吗替麦考酚酯在自身免疫性疾病患者体内的药代动力学研究

目的探讨免疫抑制剂吗替麦考酚酯(MMF)在自身免疫性疾病患者体内首次给药和稳态后的药代动力学。方法自身免疫性疾病患者14例,口服吗替麦考酚酯0.75 g,q12 h,连续服药7 d达稳态,用高效液相色谱法测定MMF的活性代谢物麦考酚酸(MPA)及二级代谢物酚化葡萄糖醛麦考酚酸(MPAG)的血药浓度,并评价2种代谢物的体内暴露药量与患者肾功能的关系。结果 MPA首次服药及稳态后的Cmax分别为(8.45±7.54),(10.89±4.37)mg·L-1,AUC0-12h分别为(41.07±49.26),(55.09±41.74)mg·h·L-1;MPAG首次及稳态后的Cmax分别为(41.24±28.57),(67.63±36.98)mg·L-1,AUC0-12h分别为(487.25±326.53),(720.79±413.86)mg·h·L-1;两者在患者个体间药代动力学参数差异均较大,且稳态后的AUC0-12h与首次给药相比均明显增大(P<0.05);MPAG的体内暴露药量与肾功能存在明显负相关(P<0.05),而MPA的体内暴露药量与患者肾功能无明显相关性(P>0.05)。结论自身免疫性疾病患者同方案给药后,MPA及MPAG血药浓度及药代动力学个体间差异大,且在体内存在明显蓄积现象。     

吗替麦考酚酯分散片的相对生物利用度及生物等效性

目的:研究吗替麦考酚酯分散片和吗替麦考酚酯胶囊在健康志愿者中的药动学及生物等效性。方法:根据交叉试验方案口服单剂量(1 000mg)两种吗替麦考酚酯制剂,采用高效液相色谱法测定血浆中霉酚酸的浓度。结果:吗替麦考酚酯分散片和吗替麦考酚酯胶囊(对照药)的tmax分别为(0.51±0.29)h和(0.54±0.26)h;Cmax分别为(53.6±22.2)mg.L-1和(52.4±18.3)mg.L-1;AUC0→48分别为(133.7±43.6)mg.h.L-1和(142.8±46.2)mg.h.L-1;分散片相对于胶囊的生物利用度为(96.1±19.7)%。经配对检验,结果表明,两种制剂的主要药动学参数Cmax、AUC0→48的差异无显著性(P>0.05)。结论:吗替麦考酚酯分散片和吗替麦考酚酯胶囊为生物等效制剂。     

麦考酚酸酯分散片在健康志愿者体内的生物等效性评价

目的:评价麦考酚酸酯(MMF)分散片与其胶囊(商品名:骁悉)的生物等效性。方法:20名健康志愿者按随机双周期交叉试验方案设计,单剂量口服MMF分散片或其胶囊各500mg,采用RP-HPLC荧光检测法测定MMF的活性代谢产物麦考酚酸(MPA)的血药浓度。用非房室模型计算MPA药动学参数,用方差分析和双单侧t检验评价两者之间的生物等效性。结果:MMF分散片与其胶囊的主要药动学参数AUC0-48分别为(32.7±6.6)与(30.6±9.9)mg.L-1.h,AUC0-∞分别为(35.8±7.4)与(33.3±10.2)mg.L-1.h,Cmax分别为(17.0±4.5)与(15.8±4.8)mg.L-1,tmax分别为(0.45±0.29)与(0.6±0.3)h,t1/2β分别为(13.4±4.7)与(12.7±4.4)h。MMF分散片相对于其胶囊的生物利用度F为(111.6±24.0)%,经统计学检验,两者差异无显著性(P>0.05)。结论:MMF分散片与其胶囊具有生物等效性。     

麦考酚酸酯分散片在健康人体的药动学和生物等效性

目的:研究麦考酚酸酯(MMF)国产分散片和进口胶囊在健康人体的药动学及其生物等效性。方法:采用随机自身对照双周期交叉试验设计,18名男性健康志愿者口服MMF分散片或胶囊各1．0 g,用反相高效液相色谱一紫外检测法测定MMF的活性代谢产物麦考酚酸(MPA)的血药浓度,用非房室模型计算MPA的药动学参数,用方差分析和双单侧t检验评价2种制剂的生物等效性。结果:MMF分散片与胶囊麦考酚酸的药动学参数如下:t_(max)分别为(0．62±s 0．21),(0．74±0．23)h;c_(max)分别为(27±5), (28±6)mg·L~(-1);AUC0～36分别为(51±9),(49±9)mg·h·L~(-1);t1/2分别为(13．7±2．5),(13．9±2．5)h。国产麦考酚酸酯分散片中麦考酚酸相对于胶囊的相对生物利用度为(104±9)％,2种制剂的主要药动学参数经统计学检验,两者差异无显著意义(P＞0．05)。结论:2种制剂在人体内生物等效。     

3×3拉丁方设计评价国产麦考酚吗乙酯片、胶囊与其进口制剂的生物等效性

目的3×3拉丁方研究国产麦考酚吗乙酯片剂、胶囊剂与进口麦考酚吗乙酯胶囊(商品名:骁悉)的生物等效性。方法24名健康男性志愿者随机交叉单剂量口服国产麦考酚吗乙酯片剂、胶囊剂和进口麦考酚吗乙酯胶囊500 mg,以HPLC法测定血药浓度,计算各药动学参数和相对生物利用度,并以WinNonlin程序计算药动学参数,评价生物等效性。结果国产麦考酚吗乙酯片剂、胶囊和进口麦考酚吗乙酯胶囊药-时曲线符合线性动力学一室开放模型,AUC0→48分别是(39.74±8.61)、(38.06±9.01)和(36.21±9.17)mg.h.L-1;AUC0→∞:(44.02±10.62)(、40.91±9.54)和(39.82±9.21)mg.h.L-1;ρmax:(20.19±9.63)、(17.42±6.03)和(18.48±7.06)mg.L-1;tmax:(0.74±0.64)(、0.72±0.35)和(0.56±0.20)h;t12:(13.43±4.58)、(12.20±3.08)和(13.59±5.40)h;MRT:(14.95±5.85)(、13.42±2.83)和(14.40±5.47)h。结论国产麦考酚吗乙酯片剂、胶囊与进口麦考酚吗乙酯胶囊具有生物等效性。     

吗替麦考酚酯分散片药动学与相对生物利用度研究

目的评价吗替麦考酚酯分散片的药动学与人体相对生物利用度。方法将18例健康男性受试者随机平均分为两组,双周期交叉口服吗替麦考酚酯胶囊或分散片1 g。采用高效液相色谱法测定血药浓度［固定相: 日本岛津C18色谱柱(150 mm ×4.6 mm,5 μm)；流动相:10 mmol·L 1醋酸铵(磷酸调节pH值至4.0)－甲醇－乙腈 (35：25：40)；柱温: 40 ℃；流速: 1 mL·min 1；检测波长: 303 nm］,计算药动学参数并判断两种制剂的生物等效性。结果吗替麦考酚酯胶囊和分散片的主要药动学参数分别 : tmax 为(0.50±0.29)和(0.49±0.17) h, Cmax 分别为(36±5)和(38± 7) mg·L 1, t1/2 分别为(14±5)和(13±8) h, AUC0～24 分别为(62±10)和(61±10) mg·h 1·L 1, AUC0～∞分别为(83±23)和(78±15) mg·h 1·L 1。吗替麦考酚酯分散片平均相对生物利用度为(99±10)%。结论吗替麦考酚酯分散片和胶囊具有生物等效性。     

吗替麦考酚酯干混悬剂的人体药动学及生物等效性研究

目的:研究国产吗替麦考酚酯(MMF)干混悬剂和进口片剂在健康人体的药动学及生物等效性。方法:采用随机自身对照双周期交叉试验设计,20名健康男性志愿者口服MMF干混悬剂或进口片剂0.75mg,用高效液相色谱法测定MMF的活性代谢产物麦考酚酸(MPA)的血药浓度,用非房室模型法计算MPA的药动学参数,用方差分析和双单侧t检验评价2种制剂的生物等效性。结果:MMF干混悬剂和进口片剂的药动学参数:t1/2β分别为(16.80±4.10)、(16.77±4.50)h,tmax分别为(0.4±0.1)、(0.7±0.4)h,Cmax分别为(19.29±6.78)、(18.22±7.19)μg.mL-1,AUC0～72分别为(39.22±10.43)、(39.38±10.46)μg.h.mL-1,AUC0～∞分别为(40.58±10.49)、(41.00±10.88)μg.h.mL-1。受试制剂的相对生物利用度为(100.9±10.6)%。结论:2种MMF制剂在人体内生物等效。     

麦考酚酸制剂体内药动学参数、临床疗效及不良反应影响因素的研究进展

目的:了解麦考酚酸(MPA)制剂体内药动学参数、临床疗效及不良反应影响因素的研究进展,为临床合理用药提供循证依据。方法:查阅近年来国内外文献,从基因多态性、患者机体因素和药物因素等方面对MPA的体内药动学参数、临床疗效和不良反应的影响进行归纳和总结。结果与结论:吗替麦考酚酯(MMF)和麦考酚钠(EC-MPS)为MPA的2种常用制剂。MMF为器官和组织移植术后抗免疫排斥反应的一线用药,其体内药动学参数、临床疗效和不良反应发生率受基因多态性、患者机体因素(种族、血清白蛋白水平、术后时间和并发症等)和药物因素(联合用药、药物剂型和给药剂量)等影响。     

吗替麦考酚酯胶囊人体生物等效性研究

目的:研究2种吗替麦考酚酯胶囊的人体生物等效性。方法:18名受试者随机、交叉、单剂量分别口服吗替麦考酚酯胶囊受试制剂(国产)和参比制剂(进口)1000mg。血药浓度采用反相高效液相色谱法测定;计算药动学参数并评价生物等效性。结果:受试制剂与参比制剂的主要药动学参数Cmax分别为(26.38±9.55)、(25.84±12.08)μg·mL-1,tmax分别为(0.79±0.40)、(0.94±0.59)h,t1/2分别为(18.01±7.65)、(15.62±8.50)h,AUC0～48分别为(54.69±15.58)、(51.68±12.36)μg.h.mL-1,AUC0～∞分别为(61.10±17.06)、(57.99±17.21)μg.h.mL-1。受试制剂的相对生物利用度为(107.22±25.39)%。结论:国产与进口吗替麦考酚酯胶囊生物等效。     

进口与国产5-单硝酸异山梨酯缓释胶囊在中国健康人体的生物等效性

目的评价进口与国产5-单硝酸异山梨酯缓释胶囊在健康中国男性受试者体内的生物等效性。方法单中心开放性单剂量双周期随机交叉设计,24位健康中国男性受试者随机分为2组,单次口服5-单硝酸异山梨酯缓释胶囊试验或参比药物50 mg,用HPLC-MS/MS法测定血浆中5-单硝酸异山梨酯浓度,用WinNonlin 5.2.1软件计算药代动力学参数。结果试验与参比药物的主要药代动力学参数:t1/2分别为(6.16±0.61),(6.29±0.50)h;Cmax分别为(473.13±107.54),(423.42±81.70)mg·L-1;tmax分别为(3.22±2.90),(2.51±2.56)h;AUC0-t分别为(6905.83±1135.22),(6495.00±1034.65)mg·h·L-1;AUC0-∞分别为(7088.75±1200.35),(6678.33±1086.71)mg·h·L-1。Cmax、AUC0-t、AUC0-∞的90%置信区间分别为102.86%～120.07%,100.54%～112.50%,100.32%～112.31%。结论进口与国产胶囊具有生物等效性。     

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.     

Lung disease and PKCs

The lung offers a rich opportunity for development of therapeutic strategies focused on isozymes of protein kinase C (PKCs). PKCs are important in many cellular responses in the lung, and existing therapies for pulmonary disorders are inadequate. The lung poses unique challenges as it interfaces with air and blood, contains a pulmonary and systemic circulation, and consists of many cell types. Key structures are bronchial and pulmonary vessels, branching airways, and distal air sacs defined by alveolar walls containing capillaries and interstitial space. The cellular composition of each vessel, airway, and alveolar wall is heterogeneous. Injurious environmental stimuli signal through PKCs and cause a variety of disorders. Edema formation and pulmonary hypertension (PHTN) result from derangements in endothelial, smooth muscle (SM), and/or adventitial fibroblast cell phenotype. Asthma, chronic obstructive pulmonary disease (COPD), and lung cancer are characterized by distinctive pathological changes in airway epithelial, SM, and mucous-generating cells. Acute and chronic pneumonitis and fibrosis occur in the alveolar space and interstitium with type 2 pneumocytes and interstitial fibroblasts/myofibroblasts playing a prominent role. At each site, inflammatory, immune, and vascular progenitor cells contribute to the injury and repair process. Many strategies have been used to investigate PKCs in lung injury. Isolated organ preparations and whole animal studies are powerful approaches especially when genetically engineered mice are used. More analysis of PKC isozymes in normal and diseased human lung tissue and cells is needed to complement this work. Since opposing or counter-regulatory effects of selected PKCs in the same cell or tissue have been found, it may be desirable to target more than one PKC isozyme and potentially in different directions. Because multiple signaling pathways contribute to the key cellular responses important in lung biology, therapeutic strategies targeting PKCs may be more effective if combined with inhibitors of other pathways for additive or synergistic effect. Mechanisms that regulate PKC activity, including phosphorylation and interaction with isozyme-specific binding proteins, are also potential therapeutic targets. Key isotypes of PKC involved in lung pathophysiology are summarized and current and evolving therapeutic approaches to target them are identified.     

Gender-related symptoms and correlates of alcohol dependence among men and women with a lifetime diagnosis of alcohol use disorders

This study explored gender-related symptoms and correlates of alcohol dependence in a crosssectional study of 150 men and 150 women with a lifetime diagnosis of alcohol use disorders (AUD). Participants were recruited in equal numbers from treatment settings, correctional centres and the general community. Standardized measures were used to determine participants' use of substances, history of psychiatric disorders and psychosocial stress, their sensation seeking and family history of substance use and mental health disorders. Multivariate analyses were used to detect patterns of variables associated with gender and the lifetime severity of AUD. Men had a longer history of severe AUD than women. Women had similar levels of alcohol dependence and medical and psychological sequelae as men, despite 6 fewer years of AUD. More women than men had a history of severe psychosocial stress, severe dependence on other substances and antecedent mental health problems, especially mood and anxiety disorders. There were differences in family history of alcohol-related problems approximating same-gender aggregation. The severity of a lifetime AUD was predicted by its earlier age at onset and the occurrence of other disorders, especially anxiety, among both men and women. The limitations in the generalizability of these findings due to sample idiosyncrasies are discussed.     

Biochemical and molecular characterisation of cubozoan protein toxins

Class Cubozoa includes several species of box jellyfish that are harmful to humans. The venoms of box jellyfish are stored and discharged by nematocysts and contain a variety of bioactive proteins that are cytolytic, cytotoxic, inflammatory or lethal. Although cubozoan venoms generally share similar biological activities, the diverse range and severity of effects caused by different species indicate that their venoms vary in protein composition, activity and potency. To date, few individual venom proteins have been thoroughly characterised, however, accumulating evidence suggests that cubozoan jellyfish produce at least one group of homologous bioactive proteins that are labile, basic, haemolytic and similar in molecular mass (42-46 kDa). The novel box jellyfish toxins are also potentially lethal and the cause of cutaneous pain, inflammation and necrosis, similar to that observed in envenomed humans. Secondary structure analysis and remote protein homology predictions suggest that the box jellyfish toxins may act as α-pore-forming toxins. However, more research is required to elucidate their structures and investigate their mechanism(s) of action. The biological, biochemical and molecular characteristics of cubozoan venoms and their bioactive protein components are reviewed, with particular focus on cubozoan cytolysins and the newly emerging family of box jellyfish toxins.     

Dose tolerability of chronically inhaled voriconazole solution in rodents

Invasive pulmonary aspergillosis (IPA) is a fungal disease of the lung associated with high mortality rates in immunosuppressed patients despite treatment. Targeted drug delivery of aqueous voriconazole solutions has been shown in previous studies to produce high tissue and plasma drug concentrations as well as improved survival in a murine model of IPA. In the present study, rats were exposed to 20 min nebulizations of normal saline (control group) or aerosolized aqueous solutions of voriconazole at 15.625 mg (low dose group) or 31.25 mg (high dose group). Peak voriconazole concentrations in rat lung tissue and plasma after 3 days of twice daily dosing in the high dose group were 0.85 ± 0.63 μg/g wet lung weight and 0.58 ± 0.30 μg/mL, with low dose group lung and plasma concentrations of 0.38 ± 0.01 μg/g wet lung weight and 0.09 ± 0.06 μg/mL, respectively. Trough plasma concentrations were low but demonstrated some drug accumulation over 21 days of inhaled voriconazole administered twice daily. Following multiple inhaled doses, statistically significant but clinically irrelevant abnormalities in laboratory values were observed. Histopathology also revealed an increase in the number of alveolar macrophages but without inflammation or ulceration of the airway, interstitial changes, or edema. Inhaled voriconazole was well tolerated in a rat model of drug inhalation.