The importance of adequate methotrexate and adequate folinic acid rescue doses in the treatment of primary brain lymphoma

In-situ formation of niobium oxide – niobium carbide – reduced graphene oxide ternary nanocomposite as an electrochemical sensor for sensitive detection of anticancer drug methotrexate

Engineering the nanostructure of an electrocatalyst is crucial in developing a high-performance electrochemical sensor. This work exhibits the hydrothermal followed by annealing synthesis of niobium oxide/niobium carbide/reduced graphene oxide (NbO/NbC/rGO) ternary nanocomposite. The oval-shaped NbO/NbC nanoparticles cover the surface of rGO evenly, and the rGO nanosheets are interlinked to produce a micro-flower-like architecture. The NbO/NbC/rGO nanocomposite-modified electrode is presented here for the first time for the rapid and sensitive electrochemical detection of the anticancer drug methotrexate (MTX). Down-sized NbO/NbC nanoparticles and rGO's high surface area provide many active sites with a rapid electron transfer rate, making them ideal for MTX detection. In comparison to previously reported MTX sensors, the developed drug sensor exhibits a lower oxidation potential and a higher peak current responsiveness. The constructed sensors worked analytically well under optimal conditions, as shown by a low detection limit of 1.6 nM, a broad linear range of 0.1-850 µM, and significant recovery findings (∼98 %, (n = 3)) in real samples analysis. Thus, NbO/NbC/rGO nanocomposite material for high-performance electrochemical applications seems promising.

A Comprehensive Review of Neuropsychologic Studies Supports the Concept That Adequate Folinic Acid Rescue Prevents Post Methotrexate Neurotoxicity

PURPOSE

To review all studies providing evidence of the correlation between folinic acid (FA) rescue inadequacy and long-term cognitive damage in neuropsychological studies of children with acute lymphoblastic leukemia or osteogenic sarcoma treated under protocols using high-dose methotrexate and FA rescue.

METHODS

A comprehensive literature search was performed of all databases of the Web of Science Citation Index, during 1990-2020, for the terms: neuropsychological, neurocognitive, and cognitive, together with acute lymphoblastic (and lymphocytic) leukemia and osteogenic sarcoma. English-language peer-reviewed articles on neuropsychological assessments of children who had been treated with high-dose methotrexate without irradiation, and which included details of methotrexate and FA schedules, were selected. In addition, a personal database of over 500 reprints of articles from over 130 journals was reviewed on the subjects of methotrexate and FA and their side effects.

RESULTS

Three groups of studies were found and analyzed, with (1) no evidence of cognitive deterioration, (2) evidence of cognitive deterioration, and (3) more than 1 protocol grouped together, preventing separate analysis of any protocols, Protocols without cognitive deterioration reported adequate FA rescue, and those with cognitive deterioration reported inadequate FA rescue.

CONCLUSION

Neuropsychological evaluation supported inadequate FA being the cause of neurocognitive damage after high-dose methotrexate and that adequate FA rescue prevents this complication.

Methotrexate inhibition of SARS-CoV-2 entry, infection and inflammation revealed by bioinformatics approach and a hamster model

Background

Drug repurposing is a fast and effective way to develop drugs for an emerging disease such as COVID-19. The main challenges of effective drug repurposing are the discoveries of the right therapeutic targets and the right drugs for combating the disease.

Methods

Here, we present a systematic repurposing approach, combining Homopharma and hierarchal systems biology networks (HiSBiN), to predict 327 therapeutic targets and 21,233 drug-target interactions of 1,592 FDA drugs for COVID-19. Among these multi-target drugs, eight candidates (along with pimozide and valsartan) were tested and methotrexate was identified to affect 14 therapeutic targets suppressing SARS-CoV-2 entry, viral replication, and COVID-19 pathologies. Through the use of in vitro (EC₅₀ = 0.4 μM) and in vivo models, we show that methotrexate is able to inhibit COVID-19 via multiple mechanisms.

Results

Our in vitro studies illustrate that methotrexate can suppress SARS-CoV-2 entry and replication by targeting furin and DHFR of the host, respectively. Additionally, methotrexate inhibits all four SARS-CoV-2 variants of concern. In a Syrian hamster model for COVID-19, methotrexate reduced virus replication, inflammation in the infected lungs. By analysis of transcriptomic analysis of collected samples from hamster lung, we uncovered that neutrophil infiltration and the pathways of innate immune response, adaptive immune response and thrombosis are modulated in the treated animals.

Conclusions

We demonstrate that this systematic repurposing approach is potentially useful to identify pharmaceutical targets, multi-target drugs and regulated pathways for a complex disease. Our findings indicate that methotrexate is established as a promising drug against SARS-CoV-2 variants and can be used to treat lung damage and inflammation in COVID-19, warranting future evaluation in clinical trials.