HPLC法检测肾移植病人全血中西罗莫司的药物浓度

目的 :建立测定全血中西罗莫司含量的方法。 方法 :采用HPLC法 ,色谱柱为 :YMC PackODS A(15 0mm× 4 .6mm ,5 μm) ,预柱为AlltimaC18(7.5mm× 4 .6mm ,5 μm)。流动相为乙腈∶四氢呋喃∶水 =5 5∶5∶4 0 ;检测波长为 2 78nm ,流速为 1.5ml/min ,柱温 :5 0℃。 32 去甲氧基西罗莫司为内标。 结果 :西罗莫司及内标 32 去甲氧基西罗莫司的保留时间分别为 10 .1、12 .1min ,全血定量线性范围 :2 .4 9～ 76 .36ng/ml,最低检测浓度为 1.98ng/ml,方法回收率为 99.93%～ 10 5 .90 % ,日内、日间RSD <7.4 0 %。 结论 :本方法准确、可靠 ,适用于临床对西罗莫司的血药浓度监测。     

西罗莫司治疗肾移植后排斥反应的疗效、不良反应与其血药浓度的相关性分析

目的:观察西罗莫司治疗肾移植后排斥反应时,其疗效、不良反应与血药浓度的相关性。方法:选择52名肾移植术后应用西罗莫司进行免疫抑制治疗的患者为研究对象,其中男性43人,女性9人。采用高效液相色谱(HPLC)法测定西罗莫司血药浓度,同时测定患者的肌酐清除率、肝功能指标、血常规等。结果:共收集西罗莫司血药浓度数据112份。西罗莫司的血药浓度与给药剂量/体重比呈正相关,与体重呈负相关,女性患者血药浓度明显高于男性患者(P<0.05),未发现西罗莫司血药浓度与年龄有明显相关性;西罗莫司的主要不良反应表现为肝功能损伤,将血药浓度分为<8ng·mL-1和>8ng·mL-1组,不同血药浓度组的肝功能差异有统计学意义(P<0.05);西罗莫司的临床疗效确切,将西罗莫司稳态谷浓度分成<4ng·mL-1、4～8ng·mL-1和>8ng·mL-1组,不同血药浓度组其肌酐清除率和肾功能恢复情况差异有统计学意义(P<0.05)。结论:西罗莫司副作用主要表现为肝功能异常,其血药浓度与临床疗效和不良反应均有相关性,西罗莫司稳态谷浓度宜控制在4～8ng·mL-1范围内。     

儿童患者西罗莫司血药浓度监测及临床应用分析

目的:探讨西罗莫司在儿童患者中的血药浓度,考察血药浓度与相关实验室指标的关系,为西罗莫司的合理应用提供更多的临床依据.方法:选择54例使用西罗莫司治疗的患儿,记录基本信息、西罗莫司全血谷浓度(CSRL)、肝功能和中性粒细胞计数(NEU)等相关信息.结果:儿童患者西罗莫司血药浓度为(8.7±5.9) ng/mL,16.7...     

西罗莫司不同血药浓度对肾移植患者肝肾功能的影响

目的探讨西罗莫司不同血药浓度对肾移植患者肝肾功能的影响。方法 45例肾移植术后服用西罗莫司治疗的患者,采用高效液相色谱法(HPLC法)检测西罗莫司的血液浓度,比较分析不同血药浓度下肝肾指标的变化情况。结果西罗莫司血药浓度≤8 ng/ml组患者的天门冬氨酸肌转酶(AST)、丙氨酸氨基转移酶(ALT)、直接胆红素(DBIL)分别为(65.26±12.68)U/L、(70.19±13.66)U/L、(11.05±9.64)μmol/L,显著低于>8 ng/ml组,差异均具有统计学意义(P<0.05);西罗莫司血药浓度为4~8 ng/ml组患者的内生肌酐清除率(Ccr)为(82.64±17.32)ml/(min·70 kg),显著高于<4 ng/ml组、>8 ng/ml组,差异具有统计学意义(P<0.05)。结论肾移植术后采用西罗莫司行免疫抑制治疗时,血药浓度控制在4~8 ng/ml最佳。     

西罗莫司在全血中的稳定性

目的:考察西罗莫司在全血中的稳定性.方法:配制浓度分别为2.5,7.5,22.5μg·L-1的西罗莫司血样,在3种温度下(25℃,4℃,-20℃)避光储存0～8 d和在-40℃存放后经历3个冻融周期,考察西罗莫司在全血中的稳定性.结果:在3种温度下储存8d和经历3个冻融周期后,西罗莫司血药浓度无显著变化.结论:西罗莫司血样可在冰冻或室温条件保存8d,经历3个冻融周期后西罗莫司在全血中仍能保持稳定.     

肾移植术后西罗莫司的应用方案选择

本综述总结西罗莫司用于预防肾移植术后排斥反应的各种用药方案,从急性排斥发生率、肾功能、人/肾存活率4个方面综合比较各种用药方案同其他传统免疫抑制方案的优劣。综合比较显示,肾移植术后转换使用西罗莫司是最值得推荐的用药方案。在环孢素与西罗莫司联用（CsA＋SRL）过程中减、停环孢素也是可以考虑的方案,但要注意控制西罗莫司浓度。西罗莫司可以替换麦考酚酸酯,此时钙调神经蛋白抑制剂（CNI）应适当减量。起始低剂量西罗莫司与CNI联用（CNI＋SRL）,以及起始足量CNI＋SRL并维持、起始不含CNI以及术后移植肾功能延迟恢复（DGF）过渡期使用西罗莫司均应当避免。西罗莫司支持术后撤停激素,此种情况下推荐西罗莫司与他克莫司联用。需定期监测西罗莫司谷浓度,并多数情形下推荐使用首剂负荷剂量。     

以降解产物的量表征西罗莫司口服溶液质量的探讨

目的 探讨对于以复合磷脂为载体且杂质谱复杂的口服溶液,以特定降解产物的量评价其质量的可行性。通过考察 不同试验条件下西罗莫司口服溶液中辅料的色谱保留行为,建立西罗莫司口服溶液中开环降解产物-断雷帕霉素的 HPLC 分析 方法。方法 采用 C18(4.6mm×250mm, 5μm) 色谱柱,流动相为乙腈 ( 含 1% 叔丁基甲醚 )-20mmol/L 甲酸铵缓冲溶液 ( 用甲酸调 节 pH 值至 3.6),梯度洗脱,流速为 1.5mL/min,检测波长为 277nm。结果 断雷帕霉素量的增加和西罗莫司含量的降低存在一 定的相关性,复合磷脂等不干扰断雷帕霉素的测定;断雷帕霉素相对于西罗莫司的响应因子在 0.9~1.1 之间,可采用主成分自身 对照法定量,西罗莫司的检测限约为 2.3ng( 相当于 0.02%)。结论 本方法重复性良好,操作简便、快速,辅料及其他杂质不干 扰断雷帕霉素的测定。对于以复合磷脂为载体且杂质谱复杂的西罗莫司口服溶液,以主要降解产物断雷帕霉素的量为指针可以 间接反映西罗莫司口服溶液的质量,该思路对其他复杂体系制剂质量的评价提供了思路。     

肾移植术后患者全血西罗莫司浓度监测结果分析

目的:探讨肾移植术后患者全血西罗莫司浓度的治疗窗以及西罗莫司对血常规、肝肾功能、血脂和尿蛋白的影响。方法:采用微粒子发光免疫分析技术（MEIA）测全血西罗莫司谷浓度。对3年来294例次肾移植术后患者全血西罗莫司浓度,以及西罗莫司对血常规、肝肾功能、血脂和尿蛋白的影响进行分析。结果:294例次全血西罗莫司浓度中有206例次（70%）在3～8ng·ml^-1范围内。肾移植6个月后,全血西罗莫司浓度测定值随移植时间延长而降低。服用西罗莫司后的尿蛋白数值升高,与服用之前相比差异有统计学意义（P<0.05或0.01）。结论:全血西罗莫司谷浓度治疗窗:术后1～3个月为4～6ng·ml^-1,第4～6个月为3～6ng·ml^-1,>6个月为3～5ng·ml^-1。     

西罗莫司-羟丙基-β-环糊精包合物的制备

目的：制备西罗莫司-羟丙基-β-环糊精（HP-β-CD）包合物,并考察HP-β-CD提高西罗莫司溶解度的效果。方法：以西罗莫司与HP-β-CD之比（mol：mol）、包合温度和包合时间为因素,包合率、收得率为指标,采用正交试验筛选西罗莫司-HP-β-CD包合物的制备工艺,并进行溶解度影响、X-射线衍射法结构验证。结果：最佳工艺为：西罗莫司与HP-β-CD之比为1：6（mol：mol）、包合温度为25℃、时间为6h;以此工艺制备3批包合物,平均包合率为25.4%（RSD=1.16%）,平均收得率为86.5%（RSD=0.83%）;随着HP-β-CD浓度增加,西罗莫司溶解度从1.18μg·mL-1增加到49.97μg·mL-1;包合物的晶体衍射峰形几乎与HP-β-CD完全一致。结论：HP-β-CD包合西罗莫司的工艺简单、易操作,能提高西罗莫司的溶解度。     

药物相互作用致三酰甘油升高1例

目的 报道并分析西罗莫司致高三酰甘油血症1例,提高临床重视西罗莫司对血脂代谢的影响。方法 1例肝移植病人使用西罗莫司后引起高三酰甘油血症的关联性评价及查阅文献印证。结果 住院第7日查血生化示:总胆固醇2.80 mmol/L,三酰甘油7.74 mmol/L;西罗莫司血药浓度为20 ng/mL;立即停用西罗莫司。住院第14日西罗莫司血药浓度为7 ng/mL,住院第21日复查血生化示:总胆固醇2.75 mmol/L,三酰甘油4.77 mmol/L。结论 该肝移植术后病人并发高三酰甘油血症很可能是西罗莫司引起。在应用西罗莫司时,应严密监测病人血脂情况,一旦出现三酰甘油值增加,应及时调整西罗莫司给药方案以期维持其血药浓度在基线范围内,从而降低其对血脂代谢的影响。     

Biotransformations of lipoglycopeptides to obtain novel antibiotics

The emergence of resistance among Gram-positive pathogens towards glycopeptide antibiotics has stimulated the research of second-generation molecules with improved activity and expanded antimicrobial spectrum. In this paper we investigate biotransformations as a way to generate novel teicoplanin- and A40926-like molecules. A range of commercial enzymes, fungi and actinomycetes were tested on A40926 and on its semi-synthetic derivatives (MDL 63,246 and dalbavancin). Oxidation of dalbavancin to MDL 63,246 was achieved by Nonomuraea sp. ATCC 39727 and Actinomadura parvosata ATCC 53463, while Actinoplanes sp. NRRL 3884, Actinoplanes missouriensis ATCC 23342 and Actinoplanes teichomyceticus ATCC 31121 deacylated MDL 63,246, dalbavancin and A40926. It is worth noting that the actinomycetes able to catalyze the deacylation of lipoglycopeptides are themselves producers of microbiologically active glycopeptides. Structurally related antibiotics (mideplanin and teicoplanin) were not transformed. Biotransformation conditions were optimised and scaled-up for the use of Actinoplanes sp. NRRL 3884 in the production of novel deacylated derivatives.     

A-16686, a new antibiotic from Actinoplanes. I. Fermentation, isolation and preliminary physico-chemical characteristics

Actinoplanes sp. ATCC 33076 is a new strain that was found to produce an antibiotic, designated A-16686, which is a complex of three closely-related polypeptides containing chlorinated phenyl moieties and D-mannose. Both the complex and the single fractions possess a good activity against Gram-positive bacteria. A-16686 specifically inhibits the synthesis of the bacterial cell wall.     

游动放线菌PDF-1代谢产物中抗耐药菌株活性成分研究

目的从一株游动放线菌Actinoplanes sp.PDF-1发酵液中分离抗多种耐药细菌的活性化合物。方法通过活性追踪,利用多种色谱技术手段,结合现代波谱学方法分离鉴定化合物结构。结果从Actinoplanes sp.PDF-1的发酵产物中分离纯化得到6个化合物,诺西肽(Nosiheptide,1)、2′-脱氧胸腺嘧啶核苷(2′-Deoxythymidine,2)、2′-脱氧胞嘧啶核苷(2′-Deoxycytidine,3)、胡萝卜苷(Daucosterol,4)、邻氨基苯甲酸(2-Aminobenzoic acid,5)和N~b-乙酰基色胺(N~b-Acetyltryptamine,6)。结论从Actinoplanessp.PDF-1的发酵产物中分离纯化得到6个化合物,其中化合物l为抗耐药细菌的主要活性成分。     

Structure and biological activity of lipiarmycin B

Actinoplanes deccanensis ATCC 21983, the producer of antibiotics lipiarmycin A3 and A4, furnished also a related antibiotic designated lipiarmycin B, active against Gram-positive bacteria, including anaerobes, and against Neisseria. The structures of the two major components, B3 and B4, were elucidated from their physico-chemical properties, 1H and 13C NMR spectra and fast atom bombardment mass spectra data in comparison with lipiarmycins A3 and A4.     

Mzabimycins A and B,novel intracellular angucycline antibiotics produced by Streptomyces sp. PAL114 in synthetic medium containing L-tryptophan

In our previous studies, the production of four bioactive molecules by Streptomyces sp. PAL114 in complex ISP2 broth medium has been described. Three of these molecules belong to the angucycline family. In this study, two novel antibiotics belonging to the same family were produced by strain PAL114 on M2 synthetic medium containing L-tryptophan as precursor. These antibiotics, named mzabimycins A and B, were intracellular and produced only in the presence of L-tryptophan. After four days of culturing PAL114 in the M2 medium, the bioactive compounds were extracted from mycelium with methanol and then analyzed by HPLC on reverse phase C18 column. Two active purplish blue fractions were purified. The chemical structures of these molecules were determined on the basis of spectroscopic and spectrometric analyses (¹H and ¹³C NMR, and mass spectra). They were identified to be novel angucycline derivative antibiotics. The pure molecules showed activity against some pathogenic Gram-positive bacteria which have multiple antibiotic resistance, such as Staphylococcus aureus MRSA 639c and Listeria monocytogenes ATCC 13932.     

Microbial transformation of immunosuppressive compounds. I. Desmethylation of FK506 and immunomycin (FR 900520) by Actinoplanes sp. ATCC 53771.

The immunosuppressants FK506 and FR 900520 were desmethylated by Actinoplanes sp. ATCC 53771 to yield various O-desmethylated products. The products were isolated and purified by solvent extraction and HPLC chromatography, and identified by NMR and MS spectroscopy.     

Ramoplanin (A-16686), a new glycolipodepsipeptide antibiotic. III. Structure elucidation

By combination of chemical, 1H and 13C NMR, and mass spectrometric studies, the structures of the three components of the antibiotic ramoplanin (A-16686), produced by Actinoplanes sp. ATCC 33076, have been elucidated. All the components have structures formed by a common depsipeptide skeleton carrying a dimannosyl group and are differentiated by the presence of various acylamide moieties, derived from C8, C9 and C10 fatty acids.     

恩拉霉素与雷莫拉宁生物合成研究进展

目前耐药革兰阳性菌在医院感染中的比例不断上升,具有新型革兰阳性病原菌抑制机制的恩拉霉素和雷莫拉宁成为目前研究的热点.含有17个氨基酸的肽类抗生素,恩拉霉素和雷莫拉宁的生物合成基因簇已分别从链霉菌Streptomyces fungicidicus ATCC21013和游动放线菌Actinoplanes sp.ATCC33076中克隆到.本文综述了恩拉霉素与雷莫拉宁生物合成途径研究的最新进展,为进一步利用基因工程手段对其进行结构改造提供依据.     

Teichomycins, new antibiotics from Actinoplanes teichomyceticus Nov. Sp. I. Description of the producer strain, fermentation studies and biological properties

A soil isolate of Actinoplanes that produces the chemically unrelated new antibiotics teichomycins A1 and A2 has been proposed as a new species named Actinoplanes teichomyceticus nov. sp. (ATCC 31121). Studies of medium and fermentation conditions indicated that the highest antibiotic titers, ca 900 u/ml, are obtained in a medium containing 1% (w/v) glucose, 1% cotton seed meal, 1% malt extract, and 0.4% yeast extract. Both teichomycin A1 and teichomycin A2 are highly active against gram-positive bacteria. Teichomycin A1 shows some activity against gram-negative bacteria. Both antibiotics cured mice experimentally infected with sensitive bacteria and showed low acute toxicity. Of the two antibiotics teichomycin A2 is the more active.     

产非达霉素药用植物内生放线菌N12W0304的分类鉴定#br#

目的 对一株分离自药用植物仙鹤草中的产非达霉素菌株N12W0304进行分类研究。方法 通过形态特征、培养特征观察、生理生化特征、胞壁分析及16S rDNA序列分析等多相分类研究对菌株进行鉴定。结果 菌株N12W0304属于游动放线菌属(Actinoplanes sp.)菌株。结论 本报道是首次从仙鹤草中分离到游动放线菌属非达霉素产生菌。