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1.
ASAIO J ; 70(6): 546-552, 2024 Jun 01.
Article in English | MEDLINE | ID: mdl-38829573

ABSTRACT

Drug treatments for coronavirus disease 2019 (COVID-19) dramatically improve patient outcomes, and although extracorporeal membrane oxygenation (ECMO) has significant use in these patients, it is unknown whether ECMO affects drug dosing. We used an ex vivo adult ECMO model to measure ECMO circuit effects on concentrations of specific COVID-19 drug treatments. Three identical ECMO circuits used in adult patients were set up. Circuits were primed with fresh human blood (temperature and pH maintained within normal limits). Three polystyrene jars with 75 ml fresh human blood were used as controls. Remdesivir, GS-441524, nafamostat, and tocilizumab were injected in the circuit and control jars at therapeutic concentrations. Samples were taken from circuit and control jars at predefined time points over 6 h and drug concentrations were measured using validated assays. Relative to baseline, mean (± standard deviation [SD]) study drug recoveries in both controls and circuits at 6 h were significantly lower for remdesivir (32.2% [±2.7] and 12.4% [±2.1], p < 0.001), nafamostat (21.4% [±5.0] and 0.0% [±0.0], p = 0.018). Reduced concentrations of COVID-19 drug treatments in ECMO circuits is a clinical concern. Remdesivir and nafamostat may need dose adjustments. Clinical pharmacokinetic studies are suggested to guide optimized COVID-19 drug treatment dosing during ECMO.


Subject(s)
Adenosine Monophosphate , Alanine , COVID-19 Drug Treatment , Extracorporeal Membrane Oxygenation , Extracorporeal Membrane Oxygenation/methods , Humans , Adenosine Monophosphate/analogs & derivatives , Adenosine Monophosphate/therapeutic use , Adenosine Monophosphate/pharmacokinetics , Alanine/analogs & derivatives , Alanine/pharmacokinetics , Alanine/therapeutic use , Antibodies, Monoclonal, Humanized/therapeutic use , Antibodies, Monoclonal, Humanized/pharmacokinetics , Antiviral Agents/pharmacokinetics , Antiviral Agents/therapeutic use , Guanidines/pharmacokinetics , Guanidines/therapeutic use , Benzamidines , COVID-19/therapy , SARS-CoV-2 , Adenosine/analogs & derivatives
2.
HIV Res Clin Pract ; 25(1): 2339576, 2024 Dec.
Article in English | MEDLINE | ID: mdl-38831550

ABSTRACT

BACKGROUND: Weight gain has been well-described with integrase strand transfer inhibitors (INSTIs) and tenofovir alafenamide (TAF). Doravirine (DOR) has been identified as a relatively "weight-neutral" drug; however, there is little data describing its effect on weight change in routine clinical practice. METHODS: We conducted a retrospective chart review of weight change among people with HIV changing from an INSTI- to a non-INSTI regimen with DOR. RESULTS: At the time of ART switch, among 49 people with HIV, the mean age was 47 years, 24% were female, and 75% had HIV-1 viral load <200 copies/mL. Most (55%) people with HIV were taking bictegravir/TAF/emtricitabine prior to the switch. Although 84% switched due to concerns about weight gain, only 16% had a weight gain of ≥10% in the year preceding, and 49% had no substantial change in weight. 86% switched to DOR/lamivudine/tenofovir disoproxil fumarate. A weight decrease (-2.6% [95% CI: -5.1, -0.1%, p = .041] was seen over the year following the ART switch. Weight change prior to switch was greatest in the year 2021 compared to 2019, 2020, and 2022. CONCLUSIONS: Overall, modest changes in weight were seen following ART switch from INSTI-based regimen to a DOR-based, non-INSTI regimen. Further investigations with larger people with HIV cohorts will be helpful to guide clinical practice, while the impact of the COVID-19 pandemic on weight change should also be considered.


Subject(s)
Alanine , HIV Infections , Pyridones , Tenofovir , Weight Gain , Humans , Female , Middle Aged , Male , Retrospective Studies , Tenofovir/therapeutic use , Tenofovir/analogs & derivatives , HIV Infections/drug therapy , HIV Infections/virology , Pyridones/therapeutic use , Adult , Alanine/therapeutic use , Alanine/analogs & derivatives , Weight Gain/drug effects , Anti-HIV Agents/therapeutic use , Viral Load/drug effects , Drug Substitution , Aminobutyrates/therapeutic use , HIV Integrase Inhibitors/therapeutic use , HIV-1/drug effects , Adenine/analogs & derivatives , Adenine/therapeutic use , Triazoles
3.
BMC Oral Health ; 24(1): 645, 2024 Jun 01.
Article in English | MEDLINE | ID: mdl-38824583

ABSTRACT

OBJECTIVES: This study aimed to evaluate the preventive and therapeutic effects of rebamipide gargle in comparison with benzydamine in head and neck cancer patients undergoing radiotherapy with or without chemotherapy. MATERIALS AND METHODS: Phase III randomized clinical trial was conducted from January 2021 till August 2022 on one hundred patients with head and neck cancer receiving high doses of radiotherapy. These patients were equally allocated into either rebamipide group or benzydamine group, The measured outcomes were the incidence of oral mucositis ≥ grade1, according to the WHO mucositis scale, in addition to the duration, and the onset of oral mucositis. RESULTS: There was no statistically significant difference between the two groups, regarding the incidence of a severe grade of oral mucositis (WHO grades 3), as well as the onset and duration of oral mucositis. Both gargles succeeded to prevent the development of WHO grade 4 oral mucositis. Side effects reported were mainly burning sensation in benzydamine group and nausea in rebamipide group. CONCLUSION: Rebamipide mouthwash was as beneficial as benzydamine mouthwash in minimizing the incidence of severe oral mucositis induced by treatment of head and neck cancer. However, rebamipide gargle proved to be superior to benzydamine in terms of reduction in the severity of the radiation-induced oral mucositis. TRIAL REGISTRATION: The trial was registered in the protocol Registration and Result system of Clinical Trials (Registration ID: NCT04685395)0.28-12-2020.


Subject(s)
Alanine , Benzydamine , Head and Neck Neoplasms , Mouthwashes , Quinolones , Stomatitis , Humans , Stomatitis/prevention & control , Stomatitis/etiology , Head and Neck Neoplasms/radiotherapy , Benzydamine/therapeutic use , Male , Middle Aged , Female , Quinolones/therapeutic use , Alanine/analogs & derivatives , Alanine/therapeutic use , Mouthwashes/therapeutic use , Chemoradiotherapy/adverse effects , Radiation Injuries/prevention & control , Aged , Adult
4.
Ann Med ; 56(1): 2361843, 2024 Dec.
Article in English | MEDLINE | ID: mdl-38830017

ABSTRACT

BACKGROUND: Literature on the safety of remdesivir in hospitalized COVID-19 patients with severe renal impairment is limited. We aimed to investigate the safety and effectiveness of remdesivir in this population. METHODS: We conducted a retrospective cohort study of adult hospitalized COVID-19 patients who received remdesivir between April 2022 and October 2022. Outcomes were compared between estimated glomerular filtration rate (eGFR) <30 mL/min/1.73 m2 and ≥30 mL/min/1.73 m2 groups. The primary safety outcomes were acute kidney injury (AKI) and bradycardia, while the primary effectiveness outcomes included mortality in COVID-19-dedicated wards and hospital mortality. Secondary outcomes included laboratory changes, disease progression, and recovery time. RESULTS: A total of 1,343 patients were recruited, with 307 (22.9%) in the eGFR <30 group and 1,036 (77.1%) in the eGFR ≥30 group. Patients with an eGFR <30 had higher risks of AKI (adjusted hazard ratio [aHR] 2.92, 95% CI 1.93-4.44) and hospital mortality (aHR 1.47, 95% CI 1.06-2.05) but had comparable risks of bradycardia (aHR 1.15, 95% CI 0.85-1.56) and mortality in dedicated wards (aHR 1.43, 95% CI 0.90-2.28) than patients with an eGFR ≥30. Risk of disease progression was higher in the eGFR <30 group (adjusted odds ratio 1.62, 95% CI 1.16-2.26). No difference between the two groups in laboratory changes and recovery time. CONCLUSIONS: Hospitalized COVID-19 patients receiving remdesivir with severe renal impairment had an increased risk of AKI, hospital mortality, and COVID-19 disease progression compared to patients without severe renal impairment.


Subject(s)
Acute Kidney Injury , Adenosine Monophosphate , Alanine , Antiviral Agents , COVID-19 Drug Treatment , Glomerular Filtration Rate , Hospital Mortality , Hospitalization , SARS-CoV-2 , Humans , Alanine/analogs & derivatives , Alanine/therapeutic use , Alanine/adverse effects , Adenosine Monophosphate/analogs & derivatives , Adenosine Monophosphate/therapeutic use , Adenosine Monophosphate/adverse effects , Male , Female , Retrospective Studies , Middle Aged , Aged , Antiviral Agents/therapeutic use , Antiviral Agents/adverse effects , Acute Kidney Injury/chemically induced , Acute Kidney Injury/epidemiology , Hospitalization/statistics & numerical data , COVID-19/complications , COVID-19/mortality , Treatment Outcome , Renal Insufficiency/epidemiology , Bradycardia/chemically induced , Bradycardia/epidemiology , Adult
5.
J Phys Chem B ; 128(22): 5310-5319, 2024 Jun 06.
Article in English | MEDLINE | ID: mdl-38806061

ABSTRACT

Every residue on a protein can be characterized by its interaction with water, in lack or in excess, as water is the matrix of biological systems. Infrared spectroscopy and the implementation of local azidohomoalanine (AHA) probes allow us to move beyond an ensemble or surface-driven conceptualization of water behavior and toward a granular, site-specific picture. In this paper, we examined the role of crowding in modulating both global and local behavior on the ß-hairpin, TrpZip2 using a combination of Fourier-transform infrared spectroscopy (FTIR) spectroscopy, two-dimensional infrared (2D IR) spectroscopy, and molecular dynamics simulations. We found that, at the amino acid level, crowding drove dehydration of both sheet and turn peptide sites as well as free AHA. However, the subpicosecond dynamics showed highly individualized responses based on the local environment. Interestingly, while steady-state FTIR measurements revealed similar responses at the amino-acid level to hard versus soft crowding (dehydration), we found that PEG and glucose had opposite stabilizing and destabilizing effects on the protein secondary structure, emphasizing an important distinction in understanding the impact of crowding on protein structure as well as the role of crowding across length scales.


Subject(s)
Alanine , Molecular Dynamics Simulation , Water , Alanine/chemistry , Alanine/analogs & derivatives , Water/chemistry , Spectroscopy, Fourier Transform Infrared , Protein Structure, Secondary , Glucose/chemistry
6.
Emerg Microbes Infect ; 13(1): 2353302, 2024 Dec.
Article in English | MEDLINE | ID: mdl-38753462

ABSTRACT

Animal models of COVID-19 facilitate the development of vaccines and antivirals against SARS-CoV-2. The efficacy of antivirals or vaccines may differ in different animal models with varied degrees of disease. Here, we introduce a mouse model expressing human angiotensin-converting enzyme 2 (ACE2). In this model, ACE2 with the human cytokeratin 18 promoter was knocked into the Hipp11 locus of C57BL/6J mouse by CRISPR - Cas9 (K18-hACE2 KI). Upon intranasal inoculation with high (3 × 105 PFU) or low (2.5 × 102 PFU) dose of SARS-CoV-2 wildtype (WT), Delta, Omicron BA.1, or Omicron BA.2 variants, all mice showed obvious infection symptoms, including weight loss, high viral loads in the lung, and interstitial pneumonia. 100% lethality was observed in K18-hACE2 KI mice infected by variants with a delay of endpoint for Delta and BA.1, and a significantly attenuated pathogenicity was observed for BA.2. The pneumonia of infected mice was accompanied by the infiltration of neutrophils and pulmonary fibrosis in the lung. Compared with K18-hACE2 Tg mice and HFH4-hACE2 Tg mice, K18-hACE2 KI mice are more susceptible to SARS-CoV-2. In the antivirals test, REGN10933 and Remdesivir had limited antiviral efficacies in K18-hACE2 KI mice upon the challenge of SARS-CoV-2 infections, while Nirmatrelvir, monoclonal antibody 4G4, and mRNA vaccines potently protected the mice from death. Our results suggest that the K18-hACE2 KI mouse model is lethal and stable for SARS-CoV-2 infection, and is practicable and stringent to antiviral development.


Subject(s)
Angiotensin-Converting Enzyme 2 , Antiviral Agents , COVID-19 , Disease Models, Animal , Mice, Inbred C57BL , SARS-CoV-2 , Animals , Angiotensin-Converting Enzyme 2/genetics , Angiotensin-Converting Enzyme 2/metabolism , COVID-19/virology , Mice , SARS-CoV-2/genetics , SARS-CoV-2/immunology , SARS-CoV-2/drug effects , Antiviral Agents/pharmacology , Humans , Lung/virology , Lung/pathology , COVID-19 Drug Treatment , Keratin-18/genetics , Viral Load , Adenosine Monophosphate/analogs & derivatives , Adenosine Monophosphate/pharmacology , Adenosine Monophosphate/therapeutic use , Alanine/analogs & derivatives , Alanine/pharmacology , Gene Knock-In Techniques , Antibodies, Viral/immunology , Antibodies, Viral/blood , Female
7.
Cells ; 13(10)2024 May 20.
Article in English | MEDLINE | ID: mdl-38786105

ABSTRACT

HIV infection is an ongoing global health issue, despite increased access to antiretroviral therapy (ART). People living with HIV (PLWH) who are virally suppressed through ART still experience negative health outcomes, including neurocognitive impairment. It is increasingly evident that ART may act independently or in combination with HIV infection to alter the immune state, though this is difficult to disentangle in the clinical population. Thus, these experiments used multiplexed chemokine/cytokine arrays to assess peripheral (plasma) and brain (nucleus accumbens; NAc) expression of immune targets in the presence and absence of ART treatment in the EcoHIV mouse model. The findings identify the effects of EcoHIV infection and of treatment with bictegravir (B), emtricitabine (F), and tenofovir alafenamide (TAF) on the expression of numerous immune targets. In the NAc, this included EcoHIV-induced increases in IL-1α and IL-13 expression and B/F/TAF-induced reductions in KC/CXCL1. In the periphery, EcoHIV suppressed IL-6 and LIF expression, while B/F/TAF reduced IL-12p40 expression. In the absence of ART, IBA-1 expression was negatively correlated with CX3CL1 expression in the NAc of EcoHIV-infected mice. These findings identify distinct effects of ART and EcoHIV infection on peripheral and central immune factors and emphasize the need to consider ART effects on neural and immune outcomes.


Subject(s)
HIV Infections , Animals , Mice , HIV Infections/immunology , HIV Infections/drug therapy , HIV Infections/virology , Emtricitabine/therapeutic use , Emtricitabine/pharmacology , Anti-Retroviral Agents/therapeutic use , Anti-Retroviral Agents/pharmacology , Disease Models, Animal , Male , Tenofovir/therapeutic use , Tenofovir/pharmacology , Tenofovir/analogs & derivatives , Cytokines/metabolism , Heterocyclic Compounds, 3-Ring/pharmacology , Heterocyclic Compounds, 3-Ring/therapeutic use , Mice, Inbred C57BL , Immunity/drug effects , Alanine/analogs & derivatives , Alanine/therapeutic use , Alanine/pharmacology , Piperazines/pharmacology , Piperazines/therapeutic use , Amides , Pyridones
8.
Biol Pharm Bull ; 47(5): 1033-1042, 2024.
Article in English | MEDLINE | ID: mdl-38797668

ABSTRACT

Eye drops, including solutions and suspensions, are essential dosage forms to treat ophthalmic diseases, with poorly water-soluble drugs typically formulated as ophthalmic suspensions. In addition to low bioavailability, suspensions exhibit limited efficacy, safety, and usability due to the presence of drug particles. Improving bioavailability can reduce the drug concentrations and the risk of problems associated with suspended drug particles. However, practical penetration enhancers capable of improving bioavailability remain elusive. Herein, we focused on penetratin (PNT), a cell-penetrating peptide (CPP) that promotes active cellular transport related to macromolecule uptake, such as micropinocytosis. According to the in vitro corneal uptake study using a reconstructed human corneal epithelial tissue model, LabCyte CORNEA-MODEL24, PNT enhanced the uptake of Fluoresbrite® YG carboxylate polystyrene microspheres without covalent binding. In an ex vivo porcine eye model, the addition of 10 µM PNT to rebamipide ophthalmic suspension markedly improved the corneal uptake of rebamipide; however, the addition of 100 µM PNT was ineffective due to potentially increased particle size by aggregation. This article provides basic information on the application of PNT as a penetration enhancer in ophthalmic suspensions, including the in vitro and ex vivo studies mentioned above, as well as the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) cytotoxicity assay and storage stability at different pH values.


Subject(s)
Cell-Penetrating Peptides , Cornea , Ophthalmic Solutions , Suspensions , Animals , Cell-Penetrating Peptides/chemistry , Cell-Penetrating Peptides/administration & dosage , Ophthalmic Solutions/administration & dosage , Humans , Cornea/metabolism , Cornea/drug effects , Swine , Quinolones/administration & dosage , Quinolones/pharmacokinetics , Quinolones/chemistry , Administration, Ophthalmic , Biological Availability , Epithelium, Corneal/drug effects , Epithelium, Corneal/metabolism , Particle Size , Alanine/analogs & derivatives
9.
Georgian Med News ; (348): 151-153, 2024 Mar.
Article in English | MEDLINE | ID: mdl-38807409

ABSTRACT

Rebamipide contributes to the improvement of blood supply of the GI mucosa, activates its barrier function, activates alkaline secretion of the stomach, increases proliferation and metabolism of epithelial cells of the GI tract, cleanses the mucosa from hydroxyl radicals and suppresses superoxides, produced by polymorphonuclear leukocytes and neutrophils in the presence of Helicobacter pylori, protects the GI mucosa from bacterial invasion and the damaging effects of non-steroidal anti-inflammatory drugs (NSAIDs) on the mucosa. Rebamipide, originally developed as a treatment for gastric ulcers, has attracted the attention of researchers as a potential drug for the treatment of UC due to its ability to stimulate mucus production, reduce oxidative stress, and decrease inflammation. Due to the presence of these properties, it is hypothesized that rebamipide may have a protective effect on the intestinal mucosa during prolonged inflammation, making it a promising candidate for inclusion in therapeutic strategies for ulcerative colitis. The results of this study suggest that rebamipide holds potential therapeutic benefits for the treatment of ulcerative colitis.


Subject(s)
Alanine , Colitis, Ulcerative , Quinolones , Quinolones/therapeutic use , Quinolones/pharmacology , Alanine/analogs & derivatives , Alanine/therapeutic use , Alanine/pharmacology , Animals , Colitis, Ulcerative/drug therapy , Colitis, Ulcerative/pathology , Rats , Anti-Ulcer Agents/therapeutic use , Anti-Ulcer Agents/pharmacology , Intestinal Mucosa/drug effects , Intestinal Mucosa/pathology , Intestinal Mucosa/metabolism , Male , Disease Progression , Disease Models, Animal , Rats, Wistar
10.
Viruses ; 16(5)2024 04 26.
Article in English | MEDLINE | ID: mdl-38793571

ABSTRACT

The COVID-19 pandemic has resulted in millions of fatalities worldwide. The case of pediatric cancer patients stands out since, despite being considered a population at risk, few studies have been carried out concerning symptom detection or the description of the mechanisms capable of modifying the course of the COVID-19 disease, such as the interaction and response between the virus and the treatment given to cancer patients. By synthesizing existing studies, this paper aims to expose the treatment challenges for pediatric patients with COVID-19 in an oncology context. Additionally, this updated review includes studies that utilized the antiviral agents Remdesivir and PaxlovidTM in pediatric cancer patients. There is no specific treatment designed exclusively for pediatric cancer patients dealing with COVID-19, and it is advisable to avoid self-medication to prevent potential side effects. Managing COVID-19 in pediatric cancer patients is indeed a substantial challenge. New strategies, such as chemotherapy application rooms, have been implemented for children with cancer who were positive for COVID-19 but asymptomatic since the risk of disease progression is greater than the risk of complications from SARS-CoV-2.


Subject(s)
Alanine , Antiviral Agents , COVID-19 , Neoplasms , SARS-CoV-2 , Humans , Neoplasms/drug therapy , Neoplasms/therapy , Neoplasms/complications , COVID-19/epidemiology , Child , Antiviral Agents/therapeutic use , SARS-CoV-2/drug effects , Alanine/analogs & derivatives , Alanine/therapeutic use , Adenosine Monophosphate/analogs & derivatives , Adenosine Monophosphate/therapeutic use , COVID-19 Drug Treatment , Pandemics
11.
Viruses ; 16(5)2024 04 30.
Article in English | MEDLINE | ID: mdl-38793600

ABSTRACT

Although the coronavirus disease 2019 (COVID-19) pandemic is coming to an end, it still poses a threat to the immunocompromised and others with underlying diseases. Especially in cases of persistent COVID-19, new mutations conferring resistance to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) therapies have considerable clinical implications. We present a patient who independently acquired a T21I mutation in the 3CL protease after nirmatrelvir exposure. The T21I mutation in the 3CL protease is one of the most frequent mutations responsible for nirmatrelvir resistance. However, limited reports exist on actual cases of SARS-CoV-2 with T21I and other mutations in the 3CL protease. The patient, a 55 year-old male, had COVID-19 during chemotherapy for multiple myeloma. He was treated with nirmatrelvir early in the course of the disease but relapsed, and SARS-CoV-2 with a T21I mutation in the 3CL protease was detected in nasopharyngeal swab fluid. The patient had temporary respiratory failure but later recovered well. During treatment with remdesivir and dexamethasone, viruses with the T21I mutation in the 3CL protease showed a decreasing trend during disease progression while increasing during improvement. The impact of drug-resistant SARS-CoV-2 on the clinical course, including its severity, remains unknown. Our study is important for examining the clinical impact of nirmatrelvir resistance in COVID-19.


Subject(s)
Antiviral Agents , COVID-19 , Drug Resistance, Viral , Immunocompromised Host , SARS-CoV-2 , Humans , Middle Aged , Male , SARS-CoV-2/genetics , SARS-CoV-2/drug effects , SARS-CoV-2/immunology , Drug Resistance, Viral/genetics , Antiviral Agents/therapeutic use , Antiviral Agents/pharmacology , COVID-19/immunology , COVID-19/virology , Mutation , Multiple Myeloma/drug therapy , Coronavirus 3C Proteases/genetics , COVID-19 Drug Treatment , Alanine/analogs & derivatives , Alanine/therapeutic use
12.
Antivir Ther ; 29(2): 13596535241248282, 2024 Apr.
Article in English | MEDLINE | ID: mdl-38725258

ABSTRACT

BACKGROUND: Darunavir/cobicistat/emtricitabine/tenofovir alafenamide (D/C/F/TAF) fixed-dose combination (FDC) was developed as a once-daily, complete antiretroviral (ARV) regimen therapy to address the need for simplified protease inhibitor-based ARV regimens. This study assessed the swallowability and acceptability for long-term use of scored placebo tablets matching the D/C/F/TAF FDC tablets in children living with HIV-1. METHODS: This study (NCT04006704) was a Phase 1, open-label, randomized, single-dose, 2-period, 2-sequence crossover study in children living with HIV-1, aged ≥6 to <12 years and weighing ≥25 to <40 kg, on a stable ARV regimen for ≥3 months. Participants were asked to swallow whole (size, 21 × 11 × 7 mm) and split matching placebo D/C/F/TAF tablets. Swallowability of the matching placebo D/C/F/TAF tablets (primary endpoint) was assessed by observers. Acceptability of taking matching placebo D/C/F/TAF tablets and current ARVs was evaluated by participants using a 3-point questionnaire. Participants rated the acceptability for long-term daily use of the placebo D/C/F/TAF tablets, and observers assessed how easily caregivers could split a scored tablet by hand, using 3-point questionnaires. RESULTS: Among the 24 participants who enrolled and completed the study, 95.8% (23/24) were able to swallow the whole and split matching placebo D/C/F/TAF tablets after 1 or 2 attempts. Most participants (>70%) rated the acceptability of tablets for long-term daily use as acceptable or good to take. Breaking the tablets was considered easy or OK by 79.2% (19/24) of caregivers. CONCLUSION: Scored D/C/F/TAF FDC tablets are swallowable - with whole favoured over split - and considered at least acceptable for long-term daily intake in children living with HIV-1 aged ≥6 to <12 years. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04006704.


Subject(s)
Anti-HIV Agents , Cobicistat , Darunavir , Drug Combinations , Emtricitabine , HIV Infections , HIV-1 , Tablets , Tenofovir , Humans , Male , HIV Infections/drug therapy , Female , Cobicistat/administration & dosage , Cobicistat/therapeutic use , Child , Emtricitabine/administration & dosage , Emtricitabine/therapeutic use , HIV-1/drug effects , Anti-HIV Agents/administration & dosage , Anti-HIV Agents/therapeutic use , Tenofovir/administration & dosage , Tenofovir/therapeutic use , Tenofovir/analogs & derivatives , Darunavir/administration & dosage , Darunavir/therapeutic use , Alanine/administration & dosage , Alanine/therapeutic use , Cross-Over Studies , Deglutition , Adenine/analogs & derivatives , Adenine/administration & dosage , Adenine/therapeutic use
13.
Org Lett ; 26(18): 3991-3996, 2024 May 10.
Article in English | MEDLINE | ID: mdl-38691578

ABSTRACT

Peptide modification by C(sp3)-H functionalization of residues at the internal positions remains underdeveloped due to the inhibitory effect of backbone amides. In this study, using histidine (His) as an endogenous directing group, we developed a novel method for the ß-C(sp3)-H functionalization of alanine (Ala) at diverse positions of peptides. Through this approach, a wide range of linear peptides were modified on the side-chain of Ala adjacent to His to afford the functionalized peptides in moderate to good yield and excellent position selectivity. Furthermore, conjugation of peptides with functional molecules such as glucuronide, oleanolic acid, dipeptide, and fluorophore derivatives was achieved.


Subject(s)
Alanine , Histidine , Peptides , Alanine/chemistry , Histidine/chemistry , Peptides/chemistry , Molecular Structure
14.
PLoS One ; 19(5): e0278957, 2024.
Article in English | MEDLINE | ID: mdl-38722986

ABSTRACT

BACKGROUND: Monkeypox is a viral zoonotic disease commonly reported in humans in parts of Central and West Africa. This protocol is for an Expanded Access Programme (EAP) to be implemented in the Central African Republic, where Clade I monkeypox virus diseases is primarily responsible for most monkeypox infections. The objective of the programme is to provide patients with confirmed monkeypox with access to tecovirimat, a novel antiviral targeting orthopoxviruses, and collect data on clinical and virological outcomes of patients to inform future research. METHODS: The study will be conducted at participating hospitals in the Central African Republic. All patients who provide informed consent to enrol in the programme will receive tecovirimat. Patients will remain in hospital for the duration of treatment. Data on clinical signs and symptoms will be collected every day while the patient is hospitalised. Blood, throat and lesion samples will be collected at baseline and then on days 4, 8, 14 and 28. Patient outcomes will be assessed on Day 14 -end of treatment-and at Day 28. Adverse event and serious adverse event data will be collected from the point of consent until Day 28. DISCUSSION: This EAP is the first protocolised treatment programme in Clade I MPXV. The data generated under this protocol aims to describe the use of tecovirimat for Clade I disease in a monkeypox endemic region of Central Africa. It is hoped that this data can inform the definition of outcome measures used in future research and contribute to the academic literature around the use of tecovirimat for the treatment of monkeypox. The EAP also aims to bolster research capacity in the region in order for robust randomised controlled trials to take place for monkeypox and other diseases. TRIAL REGISTRATION: {2a & 2b}: ISRCTN43307947.


Subject(s)
Antiviral Agents , Mpox (monkeypox) , Humans , Mpox (monkeypox)/drug therapy , Antiviral Agents/therapeutic use , Monkeypox virus/drug effects , Benzamides/therapeutic use , Male , Adult , Female , Isoindoles/therapeutic use , Adolescent , Treatment Outcome , Alanine/analogs & derivatives , Alanine/therapeutic use , Phthalimides
15.
Org Lett ; 26(19): 4127-4131, 2024 May 17.
Article in English | MEDLINE | ID: mdl-38718303

ABSTRACT

Hybrid genome-mining/15N-NMR was used to target compounds containing piperazate (Piz) residues, leading to the discovery of caveamides A (1) and B (2) from Streptomyces sp. strain BE230, isolated from New Rankin Cave (Missouri). Caveamides are highly dynamic molecules containing an unprecedented ß-ketoamide polyketide fragment, two Piz residues, and a new N-methyl-cyclohexenylalanine residue. Caveamide B (2) exhibited nanomolar cytotoxicity against several cancer cell lines and nanomolar antimicrobial activity against MRSA and E. coli.


Subject(s)
Escherichia coli , Methicillin-Resistant Staphylococcus aureus , Streptomyces , Humans , Molecular Structure , Streptomyces/chemistry , Escherichia coli/drug effects , Methicillin-Resistant Staphylococcus aureus/drug effects , Anti-Bacterial Agents/pharmacology , Anti-Bacterial Agents/chemistry , Anti-Bacterial Agents/isolation & purification , Microbial Sensitivity Tests , Antineoplastic Agents/pharmacology , Antineoplastic Agents/chemistry , Antineoplastic Agents/isolation & purification , Alanine/chemistry , Alanine/pharmacology , Alanine/analogs & derivatives , Drug Screening Assays, Antitumor , Peptides/chemistry , Peptides/pharmacology , Peptides/isolation & purification , Cell Line, Tumor , Pyridazines
16.
Medicine (Baltimore) ; 103(20): e37953, 2024 May 17.
Article in English | MEDLINE | ID: mdl-38758884

ABSTRACT

To explore the therapeutic effectiveness of tenofovir alafenamide (TAF) and tenofovir disoproxil fumarate (TDF) on the treatment for chronic hepatitis B (CHB). Retrospectively analyzing 241 cases of chronic hepatitis B patients admitted to our hospital from January 2020 to December 2021, they were divided into a TAF group of 180 cases and a TDF group of 61 cases. The liver function, serum virus markers, clinical efficacy, adverse reactions and cost-effectiveness ratio (CER) analysis of 2 groups were compared. Two groups of patients had no statistically significant difference in the levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST) and total bilirubin (TBIL) before treatment. After treatment, the levels of ALT, AST and TBIL were lower than before treatment in both groups (P < .05), but the inter-group difference was not statistically significant (P > .05). After treatment, Hepatitis B surface antigen (HBsAg) conversion rate and Hepatitis B virus DNA (HBV-DNA) conversion rate in the 2 groups had no statistically significant difference. After treatment, the difference in total clinical cure rate between the 2 groups has no statistical significance (P > .05), adverse reactions rate of TAF group was lower than that of TDF group (P < .05). The drug cost median of TAF group was higher than that of TDF (P < .05), but Cost-effectiveness analysis showed the CER of TAF group was similar of TDF group. TAF or TDF therapy can both improve liver function and promote recovery in patients with CHB, achieving the goal of treatment. TAF have more cost but have similar CER to TDF. Moreover, TAF therapy has a higher safety profile.


Subject(s)
Antiviral Agents , Hepatitis B, Chronic , Tenofovir , Humans , Tenofovir/therapeutic use , Tenofovir/adverse effects , Tenofovir/analogs & derivatives , Hepatitis B, Chronic/drug therapy , Male , Female , Retrospective Studies , Antiviral Agents/therapeutic use , Antiviral Agents/adverse effects , Adult , Middle Aged , Treatment Outcome , Cost-Benefit Analysis , Alanine/therapeutic use , DNA, Viral/blood , Alanine Transaminase/blood , Hepatitis B Surface Antigens/blood
17.
Nat Commun ; 15(1): 4216, 2024 May 17.
Article in English | MEDLINE | ID: mdl-38760394

ABSTRACT

Antimicrobial peptides (AMPs), ancient scavengers of bacteria, are very poorly induced in macrophages infected by Mycobacterium tuberculosis (M. tuberculosis), but the underlying mechanism remains unknown. Here, we report that L-alanine interacts with PRSS1 and unfreezes the inhibitory effect of PRSS1 on the activation of NF-κB pathway to induce the expression of AMPs, but mycobacterial alanine dehydrogenase (Ald) Rv2780 hydrolyzes L-alanine and reduces the level of L-alanine in macrophages, thereby suppressing the expression of AMPs to facilitate survival of mycobacteria. Mechanistically, PRSS1 associates with TAK1 and disruptes the formation of TAK1/TAB1 complex to inhibit TAK1-mediated activation of NF-κB pathway, but interaction of L-alanine with PRSS1, disables PRSS1-mediated impairment on TAK1/TAB1 complex formation, thereby triggering the activation of NF-κB pathway to induce expression of AMPs. Moreover, deletion of antimicrobial peptide gene ß-defensin 4 (Defb4) impairs the virulence by Rv2780 during infection in mice. Both L-alanine and the Rv2780 inhibitor, GWP-042, exhibits excellent inhibitory activity against M. tuberculosis infection in vivo. Our findings identify a previously unrecognized mechanism that M. tuberculosis uses its own alanine dehydrogenase to suppress host immunity, and provide insights relevant to the development of effective immunomodulators that target M. tuberculosis.


Subject(s)
Alanine , Antimicrobial Peptides , Macrophages , Mycobacterium tuberculosis , NF-kappa B , Tuberculosis , Mycobacterium tuberculosis/pathogenicity , Mycobacterium tuberculosis/metabolism , Animals , Mice , NF-kappa B/metabolism , Humans , Macrophages/microbiology , Macrophages/metabolism , Macrophages/immunology , Alanine/metabolism , Antimicrobial Peptides/metabolism , Antimicrobial Peptides/genetics , Tuberculosis/microbiology , Tuberculosis/immunology , Alanine Dehydrogenase/metabolism , Alanine Dehydrogenase/genetics , MAP Kinase Kinase Kinases/metabolism , MAP Kinase Kinase Kinases/genetics , Bacterial Proteins/metabolism , Bacterial Proteins/genetics , Signal Transduction , Mice, Inbred C57BL , RAW 264.7 Cells , Female
18.
J Agric Food Chem ; 72(19): 11153-11163, 2024 May 15.
Article in English | MEDLINE | ID: mdl-38695891

ABSTRACT

Maillard reaction (MR) plays a pivotal role in the food flavor industry, including a cascade of reactions starting with the reaction between amino compounds and reducing sugars, and thus provides various colors and flavors. A new group of volatile compounds called pyrazinones found in MR are now getting more attention. In this study, eight volatile pyrazinones were found in the asparagine MR systems, in which 3,5-dimethyl- and 3,6-dimethyl-2(1H)-pyrazinones were reported for the first time. The major formation pathways were the reactions between asparagine and α-dicarbonyls, with decarboxylation as a critical step. Besides, novel alternative pathways involving alanine amidation and successive reactions with α-dicarbonyls were explored and successfully formed eight pyrazinones. The major differences between alanine-amidated pathways and decarboxylation pathways are the amidation step and absence of the decarboxylation step. For the alanine-amidated pathways, the higher the temperature, the better the amidation effect. The optimal amidation temperature was 200 °C in this study. The reaction between the alanine amide and α-dicarbonyls after amidation can happen at low temperatures, such as 35 and 50 °C, proposing the possibility of pyrazinone formation in real food systems. Further investigations should be conducted to investigate volatile pyrazinones in various food systems as well as the biological effects and kinetic formation differences of the volatile pyrazinones.


Subject(s)
Alanine , Asparagine , Maillard Reaction , Pyrazines , Volatile Organic Compounds , Pyrazines/chemistry , Alanine/chemistry , Asparagine/chemistry , Volatile Organic Compounds/chemistry , Flavoring Agents/chemistry
19.
Microb Cell Fact ; 23(1): 143, 2024 May 22.
Article in English | MEDLINE | ID: mdl-38773442

ABSTRACT

BACKGROUND: Zymomonas mobilis is well known for its outstanding ability to produce ethanol with both high specific productivity and with high yield close to the theoretical maximum. The key enzyme in the ethanol production pathway is the pyruvate decarboxylase (PDC) which is converting pyruvate to acetaldehyde. Since it is widely considered that its gene pdc is essential, metabolic engineering strategies aiming to produce other compounds derived from pyruvate need to find ways to reduce PDC activity. RESULTS: Here, we present a new platform strain (sGB027) of Z. mobilis in which the native promoter of pdc was replaced with the IPTG-inducible PT7A1, allowing for a controllable expression of pdc. Expression of lactate dehydrogenase from E. coli in sGB027 allowed the production of D-lactate with, to the best of our knowledge, the highest reported specific productivity of any microbial lactate producer as well as with the highest reported lactate yield for Z. mobilis so far. Additionally, by expressing the L-alanine dehydrogenase of Geobacillus stearothermophilus in sGB027 we produced L-alanine, further demonstrating the potential of sGB027 as a base for the production of compounds other than ethanol. CONCLUSION: We demonstrated that our new platform strain can be an excellent starting point for the efficient production of various compounds derived from pyruvate with Z. mobilis and can thus enhance the establishment of this organism as a workhorse for biotechnological production processes.


Subject(s)
Escherichia coli , Ethanol , Lactic Acid , Metabolic Engineering , Pyruvate Decarboxylase , Zymomonas , Zymomonas/metabolism , Zymomonas/genetics , Pyruvate Decarboxylase/metabolism , Pyruvate Decarboxylase/genetics , Metabolic Engineering/methods , Ethanol/metabolism , Lactic Acid/metabolism , Lactic Acid/biosynthesis , Escherichia coli/metabolism , Escherichia coli/genetics , L-Lactate Dehydrogenase/metabolism , L-Lactate Dehydrogenase/genetics , Alanine/metabolism , Pyruvic Acid/metabolism , Fermentation
20.
J Am Chem Soc ; 146(20): 14213-14224, 2024 May 22.
Article in English | MEDLINE | ID: mdl-38739765

ABSTRACT

The formation of an amide bond is an essential step in the synthesis of materials and drugs, and in the assembly of amino acids to form peptides. The mechanism of this reaction has been studied extensively, in particular to understand how it can be catalyzed, but a representation capable of explaining all the experimental data is still lacking. Numerical simulation should provide the necessary molecular description, but the solvent involvement poses a number of challenges. Here, we combine the efficiency and accuracy of neural network potential-based reactive molecular dynamics with the extensive and unbiased exploration of reaction pathways provided by transition path sampling. Using microsecond-scale simulations at the density functional theory level, we show that this method reveals the presence of two competing distinct mechanisms for peptide bond formation between alanine esters in aqueous solution. We describe how both reaction pathways, via a general base catalysis mechanism and via direct cleavage of the tetrahedral intermediate respectively, change with pH. This result contrasts with the conventional mechanism involving a single pathway in which only the barrier heights are affected by pH. We show that this new proposal involving two competing mechanisms is consistent with the experimental data, and we discuss the implications for peptide bond formation under prebiotic conditions and in the ribosome. Our work shows that integrating deep potential molecular dynamics with path sampling provides a powerful approach for exploring complex chemical mechanisms.


Subject(s)
Molecular Dynamics Simulation , Peptides , Water , Water/chemistry , Peptides/chemistry , Density Functional Theory , Hydrogen-Ion Concentration , Alanine/chemistry , Amides/chemistry
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