario (objetivos secundarios). RESULTADOS: Se incluyeron 470 pacientes [edad 68 años (rango 57-78), 61,1% hombres] de los que 151 (32,1%) formaban el grupo con infratriaje. Los factores relacionados con el infratriaje fueron la edad (OR = 1,017; IC 95% 1,003- 1,032), indicador qSOFA 0-1 (OR = 1,761; IC 95% 1,038-2,988), índice SpO2/FiO2 > 300 (OR = 2,447; IC 95% 1,418- 4,223) y el diagnóstico de infección (OR = 5,003; IC 95% 2,727-9,188), respiratorio (OR = 3,993; IC 95% 1,919-8,310) u otro (OR = 1,980; IC 95% 1,036-3,785) respecto al diagnóstico cardiovascular, mientras que la admisión en horario de tarde (OR = 0,512; IC 95% 0,306-0,856) o el traslado en ambulancia (OR = 0,373; IC 95% 0,232- 0,600) se relacionaron de forma inversa con el infratriaje. El evento mortalidad a 30 días tuvo lugar en 90 pacientes (19,1%). El infratriaje no se relacionó con la mortalidad a 30 días ni con el resto de los objetivos analizados. CONCLUSIONES: El infratriaje no se relacionó con un peor pronóstico en pacientes con ingreso directo en intensivos por enfermedad médica. Se han identificado factores relacionados con el infratriaje, como la edad o el horario de admisión que merecen una atención especial, ya que no deberían afectar el proceso de triaje.


Subject(s)
Emergency Service, Hospital , Triage , Aged , Critical Care , Humans , Male , Middle Aged , Prognosis , Retrospective Studies
17.
Cell Chem Biol ; 28(10): 1433-1445.e3, 2021 10 21.
Article in English | MEDLINE | ID: mdl-34077750

ABSTRACT

Most small molecules interact with several target proteins but this polypharmacology is seldom comprehensively investigated or explicitly exploited during drug discovery. Here, we use computational and experimental methods to identify and systematically characterize the kinase cross-pharmacology of representative HSP90 inhibitors. We demonstrate that the resorcinol clinical candidates ganetespib and, to a lesser extent, luminespib, display unique off-target kinase pharmacology as compared with other HSP90 inhibitors. We also demonstrate that polypharmacology evolved during the optimization to discover luminespib and that the hit, leads, and clinical candidate all have different polypharmacological profiles. We therefore recommend the computational and experimental characterization of polypharmacology earlier in drug discovery projects to unlock new multi-target drug design opportunities.


Subject(s)
Drug Discovery , Evolution, Molecular , HSP90 Heat-Shock Proteins/metabolism , Protein Kinase Inhibitors/metabolism , Binding Sites , Discoidin Domain Receptor 1/antagonists & inhibitors , Discoidin Domain Receptor 1/metabolism , HSP90 Heat-Shock Proteins/antagonists & inhibitors , Humans , Isoxazoles/chemistry , Isoxazoles/metabolism , Molecular Docking Simulation , Protein Kinase Inhibitors/chemistry , Proto-Oncogene Proteins c-abl/antagonists & inhibitors , Proto-Oncogene Proteins c-abl/metabolism , Resorcinols/chemistry , Resorcinols/metabolism , Triazoles/chemistry , Triazoles/metabolism
18.
Nucleic Acids Res ; 49(D1): D1074-D1082, 2021 01 08.
Article in English | MEDLINE | ID: mdl-33219674

ABSTRACT

canSAR (http://cansar.icr.ac.uk) is the largest, public, freely available, integrative translational research and drug discovery knowledgebase for oncology. canSAR integrates vast multidisciplinary data from across genomic, protein, pharmacological, drug and chemical data with structural biology, protein networks and more. It also provides unique data, curation and annotation and crucially, AI-informed target assessment for drug discovery. canSAR is widely used internationally by academia and industry. Here we describe significant developments and enhancements to the data, web interface and infrastructure of canSAR in the form of the new implementation of the system: canSARblack. We demonstrate new functionality in aiding translation hypothesis generation and experimental design, and show how canSAR can be adapted and utilised outside oncology.


Subject(s)
Computational Biology/methods , Databases, Genetic , Drug Discovery/methods , Knowledge Bases , Neoplasms/genetics , Translational Research, Biomedical/methods , Antineoplastic Agents/chemistry , Antineoplastic Agents/therapeutic use , Data Mining/methods , Genomics/methods , Humans , Internet , Medical Oncology/methods , Molecular Structure , Neoplasms/metabolism , Proteomics/methods , User-Computer Interface
19.
Future Med Chem ; 13(8): 731-747, 2021 04.
Article in English | MEDLINE | ID: mdl-31778323

ABSTRACT

High-quality small molecule chemical probes are extremely valuable for biological research and target validation. However, frequent use of flawed small-molecule inhibitors produces misleading results and diminishes the robustness of biomedical research. Several public resources are available to facilitate assessment and selection of better chemical probes for specific protein targets. Here, we review chemical probe resources, discuss their current strengths and limitations, and make recommendations for further improvements. Expert review resources provide in-depth analysis but currently cover only a limited portion of the liganded proteome. Computational resources encompass more proteins and are regularly updated, but have limitations in data availability and curation. We show how biomedical scientists may use these resources to choose the best available chemical probes for their research.


Subject(s)
Enzyme Inhibitors/chemistry , Molecular Probes/chemistry , Proteins/metabolism , Small Molecule Libraries/chemistry , Algorithms , Animals , Computer Simulation , Databases, Chemical , Enzyme Inhibitors/pharmacology , Humans , Molecular Probes/pharmacology , Proteome/chemistry , Small Molecule Libraries/pharmacology , Structure-Activity Relationship
20.
Sci Rep ; 10(1): 2585, 2020 02 17.
Article in English | MEDLINE | ID: mdl-32066817

ABSTRACT

Polypharmacology plays an important role in defining response and adverse effects of drugs. For some mechanisms, experimentally mapping polypharmacology is commonplace, although this is typically done within the same protein class. Four PARP inhibitors have been approved by the FDA as cancer therapeutics, yet a precise mechanistic rationale to guide clinicians on which to choose for a particular patient is lacking. The four drugs have largely similar PARP family inhibition profiles, but several differences at the molecular and clinical level have been reported that remain poorly understood. Here, we report the first comprehensive characterization of the off-target kinase landscape of four FDA-approved PARP drugs. We demonstrate that all four PARP inhibitors have a unique polypharmacological profile across the kinome. Niraparib and rucaparib inhibit DYRK1s, CDK16 and PIM3 at clinically achievable, submicromolar concentrations. These kinases represent the most potently inhibited off-targets of PARP inhibitors identified to date and should be investigated further to clarify their potential implications for efficacy and safety in the clinic. Moreover, broad kinome profiling is recommended for the development of PARP inhibitors as PARP-kinase polypharmacology could potentially be exploited to modulate efficacy and side-effect profiles.


Subject(s)
Antineoplastic Agents/chemistry , Indazoles/chemistry , Indoles/chemistry , Phthalazines/chemistry , Piperazines/chemistry , Piperidines/chemistry , Poly (ADP-Ribose) Polymerase-1/antagonists & inhibitors , Poly(ADP-ribose) Polymerase Inhibitors/chemistry , Antineoplastic Agents/administration & dosage , Antineoplastic Agents/adverse effects , Binding Sites , Cyclin-Dependent Kinases/antagonists & inhibitors , Cyclin-Dependent Kinases/genetics , Cyclin-Dependent Kinases/metabolism , HEK293 Cells , Humans , Indazoles/administration & dosage , Indazoles/adverse effects , Indoles/administration & dosage , Indoles/adverse effects , Isoenzymes/antagonists & inhibitors , Isoenzymes/genetics , Isoenzymes/metabolism , Molecular Docking Simulation , Neoplasms/drug therapy , Neoplasms/enzymology , Neoplasms/pathology , Phthalazines/administration & dosage , Phthalazines/adverse effects , Piperazines/administration & dosage , Piperazines/adverse effects , Piperidines/administration & dosage , Piperidines/adverse effects , Poly (ADP-Ribose) Polymerase-1/genetics , Poly (ADP-Ribose) Polymerase-1/metabolism , Poly(ADP-ribose) Polymerase Inhibitors/administration & dosage , Poly(ADP-ribose) Polymerase Inhibitors/adverse effects , Polypharmacology , Protein Binding , Protein Interaction Domains and Motifs , Protein Serine-Threonine Kinases/antagonists & inhibitors , Protein Serine-Threonine Kinases/genetics , Protein Serine-Threonine Kinases/metabolism , Protein Structure, Secondary , Protein-Tyrosine Kinases/antagonists & inhibitors , Protein-Tyrosine Kinases/genetics , Protein-Tyrosine Kinases/metabolism , Proto-Oncogene Proteins/antagonists & inhibitors , Proto-Oncogene Proteins/genetics , Proto-Oncogene Proteins/metabolism , Substrate Specificity , Dyrk Kinases
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