药物基因组学及其在合理用药中的应用

药物基因组学 (ｐｈａｒｍａｃｏｇｃｎｏｍｉｃｓ)是 2 0世纪 90年代末发展起来的基于功能基因组学 (ｆｕｎｃｔｉｏｎａｌｇｅｎｏｍｉｃｓ)与分子药理学的一门科学。它从基因水平研究基因序列的多态性与药物效应多样性之间的关系 ,即 :研究基因本身及其突变体对不同个体药物作用效应差异的影响 ,以此为平台开发药物 ,指导合理用药 ,提高用药的安全性和有效性 ,避免不良反应 ,减少药物治疗的费用和风险[1,2 ] 。1　药物基因组学的研究内容与方法药物基因组学是基于药物反应的遗传多态性提出来的 ,遗传多态性是药物基因组学的基础。药物遗…     

药物遗传学：药效学方面

个体间差异在药代动力学方面的认识已逾百年，但在药效学方面相应的认识却比较短暂。药物遗传学在药效学方面表现出两种不同的基本机制，一个是作为疾病异质性反应的Ⅰ型药物遗传学，另一个是作为疾病－病因学非相关的个体间差异反应的Ⅱ型药物遗传学，药物遗传学的药效学方面，对于认识临床药物反应，指导药物研发及临床实践将会发挥越来越重要的作用。     

药物基因组学与临床个体化给药研究进展

在临床,不同个体表现出对相同药物有很多不同反应,甚至具有同样病症、一般状况相同的不同患者常会对相同剂量的同一种治疗药物出现不同的药物反应。对此,应用传统药动学、药效学是无法解释的。随着认识的加深,人们发现药物的药效和毒性存在个体差异,这些差异大多源于基因差异。为了增加药物疗效,保证用药安全,研究药动学和药效学差异的基因特征,以及基因变异所致的不同个体对药物不同反应的药物基因组学应运而生。     

基因多态性与药物不良反应发生风险的相关性及其临床证据

药物不良反应(ADR)是临床用药中常常出现的难题,不但影响药效,还严重威胁患者的生命安全。随着药物基因组学的快速发展,个体间的基因序列差异与ADR之间的相关性不断被证实,但是缺乏全面的归纳和总结。基于遗传药理学和药物基因组学知识库(PharmGKB)和临床药物遗传学实施联盟(CPIC)、美国食品和药品管理局(FDA)等权威组织发布的药物基因组学相关指南,综述近年来高证据等级的基因多态性在预测和避免ADR中的最新进展和重要意义,以期为基因导向的个体化给药提供参考。     

李权

性别:男职称:药学博士供职单位:美国俄亥俄州立大学(The Ohio State University)詹姆斯肿瘤医院(The James Cancer Hospital)和Richard J .Solove肿瘤研究所研究兴趣:癌症治疗中的支持疗法,临床肿瘤治疗学,化疗相关的毒性监测,化疗药物相互作用,药物遗传学和药物基因组学。     

药物基因组学与临床合理用药

近年来，随着分子生物学、分子遗传学与分子药理学的发展，人们逐渐认识到不同个体对同一药物的不同反应，大多源于基因的差异。由此在药物遗传学的基础上发展形成了药物基因组学，在分子和基因水平上研究揭示个体对药物不同反应的机理，为研究高效和特效药物开辟了新的途径，同时为患者或特定人群寻找合适的药物及适宜的用药方法开辟了新的前景。     

药物基因组学指导下的个体化抗栓治疗

药物基因组学是在药物遗传学基础上发展起来的,是以功能基因组学与分子药理学为基础的一门科学。药物基因组学通过对特定药物具敏感性或抵抗性的患病人群的单核苷酸多态性差异检测,指导制定适合每个个体的治疗方案,使病人既能获得最佳治疗效果,又能避免药物不良反应,达到用药个体化的目的。抗栓药物是临床应用非常普遍的一类药物,用于预防冠脉支架内血栓、心肌梗死和脑卒中,但是不同的人对抗栓药物的反应性存在差异,少数人甚至有＂抵抗＂现象,导致药物不能达到治疗效果。用基因检测指导个体化抗栓治疗能为用药的合理性和安全性提供参考依据,减少不良事件的发生。     

心血管药物基因组学

对药物反应的个体差异可引起严重不良反应或治疗失败。药物基因组学和药物遗传学如何运用遗传信息而确定个性化的药物治疗?这是本文将要回答的问题。     

临床个体化用药中的药物基因组学考虑

虽然引起药物反应个体差异的原因很多,但遗传因素起相当重要的作用。药物代谢酶、转运药物的蛋白质、受体和其它药物靶体的遗传多态性与药物效应、毒性的个体差异密切相关。药物基因组学是利用已知的基因组学理论,研究遗传因素对药物反应的影响,即研究药物动力学和药效学差异的基因特征,以及基因变异所致的不同个体对药物的不同反应。深入研究遗传因素与临床合理用药之间的重要关系,确定引起个体对药物处置和疗效差异的遗传学特征,将为个体化合理用药提供强有力的科学依据。本文简要介绍药物在血浆中结合的蛋白质的基因多态性和与高血压相关的药物基因组学在临床个体化合理用药中的意义。     

FDA发布药物基因组学术语指南

美国食品药品监督管理局公布了国际协调会议（ICH）对基因组生物标记物、药物基因组学、药物遗传学、基因组学数据和样本编码类别等领域定义关键术语指南的最终版本。指南旨在促进药物基因组学及相关学科与药物开发和批准过程的融合。     

Efficacy of gut lavage,hemodialysis, and hemoperfusion in the therapy of paraquat or diquat intoxication

Clinical and in vitro investigations were carried out to test the efficacy of gut lavage, hemodialysis, and hemoperfusion in the treatment of poisoning with paraquat or diquat. In a patient suffering from diquat intoxication 130 times more diquat was removed by gut lavage 30 h after ingestion than was removed by complete aspiration of the gastric contents.Determination of in vitro clearances for paraquat and diquat by hemodialysis showed that, at serum concentrations of 1–2 ppm, such as are frequently encountered in poisoning in man, toxicologically relevant quantities of herbicide cannot be removed from the body. At a concentration of 20 ppm, on the other hand, hemodialysis proved to be effective, the clearance being 70 ml/min at a blood flow rate of 100 ml/min. The efficacy of hemoperfusion with coated activated charcoal was on the whole better. Especially at concentrations around 1–2 ppm, the clearance values for hemoperfusion were some 5–7 times higher than those for hemodialysis.In a patient suffering from paraquat poisoning, both hemodialysis as well as hemoperfusion were carried out. The in vitro results could be confirmed: At serum concentrations of paraquat less than 1 ppm no clearance could be obtained by hemodialysis while by hemoperfusion with activated charcoal quite high clearance values were measured and the serum level dropped down to zero.

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Zusammenfassung Klinische Untersuchungen und Laboratoriumsversuche wurden durchgeführt, um die Wirksamkeit von Darmspülung, Hämodialyse und Hämoperfusion bei Paraquat- und Deiquat-Vergiftungen zu prüfen.Bei einem Patienten wurde 30 Std nach Deiquat-Aufnahme durch Darmspülung 130mal mehr Deiquat entfernt als durch vollständige Aspiration des Mageninhaltes. In vitro-Versuche ergaben, daß bei Blutserumkonzentrationen von 1–2 ppm, die bei Vergiftungen oft gemessen werden, durch Hämodialyse keine toxikologisch relevanten Paraquat- oder Deiquat-Mengen entfernt werden können. Dagegen erwies sich die Hämodialyse bei 20 ppm und einer Blutumlaufgeschwindigkeit von 100 ml/min mit einer Clearance von 70 ml/min als wirksam. Die Hämoperfusion mit beschicheter Aktivkohle war in diesen Versuchen aber eindeutig überlegen, denn insbesondere bei Konzentrationen um 1–2 ppm waren die Clearance-Werte 5–7mal höher als bei der Hämodialyse.Die in vitro-Ergebnisse wurden bei einem Patienten mit einer Paraquat-Vergiftung bestätigt: Bei Konzentrationen unter 1 ppm war die Hämodialyse wirkungslos, während durch Hämoperfusion relativ hohe Clearance-Werte erreicht wurden, so daß der Serumspiegel rasch unter die Nachweisgrenze abfiel.

     

In vitro studies on sterically stabilized liposomes (SL) as enzyme carriers in organophosphorus (OP) antagonism

This study describes a new approach for organophosphorous (OP) antidotal treatment by encapsulating an OP hydrolyzing enzyme, OPA anhydrolase (OPAA), within sterically stabilized liposomes. The recombinant OPAA enzyme was derived from Alteromonas strain JD6. It has broad substrate specificity to a wide range of OP compounds: DFP and the nerve agents, soman and sarin. Liposomes encapsulating OPAA (SL)* were made by mechanical dispersion method. Hydrolysis of DFP by (SL)* was measured by following an increase of fluoride ion concentration using a fluoride ion selective electrode. OPAA entrapped in the carrier liposomes rapidly hydrolyze DFP, with the rate of DFP hydrolysis directly proportional to the amount of (SL)* added to the solution. Liposomal carriers containing no enzyme did not hydrolyze DFP. The reaction was linear and the rate of hydrolysis was first order in the substrate. This enzyme carrier system serves as a biodegradable protective environment for the recombinant OP-metabolizing enzyme, OPAA, resulting in prolongation of enzymatic concentration in the body. These studies suggest that the protection of OP intoxication can be strikingly enhanced by adding OPAA encapsulated within (SL)* to pralidoxime and atropine.     

Steroidal sapogenin contents in some domestic plants

In order to find out the values of the steroid resources for the future use. the compositions and contents of steroidal sapogenins from 13 domestic plants have been investigated. As a result,Dioscorea nipponica, D. quinqueloba andSmilax china were found to have large amount of diosgenin. And pennogenin inTrillium kamtschaticum andParis verticillata, yuccagenin inAllium fistulosum, hecogenin inAgave americana and neochlorogenin inSolanum nigum were appeared to be major steroidal sapogenins.     

Synthesis,Cytotoxicity and Antileishmanial Activity of Some N-(2-(indol-3-yl)ethyl)-7-chloroquinolin-4-amines

We report herein the condensation of 4,7-dichloroquinoline (1) with tryptamine (2) and D-tryptophan methyl ester (3) . Hydrolysis of the methyl ester adduct (5) yielded the free acid (6) . The compounds were evaluated in vitro for activity against four different species of Leishmania promastigote forms and for cytotoxic activity against Kb and Vero cells. Compound (5) showed good activity against the Leishmania species tested, while all three compounds displayed moderate activity in both Kb and Vero cells.     

Aquatic Insects and Trace Metals: Bioavailability,Bioaccumulation, and Toxicity

Abstract

The uptake of metals from food and water sources by insects is thought to be additive. For a given metal, the proportions taken up from water and food will depend both on the bioavailable concentration of the metal associated with each source and the mechanism and rate by which the metal enters the insect. Attempts to correlate insect trace metal concentrations with the trophic level of insects should be made with a knowledge of the feeding relationships of the individual taxa concerned. Pathways for the uptake of essential metals, such as copper and zinc, exist at the cellular level, and other nonessential metals, such as cadmium, also appear to enter via these routes. Within cells, trace metals can be bound to proteins or stored in granules. The internal distribution of metals among body tissues is very heterogeneous, and distribution patterns tend to be both metal and taxon specific. Trace metals associated with insects can be both bound on the surface of their chitinous exoskeleton and incorporated into body tissues. The quantities of trace meals accumulated by an individual reflect the net balance between the rate of metal influx from both dissolved and particulate sources and the rate of metal efflux from the organism. The toxicity of metals has been demonstrated at all levels of biological organization: cell, tissue, individual, population, and community. Much of the literature pertaining to the toxic effects of metals on aquatic insects is based on laboratory observations and, as such, it is difficult to extrapolate the data to insects in nature. The few experimental studies in nature suggest that trace metal contaminants can affect both the distribution and the abundance of aquatic insects. Insects have a largely unexploited potential as biomonitors of metal contamination in nature. A better understanding of the physico-chemical and biological mechanisms mediating trace metal bioavailability and exchange will facilitate the development of general predictive models relating trace metal concentrations in insects to those in their environment. Such models will facilitate the use of insects as contaminant biomonitors.     

Alzheimer’s disease – current trends in basic and clinical research. Highlights from the 16th ECNP

Advances in the molecular biological knowledge of neuronal nicotinic acetylcholine receptors (nAChRs) have led to a growing interest by the pharmaceutical industry in the development of novel compounds that selectively modulate nAChR function. The ability of (-)-nicotine, an activator of nAChRs, to enhance attentional aspects of cognition in animals and humans, to exert neuroprotective and anxiolytic-like effects, and presumably to mediate the negative correlation between smoking and Alzheimer's (and Parkinson's) Disease, has focused interest on the potential therapeutic utility of modulators of nAChR function for treatment of some of the deficits associated with these progressive, neurodegenerative conditions. Numerous compounds are known which activate nAChRs and which might serve as lead compounds toward the development of such agents. The pharmacologic diversity of neuronal nAChR subtypes suggests the possibility of developing selective compounds which would have more favourable side-effect profiles than existing agents. This broader class of agents, collectively called cholinergic channel modulators (ChCMs), is anticipated to encompass compounds which would have more favourable side-effect profiles than existing agents, which generally exhibit low selectivity. This selectivity may be achieved by preferentially activating some subtypes of nAChRs (i.e., Cholinergic Channel Activators, ChCAs) or inhibiting the function of other subtypes (Cholinergic Channel Inhibitors, ChCIs). An overview of the biology of nAChRs and the rationale for the use of ChCMs for the treatment of dementia related to neurodegenerative diseases are presented, followed by a discussion of lead compounds and compounds under consideration for clinical evaluation.