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  • 1
    In: Molecules, MDPI AG, Vol. 26, No. 23 ( 2021-11-25), p. 7145-
    Abstract: Gelsemium elegans Benth (GEB), also known as heartbreak grass, is a highly poisonous plant belonging to the family Loganiaceae and genus Gelsemium that has broad application prospects in medicine. This article reviews its chemical components, pharmacological effects, toxicity mechanisms, and research progress in clinical applications in recent years. Indole alkaloids are the main active components of GEB and have a variety of pharmacological and biological functions. They have anti-tumor, anti-inflammatory, analgesic, and immunomodulation properties, with the therapeutic dose being close to the toxic dose. Application of small-dose indole alkaloids fails to work effectively, while high-dose usage is prone to poisoning, aggravating the patient’s conditions. Special caution is needed, especially to observe the changes in the disease condition of the patients in clinical practice. In-depth research on the chemical components and mechanisms of GEB is essential to the development of promising lead compounds and lays the foundation for extensive clinical application and safe usage of GEB in the future.
    Type of Medium: Online Resource
    ISSN: 1420-3049
    Language: English
    Publisher: MDPI AG
    Publication Date: 2021
    detail.hit.zdb_id: 2008644-1
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  • 2
    In: International Immunopharmacology, Elsevier BV, Vol. 114 ( 2023-01), p. 109573-
    Type of Medium: Online Resource
    ISSN: 1567-5769
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2023
    detail.hit.zdb_id: 2049924-3
    SSG: 15,3
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  • 3
    In: Pharmaceutics, MDPI AG, Vol. 14, No. 11 ( 2022-10-28), p. 2323-
    Abstract: Polymyxin B (PMB) is the final option for treating multidrug-resistant Gram-negative bacterial infections. The acceptable pharmacokinetic/pharmacodynamic target is an area under the concentration–time curve across 24 h at a steady state (AUCss,24h) of 50–100 mg·h/L. The limited sampling strategy (LSS) is useful for predicting AUC values. However, establishing an LSS is a time-consuming process requiring a relatively dense sampling of patients. Further, given the variability among different centers, the predictability of LSSs is frequently questioned when it is extrapolated to other clinical centers. Currently, limited data are available on a reliable PMB LSS for estimating AUCss,24h. This study assessed and validated the practicability of LSSs established in the literature based on data from our center to provide reliable and ready-made PMB LSSs for laboratories performing therapeutic drug monitoring (TDM) of PMB. The influence of infusion and sampling time errors on predictability was also explored to obtain the optimal time points for routine PMB TDM. Using multiple regression analysis, PMB LSSs were generated from a model group of 20 patients. A validation group (10 patients) was used to validate the established LSSs. PMB LSSs from two published studies were validated using a dataset of 30 patients from our center. A population pharmacokinetic model was established to simulate the individual plasma concentration profiles for each infusion and sampling time error regimen. Pharmacokinetic data obtained from the 30 patients were fitted to a two-compartment model. Infusion and sampling time errors observed in real-world clinical practice could considerably affect the predictability of PMB LSSs. Moreover, we identified specific LSSs to be superior in predicting PMB AUCss,24h based on different infusion times. We also discovered that sampling time error should be controlled within −10 to 15 min to obtain better predictability. The present study provides validated PMB LSSs that can more accurately predict PMB AUCss,24h in routine clinical practice, facilitating PMB TDM in other laboratories and pharmacokinetics/pharmacodynamics-based clinical studies in the future.
    Type of Medium: Online Resource
    ISSN: 1999-4923
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
    detail.hit.zdb_id: 2527217-2
    SSG: 15,3
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  • 4
    Online Resource
    Online Resource
    Springer Science and Business Media LLC ; 2022
    In:  Journal of Public Health Vol. 30, No. 6 ( 2022-06), p. 1421-1429
    In: Journal of Public Health, Springer Science and Business Media LLC, Vol. 30, No. 6 ( 2022-06), p. 1421-1429
    Type of Medium: Online Resource
    ISSN: 2198-1833 , 1613-2238
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 1149070-6
    detail.hit.zdb_id: 2140791-5
    detail.hit.zdb_id: 2136860-0
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  • 5
    In: British Journal of Clinical Pharmacology, Wiley, Vol. 88, No. 7 ( 2022-07), p. 3052-3063
    Abstract: Proton pump inhibitors (PPIs) are often prescribed to prevent or treat gastrointestinal disease. Whether the combination of systemic anti‐tumour therapy and PPIs leads to poor outcomes in patients with advanced non‐small cell lung cancer (NSCLC) is unclear. This systematic review explored the relationship between PPIs and survival outcomes of patients with advanced NSCLC who are receiving systemic anti‐tumour therapy. Methods We searched studies reporting the overall survival (OS) and/or progression‐free survival (PFS) of advanced NSCLC patients who are receiving systemic anti‐tumour therapy with or without PPIs on PubMed, EMBASE and the Cochrane Library for literature published prior to 31 August 2021. The meta‐analysis used a random effects model to estimate the hazard ratio (HR) with 95% confidence intervals (CI) and I 2 to assess statistical heterogeneity. Publication bias and sensitivity analysis were performed. Results Fourteen retrospective studies comprising 13 709 advanced NSCLC patients were identified. Subgroup analyses showed that the use of PPI was correlated with the OS or PFS of patients receiving chemotherapy, targeted therapy, and immunotherapy (PPI users' group vs non‐users' group: HR for OS = 1.35, 95% CI = 1.21–1.51, P   〈  .00001; HR for PFS = 1.50, 95% CI = 1.25–1.80, P   〈  .0001). Publication bias and sensitivity analyses confirmed that the results were robust. Conclusion Meta‐analysis demonstrated that PPI use in advanced NSCLC patients who were undergoing systemic anti‐tumour therapy was correlated with increased mortality risk. Until results are further confirmed, caution should be applied when administering PPIs and systemic anti‐tumour therapy to advanced NSCLC patients.
    Type of Medium: Online Resource
    ISSN: 0306-5251 , 1365-2125
    URL: Issue
    RVK:
    Language: English
    Publisher: Wiley
    Publication Date: 2022
    detail.hit.zdb_id: 1498142-7
    SSG: 15,3
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  • 6
    In: BMC Complementary Medicine and Therapies, Springer Science and Business Media LLC, Vol. 21, No. 1 ( 2021-12)
    Abstract: Colorectal cancer (CRC) remains one of the leading causes of cancer-related death worldwide. Gelsemium elegans Benth (GEB) is a traditional Chinese medicine commonly used for treatment for gastrointestinal cancer, including CRC. However, the underlying active ingredients and mechanism remain unknown. This study aims to explore the active components and the functional mechanisms of GEB in treating CRC by network pharmacology-based approaches. Methods Candidate compounds of GEB were collected from the Traditional Chinese Medicine@Taiwan, Traditional Chinese Medicines Integrated Database, Bioinformatics Analysis Tool for Molecular mechanism of Traditional Chinese Medicine, and published literature. Potentially active targets of compounds in GEB were retrieved from SwissTargetPrediction databases. Keywords “colorectal cancer”, “rectal cancer” and “colon cancer” were used as keywords to search for related targets of CRC from the GeneCards database, then the overlapped targets of compounds and CRC were further intersected with CRC related genes from the TCGA database. The Cytoscape was applied to construct a graph of visualized compound-target and pathway networks. Protein-protein interaction networks were constructed by using STRING database. The DAVID tool was applied to carry out Gene Ontology and Kyoto Encyclopedia of Genes and Genome pathway enrichment analysis of final targets. Molecular docking was employed to validate the interaction between compounds and targets. AutoDockTools was used to construct docking grid box for each target. Docking and molecular dynamics simulation were performed by Autodock Vina and Gromacs software, respectively. Results Fifty-three bioactive compounds were successfully identified, corresponding to 136 targets that were screened out for the treatment of CRC. Functional enrichment analysis suggested that GEB exerted its pharmacological effects against CRC via modulating multiple pathways, such as pathways in cancer, cell cycle, and colorectal cancer. Molecular docking analysis showed that the representative compounds had good affinity with the key targets. Molecular dynamics simulation indicated that the best hit molecules formed a stable protein-ligand complex. Conclusion This network pharmacology study revealed the multiple ingredients, targets, and pathways synergistically involved in the anti-CRC effect of GEB, which will enhance our understanding of the potential molecular mechanism of GEB in treatment for CRC and lay a foundation for further experimental research.
    Type of Medium: Online Resource
    ISSN: 2662-7671
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 3037610-5
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  • 7
    In: British Journal of Clinical Pharmacology, Wiley
    Abstract: Polymyxin B (PMB) is widely used to treat infections caused by multidrug‐resistant Gram‐negative pathogens. Currently, the pharmacokinetic data of PMB in patients with liver dysfunction are limited. This study aimed to develop a population pharmacokinetic (PopPK) model of PMB in patients with liver dysfunction and identify the factors affecting PMB pharmacokinetics. Methods We conducted a retrospective pharmacokinetic study involving 136 adults with different levels of liver function. Nonlinear mixed effects modelling was used to develop a PopPK model of PMB. Monte Carlo simulation was used to design PMB dosage schedules across various liver and renal functions. Results PMB pharmacokinetic analyses included 401 steady‐state concentrations in 136 adult patients. A one‐compartment pharmacokinetic model with first‐order absorption and elimination was used to describe the data. The typical population value of PMB clearance was 2.43 L/h and the volume of distribution was 23.11 L. This study revealed that creatinine clearance (CrCL) and Child–Pugh class were significantly associated with PMB pharmacokinetic parameters; however, clinically relevant variations of dose‐normalized drug exposure were not significant. For patients with a minimum inhibitory concentration of ≤0.5 mg/L, the appropriate dose was 40–75 mg/12‐h. When the dose exceeded 100 mg/12‐h, the risk of nephrotoxicity increased significantly. Conclusions This study provided PMB pharmacokinetic information for patients with liver dysfunction. Patients with renal and liver dysfunctions may not require an initial dose adjustment. Rather than PopPK‐guided dose adjustment, therapeutic drug monitoring of PMB plays a more direct role in optimizing dosing regimens based on its therapeutic window.
    Type of Medium: Online Resource
    ISSN: 0306-5251 , 1365-2125
    RVK:
    Language: English
    Publisher: Wiley
    Publication Date: 2023
    detail.hit.zdb_id: 1498142-7
    SSG: 15,3
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  • 8
    Online Resource
    Online Resource
    Bentham Science Publishers Ltd. ; 2019
    In:  Current Pharmaceutical Analysis Vol. 15, No. 6 ( 2019-07-18), p. 640-649
    In: Current Pharmaceutical Analysis, Bentham Science Publishers Ltd., Vol. 15, No. 6 ( 2019-07-18), p. 640-649
    Abstract: Of two main alkaloids extracted from Gelsemium, koumine was shown to be a promising analgesic, while gelsemine proved to be deleterious. Many patients suspected to be poisoned by Gelsemium cannot be timely diagnosed due to the lack of UPLC-MS/MS. Additionally, the concentration of alkaloids in humans has never been reported. The aim of this study was to establish a more economical and accessible method using HPLC-UV for diagnosis and quantitative analysis of Gelsemium poisoning. Methods: Plasma spiked with an internal standard, oxcarbazepine, was prepared with solid-phase extraction. Koumine and gelsemine were separated on a C18 column using a mobile phase consisting of methanol, water, and di-n-butylamine (58:42:0.01) pumped at a flow rate of 1.00 mL/min. The detection wavelength was set at 263 nm. Plasma concentrations of two different times were determined for the patients. Results: The calibration curves for both monomers possessed good linearity from 0.05-50 mg/L (r=0.9997 and 0.9999, respectively). The extraction recoveries were greater than 88.5 %. Variation for intraday and interday assays of koumine and gelsemine were less than 8.3% and 7.7%, respectively. The concentrations of the two alkaloids were identified in 5 patients with Gelsemium poisoning by using the established method. Conclusion: The established method by using HPLC-UV is applicable for diagnosis and quantitative analysis of Gelsemium poisoning in such cases. TDM of koumine and gelsemine in patients with Gelsemium poisoning may provide additional information for the clinic to improve rescue strategy.
    Type of Medium: Online Resource
    ISSN: 1573-4129
    Language: English
    Publisher: Bentham Science Publishers Ltd.
    Publication Date: 2019
    SSG: 15,3
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  • 9
    Online Resource
    Online Resource
    Frontiers Media SA ; 2022
    In:  Frontiers in Pharmacology Vol. 12 ( 2022-1-3)
    In: Frontiers in Pharmacology, Frontiers Media SA, Vol. 12 ( 2022-1-3)
    Abstract: Gelsemium elegans (Gardner and Champ.) Benth. (Gelsemiaceae ) (GEB) is a toxic plant indigenous to Southeast Asia especially China, and has long been used as Chinese folk medicine for the treatment of various types of pain, including neuropathic pain (NPP). Nevertheless, limited data are available on the understanding of the interactions between ingredients-targets-pathways. The present study integrated network pharmacology and experimental evidence to decipher molecular mechanisms of GEB against NPP. The candidate ingredients of GEB were collected from the published literature and online databases. Potentially active targets of GEB were predicted using the SwissTargetPrediction database. NPP-associated targets were retrieved from GeneCards, Therapeutic Target database, and DrugBank. Then the protein-protein interaction network was constructed. The DAVID database was applied to Gene Ontology and Kyoto Encyclopedia of Genes and Genome pathway enrichment analysis. Molecular docking was employed to validate the interaction between ingredients and targets. Subsequently, a 50 ns molecular dynamics simulation was performed to analyze the conformational stability of the protein-ligand complex. Furthermore, the potential anti-NPP mechanisms of GEB were evaluated in the rat chronic constriction injury model. A total of 47 alkaloids and 52 core targets were successfully identified for GEB in the treatment of NPP. Functional enrichment analysis showed that GEB was mainly involved in phosphorylation reactions and nitric oxide synthesis processes. It also participated in 73 pathways in the pathogenesis of NPP, including the neuroactive ligand-receptor interaction signaling pathway, calcium signaling pathway, and MAPK signaling pathway. Interestingly, 11-Hydroxyrankinidin well matched the active pockets of crucial targets, such as EGFR, JAK1, and AKT1. The 11-hydroxyrankinidin-EGFR complex was stable throughout the entire molecular dynamics simulation. Besides, the expression of EGFR and JAK1 could be regulated by koumine to achieve the anti-NPP action. These findings revealed the complex network relationship of GEB in the “multi-ingredient, multi-target, multi-pathway” mode, and explained the synergistic regulatory effect of each complex ingredient of GEB based on the holistic view of traditional Chinese medicine. The present study would provide a scientific approach and strategy for further studies of GEB in the treatment of NPP in the future.
    Type of Medium: Online Resource
    ISSN: 1663-9812
    Language: Unknown
    Publisher: Frontiers Media SA
    Publication Date: 2022
    detail.hit.zdb_id: 2587355-6
    SSG: 15,3
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  • 10
    In: Journal of Clinical Pharmacy and Therapeutics, Hindawi Limited, Vol. 47, No. 9 ( 2022-09), p. 1426-1437
    Type of Medium: Online Resource
    ISSN: 0269-4727 , 1365-2710
    URL: Issue
    Language: English
    Publisher: Hindawi Limited
    Publication Date: 2022
    detail.hit.zdb_id: 2006678-8
    SSG: 15,3
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