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Wang MN, Yu HT, Li YQ, Zeng Y, Yang S, Yang GP, Pei Q, Huang J. Bioequivalence and Pharmacokinetic Profiles of Generic and Branded Obeticholic Acid in Healthy Chinese Subjects Under Fasting and Fed Conditions. DRUG DESIGN DEVELOPMENT AND THERAPY 2021; 15:185-193. [PMID: 33469270 PMCID: PMC7813459 DOI: 10.2147/dddt.s289016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 12/09/2020] [Indexed: 12/12/2022]
Abstract
Objectives This study was conducted to evaluate the bioequivalence (BE) of a generic form of obeticholic acid (OCA) and OcalivaTM under fasting and fed conditions and to determine the effects of food on the pharmacokinetic (PK) profiles of OCA in healthy Chinese subjects. Methods A randomized, single-dose, three-sequence, three-period, partial replicated crossover study was conducted with a 21-day washout interval between periods under fasting (n=48) and fed (n=48) conditions. Blood samples for OCA and its metabolites Glyco-OCA and Tauro-OCA were collected up to 168 hours after administration in each period. PK parameters were calculated using the non-compartmental method. Geometric mean ratios for PK parameters of the test to reference drug under fasting and fed conditions and their 90% confidence intervals were estimated. Safety evaluations were carried out all through the study. Results A total of 91 subjects completed the study with 45 in a fasted state and 46 receiving a high-fat diet. There were no serious or unexpected drug-related adverse events occurring during the study. There was no significant difference in the main PK parameters of the two preparations, irrespective of the fasting or fed conditions. Under fasting and fed conditions, the SWR of lnCmax, lnAUC0-t and lnAUC0-∞ were 0.445, 0.370, 0.448, 0.340, 0.168, and 0.180, respectively. Thus, the average BE or the reference-scaled average BE was used to verify that the two preparations were bioequivalent under fasting and fed conditions. Compared with the fasting state, the AUC0-t of the test drug, the AUC0-t, and AUC0-∞ of the reference drug were higher in the fed state. Conclusion The test drug and the reference drug were BE and well tolerated in Chinese healthy subjects under both fasting and fed conditions. Food-intake may cause a significant difference in the main PK parameters of the two preparations.
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Affiliation(s)
- Meng-Na Wang
- Center for Clinical Pharmacology, The Third Xiangya Hospital, Central South University, Changsha, Hunan 410013, People's Republic of China
| | - Hai-Tao Yu
- Research and Development Center, Nanjing Chia Tai Tianqing Pharmaceutical Co., Ltd., Nanjing 210038, People's Republic of China
| | - Ya-Qian Li
- Center for Clinical Pharmacology, The Third Xiangya Hospital, Central South University, Changsha, Hunan 410013, People's Republic of China
| | - Yun Zeng
- Center for Clinical Pharmacology, The Third Xiangya Hospital, Central South University, Changsha, Hunan 410013, People's Republic of China
| | - Shuang Yang
- Research Center of Drug Clinical Evaluation of Central South University, Changsha, Hunan 410013, People's Republic of China
| | - Guo-Ping Yang
- Center for Clinical Pharmacology, The Third Xiangya Hospital, Central South University, Changsha, Hunan 410013, People's Republic of China.,Research Center of Drug Clinical Evaluation of Central South University, Changsha, Hunan 410013, People's Republic of China.,XiangYa School of Pharmaceutical Sciences, Central South University, Changsha, Hunan 410013, People's Republic of China.,National-Local Joint Engineering Laboratory of Drug Clinical Evaluation Technology, Changsha, Hunan 410013, People's Republic of China.,Department of Pharmacy, The Third Xiangya Hospital, Central South University, Changsha, Hunan 410013, People's Republic of China
| | - Qi Pei
- Department of Pharmacy, The Third Xiangya Hospital, Central South University, Changsha, Hunan 410013, People's Republic of China
| | - Jie Huang
- Center for Clinical Pharmacology, The Third Xiangya Hospital, Central South University, Changsha, Hunan 410013, People's Republic of China.,Research Center of Drug Clinical Evaluation of Central South University, Changsha, Hunan 410013, People's Republic of China
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Meng L, Quezada M, Levine P, Han Y, McDaniel K, Zhou T, Lin E, Glaser S, Meng F, Francis H, Alpini G. Functional role of cellular senescence in biliary injury. THE AMERICAN JOURNAL OF PATHOLOGY 2015; 185:602-9. [PMID: 25619959 DOI: 10.1016/j.ajpath.2014.10.027] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Revised: 10/06/2014] [Accepted: 10/28/2014] [Indexed: 01/02/2023]
Abstract
Cellular senescence is a state of irreversible cell cycle arrest that has been involved in many gastrointestinal diseases, including human cholestatic liver disorders. Senescence may play a role in biliary atresia, primary sclerosing cholangitis, cellular rejection, and primary biliary cirrhosis, four liver diseases affecting cholangiocytes and the biliary system. In this review, we examine proposed mechanisms of senescence-related biliary diseases, including hypotheses associated with the senescence-associated phenotype, induction of senescence in nearby cells, and the depletion of stem cell subpopulations. Current evidence for the molecular mechanisms of senescence in the previously mentioned diseases is discussed in detail, with attention to recent advances on the role of pathways associated with senescence-associated phenotype, stress-induced senescence, telomere dysfunction, and autophagy.
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Affiliation(s)
- Luke Meng
- Department of Research, Central Texas Veterans Health Care System, Temple, Texas; Department of Medicine, Digestive Disease Research Center, Scott & White Healthcare, Texas A&M Health Science Center, College of Medicine, Baylor Scott & White Health, Temple, Texas; Doctor of Medicine Program, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Morgan Quezada
- Department of Medicine, Digestive Disease Research Center, Scott & White Healthcare, Texas A&M Health Science Center, College of Medicine, Baylor Scott & White Health, Temple, Texas
| | - Phillip Levine
- Department of Medicine, Digestive Disease Research Center, Scott & White Healthcare, Texas A&M Health Science Center, College of Medicine, Baylor Scott & White Health, Temple, Texas; Academic Operations, Scott & White Memorial Hospital, Baylor Scott & White Health, Temple, Texas
| | - Yuyan Han
- Department of Research, Central Texas Veterans Health Care System, Temple, Texas; Department of Medicine, Digestive Disease Research Center, Scott & White Healthcare, Texas A&M Health Science Center, College of Medicine, Baylor Scott & White Health, Temple, Texas
| | - Kelly McDaniel
- Department of Research, Central Texas Veterans Health Care System, Temple, Texas; Department of Medicine, Digestive Disease Research Center, Scott & White Healthcare, Texas A&M Health Science Center, College of Medicine, Baylor Scott & White Health, Temple, Texas; Academic Operations, Scott & White Memorial Hospital, Baylor Scott & White Health, Temple, Texas
| | - Tianhao Zhou
- Department of Research, Central Texas Veterans Health Care System, Temple, Texas; Department of Medicine, Digestive Disease Research Center, Scott & White Healthcare, Texas A&M Health Science Center, College of Medicine, Baylor Scott & White Health, Temple, Texas
| | - Emily Lin
- Department of Research, Central Texas Veterans Health Care System, Temple, Texas; Department of Medicine, Digestive Disease Research Center, Scott & White Healthcare, Texas A&M Health Science Center, College of Medicine, Baylor Scott & White Health, Temple, Texas
| | - Shannon Glaser
- Department of Research, Central Texas Veterans Health Care System, Temple, Texas; Department of Medicine, Digestive Disease Research Center, Scott & White Healthcare, Texas A&M Health Science Center, College of Medicine, Baylor Scott & White Health, Temple, Texas
| | - Fanyin Meng
- Department of Research, Central Texas Veterans Health Care System, Temple, Texas; Department of Medicine, Digestive Disease Research Center, Scott & White Healthcare, Texas A&M Health Science Center, College of Medicine, Baylor Scott & White Health, Temple, Texas; Academic Operations, Scott & White Memorial Hospital, Baylor Scott & White Health, Temple, Texas
| | - Heather Francis
- Department of Research, Central Texas Veterans Health Care System, Temple, Texas; Department of Medicine, Digestive Disease Research Center, Scott & White Healthcare, Texas A&M Health Science Center, College of Medicine, Baylor Scott & White Health, Temple, Texas; Academic Operations, Scott & White Memorial Hospital, Baylor Scott & White Health, Temple, Texas
| | - Gianfranco Alpini
- Department of Research, Central Texas Veterans Health Care System, Temple, Texas; Department of Medicine, Digestive Disease Research Center, Scott & White Healthcare, Texas A&M Health Science Center, College of Medicine, Baylor Scott & White Health, Temple, Texas.
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Abstract
Primary biliary cirrhosis (PBC) is an autoimmune liver disease characterized by selective destruction of intrahepatic cholangiocytes. Mechanisms underlying the development and progression of the disease are still controversial and largely undefined. Evidence suggests that PBC results from an articulated immunologic response against an immunodominant mitochondrial autoantigen, the E2 component of the pyruvate dehydrogenase complex (PDC-E2); characteristics of the disease are also the presence of disease-specific antimitochondrial autoantibodies (AMAs) and autoreactive CD4 and CD8 T cells. Recent evidence suggests that cholangiocytes show specific immunobiological features that are responsible for the selective targeting of those cells by the immune system. The immune reaction in PBC selectively targets small sized, intrahepatic bile ducts; although a specific reason for that has not been defined yet, it has been established that the biliary epithelium displays a unique heterogeneity, for which the physiological and pathophysiological features of small and large cholangiocytes significantly differ. In this review article, the authors provide a critical overview of the current evidence on the role of cholangiocytes in the immune-mediated destruction of the biliary tree that characterizes PBC.
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Affiliation(s)
- Ana Lleo
- Liver Unit and Center for Autoimmune Liver Diseases, Humanitas Clinical and Research Center, Rozzano (MI), Italy
| | - Luca Maroni
- Clinic of Gastroenterology and Hepatology, Università Politecnica delle Marche, Ancona, Italy
| | - Shannon Glaser
- Research, Central Texas Veterans Health Care System, S and W and Texas A and M System Health Science Center, College of Medicine, Temple, Texas,Scott & White Digestive Disease Research Center, S and W and Texas A and M System Health Science Center, College of Medicine, Temple, Texas,Department of Medicine, Division Gastroenterology, S and W and Texas A and M System Health Science Center, College of Medicine, Temple, Texas
| | - Gianfranco Alpini
- Research, Central Texas Veterans Health Care System, S and W and Texas A and M System Health Science Center, College of Medicine, Temple, Texas,Scott & White Digestive Disease Research Center, S and W and Texas A and M System Health Science Center, College of Medicine, Temple, Texas,Department of Medicine, Division Gastroenterology, S and W and Texas A and M System Health Science Center, College of Medicine, Temple, Texas
| | - Marco Marzioni
- Clinic of Gastroenterology and Hepatology, Università Politecnica delle Marche, Ancona, Italy
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Lleo A, Invernizzi P. Apotopes and innate immune system: novel players in the primary biliary cirrhosis scenario. Dig Liver Dis 2013; 45:630-6. [PMID: 23415798 DOI: 10.1016/j.dld.2013.01.005] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2012] [Accepted: 01/07/2013] [Indexed: 12/11/2022]
Abstract
Our understanding of primary biliary cirrhosis has been rapidly growing over the past decade and the disease is now regarded as a model for other female-predominant, organ-specific autoimmune conditions. Primary biliary cirrhosis ensues from a multi-lineage loss of tolerance to the E2 component of the pyruvate dehydrogenase complex. One of the major unanswered questions in the pathogenesis of primary biliary cirrhosis is the specificity of small intrahepatic bile ducts attack while PDC-E2 is present in mitochondria of all nucleated cells. Recent findings suggest that the uniqueness of the primary target tissue, biliary epithelium, may be of considerable importance for understanding primary biliary cirrhosis and that the biliary epithelial cell is more than an innocent victim. Rather, it attracts an immune attack by virtue of the unique apoptotic mechanisms and by the way it handles PDC-E2. Moreover, recent evidence suggests that apoptotic bodies of biliary epithelial cell are able to activate the innate immune system in the presence of anti-mitochondrial antibodies. This review article is intended to provide a critical overview of the role of apoptosis in biliary epithelial cells, the activation of the innate immune system, and its biological and clinical significance in primary biliary cirrhosis.
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Affiliation(s)
- Ana Lleo
- Center for Autoimmune Liver Diseases, Humanitas Clinical and Research Center, Rozzano, MI, Italy
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