A Comparative Study of Dihydroartemisin in Compounds in Treatment of Uncomplicated Falciparum Malaria in Kampong of Cambodia

Objective: To compare the safety and efficacy of two compounds of dihydroartemisinin(DHA) -Artekin and Artekin (T) in the treatment of uncomplicated falciparum malaria. Methods:The regimen of 8-tablet for 2 days of Artekin and Artekin (T) were applied to 100 patients with uncomplicated falciparum malaria, who were randomly divided into two groups. Each group contained 50 cases. The cure rate, the mean parasites clearance time, the mean fever clearance and side-effects were observed to assess the safety and efficacy of the compounds used. Results: The mean parasites clearance time was 31. 7±9.0 hours in the Artekin group and 32. 8±8. 8 hours in Artekin (T) group respectively; the mean fever clearance time was 12. 7±7. 2 hours in Artekin group and 16. 5±7. 9 hours in Artekin (T) group; there were no recrudescence case in both groups within the 28 days of follow-up, the cure rates in Artekin group and Artekin (T) groups were 100%. It indicated that the tolerability of both compounds were very good, the     

蒿甲醚合成母液中一个新成分的分离和鉴定

目的：为了弄清蒿甲醚合成母液中的衍生杂质结构及开发新的药源。方法：用色谱法从合成蒿甲醚的母液中分离其衍生物成分,并用化学波谱法鉴定其结构,结果：分离得到5个化合物分别鉴定为α-蒿甲醚（Ⅰ）,二氢青蒿素（Ⅱ）,青蒿素（Ⅲ）,八氢－8－甲氧基－4,7－二甲基－呋喃[3,2-i]苯并吡喃－10－乙酸酯（Ⅳ）和12－脱氧－11－烯青蒿素（Ⅴ）。结论：化合物Ⅴ为一新化合物,命名为12－脱氧－11－烯青蒿素,并首次从合成蒿甲醚的母液中得到。     

三波长分光光度法测定复方双氢青蒿素片中双氢青蒿素的含量

目的:建立复方双氢青蒿素片中双氢青蒿素含量测定的方法。方法:主波长为250nm,基线波长1为271nm,基线波长2为301nm。结果:在6～30μg·mL~(-1),范围内线性良好,r=0.99992(n=10),平均回收率为101.7％,RSD为0.66％。结论:三波长分光光度法可不经分离,能消除甲氧苄啶和磷酸哌喹的干扰,从而直接测定复方制剂中双氢青蒿素的含量,该法操作简便、快捷、准确。     

Opposite malaria and pregnancy effect on oral bioavailability of artesunate – a population pharmacokinetic evaluation

Aim

The aim was to compare the pharmacokinetic properties of artesunate and dihydroartemisinin in the same women: i) pregnant with acute uncomplicated malaria on day 1 and 2, ii) pregnant with convalescent malaria on day 7 and iii) in a healthy state 3 months post-partum on day 1, 2 and 7.

Methods

Non-linear mixed-effects modelling was used to compare plasma concentration–time profiles of artesunate and dihydroartemisinin over 7 days of treatment following oral and intravenous artesunate administration to pregnant women with uncomplicated Plasmodium falciparum malaria during their second or third trimesters of pregnancy. The same women were restudied 3 months after delivery when fully recovered. Non-compartmental results of the same study have been published previously.

Results

Twenty pregnant patients on the Thailand-Myanmar border were studied and 15 volunteered to be restudied 3 months post-partum. Malaria and pregnancy had no effect on the pharmacokinetic properties of artesunate or dihydroartemisinin after intravenous artesunate administration. However, malaria and pregnancy had opposite effects on the absorption of orally administered artesunate. Malaria increased the absolute oral bioavailability of artesunate by 87%, presumably by inhibiting first pass effect, whereas pregnancy decreased oral bioavailability by 23%.

Conclusions

The population pharmacokinetic analysis demonstrated opposite effects of malaria and pregnancy on the bioavailability of orally administered artesunate. Lower drug exposures during the second and third trimesters of pregnancy may contribute to lower cure rates and thus the development of drug resistance. Dose optimization studies are required for artesunate containing artemisinin-based combination therapies (ACTs) in later pregnancy.     

蒿甲醚和双氢青蒿素治疗维和部队疟疾93例分析

目的 为了保证维和部队的任务完成及官兵的身体健康,防治维和部队的疟疾患者并总结疟疾的防治经验.方法 对所属维和部队官兵参与进行抗疟药物分组治疗效果观察.结果 双氢青蒿素(科泰新)防治效果肯定,用于进人高疟区的易感人群疟疾防治效果显著.结论 蒿甲醚对疟疾的疗效肯定;双氢青蒿素作为一种新的选择更适应未来的战争需要.     

Dihydroartemisinin suppresses ovalbumin-induced airway inflammation in a mouse allergic asthma model

Abstract

Asthma is a complex disease characterized by reversible airway obstruction, airway hyper-responsiveness (AHR) and chronic inflammation of the airways. Dihydroartemisinin (DHA), a semi-synthetic derivative of artemisinin isolated from the traditional Chinese herb Artemisia annua, has been shown to possess antimalarial and antitumor activities, but whether it can be used in asthma treatment has not been investigated. In this study, we attempted to determine whether DHA regulates inflammatory mediators in the ovalbumin (OVA)-induced mouse asthma model. BALB/c mice were sensitized and challenged by OVA to induce chronic airway inflammation. The intragastrical administration of DHA at 30?mg/kg significantly decreased the number of infiltrating inflammatory cells, T-helper type 2 (Th2) cytokines, OVA-specific immunoglobulin E (IgE) and AHR. Treatment with DHA also attenuated OVA-induced mRNA expression of Muc5ac and chitinase 3-like protein 4 (Ym2) in lung tissues. In addition, lung histopathological studies revealed that DHA inhibited inflammatory cell infiltration and mucus hypersecretion. Then signal transduction studies showed that DHA significantly inhibited extracellular signal-regulated protein kinase (ERK), p38 mitogen-activated protein kinase phosphorylation. DHA also inhibited nuclear factor-κB (NF-κB) activation via the inhibition of phosphorylation of IκBα. These findings provide new insight into the immunopharmacological role of DHA in terms of its effects in a mouse model of asthma.     

双氢青蒿素诱导肿瘤细胞凋亡的信号通路研究进展

双氢青蒿素作为青蒿素的重要衍生物,是我国自行研制出的抗疟新药。近些年来,人们对双氢青蒿素进行了多方面的研究,在抗肿瘤研究方面有许多新进展,发现其诱导肿瘤细胞凋亡的机制与多条信号通路有关,例如PI3K/Akt、MAPK、STAT3、Wnt/β-catenin、NF-κB等信号通路。通过对作用机制的深入研究和阐述有望发现双氢青蒿素的新适应症,使其在临床上的应用更加广泛。     

青蒿琥酯和复方双氢青蒿素序贯治疗对南苏丹恶性疟疾的疗效

目的：观察注射用青蒿琥酯和复方双氢青蒿素片序贯治疗对南苏丹恶性疟疾病人的疗效。方法：回顾性分析2011年7月-2013年11月在南苏丹瓦乌中国二级医院住院的55例恶性疟疾病历。结果：肌注或静脉注射青蒿琥酯注射液（首剂120mg,后60mg/d）1~5d[（3.2±0.9）d],最后一次静脉注射或肌注后24、30、48、72h口服复方双氢青蒿素片2片,共8片。55例疟疾病人的总治愈率为100%,其中3d治愈52例（94.5%）,3~7d治愈3例（5.5%）。4例（7.3%）病人发生恶心、呕吐、腹泻或头晕等轻度不良反应。结论：注射用青蒿琥酯和复方双氢青蒿素片序贯治疗,对南苏丹恶性疟疾病人具有非常好的临床疗效,适合多种人群,耐受性好。     

双氢青蒿素对UVB诱导的人皮肤HaCaT细胞凋亡的保护作用

目的:明确双氢青蒿素(DHA)对UVB诱导人皮肤HaCaT细胞凋亡的保护作用。方法:将体外培养的HaCaT细胞分为空白对照组,UVB照射组和UVB+DHA(20、40、60、80μmol/L)组,采用MTT法检测细胞系的增殖情况,流式细胞仪检测细胞的凋亡率,RT-PCR法检测抗凋亡基因survivin和促凋亡基因caspease-3(激活型)mRNA水平,Western检测相关蛋白表达水平。结果:30 mJ/cm~2 UVB照射24 h后,UVB组和UVB+DHA(20、40、60、80μmol/L)组细胞的增殖率分别为空白对照组的(50.13±2.42)%,(60.23±2.30)%,(69.24±3.19)%,(79.37±2.47)%和(70.41±2.24)%。UVB组和UVB+60μmol/L DHA组中HaCaT细胞凋亡率分别为(46.7±3.2)%和(23.71±1.2)%。与UVB组比较,UVB+60μmol/L DHA组中HaCaT细胞caspase-3 mRNA及蛋白表达降低、survivin mRNA及蛋白表达升高。结论:DHA可抑制UVB所致HaCaT细胞的凋亡,其机制可能与survivin和caspase-3有关。