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Zhao Y, Xie L, Ou N, Wu J, Zhang H, Zhou S, Liu Y, Chen J, Wang L, Wang L, Wang J, Shao F. Tolerability, safety, pharmacokinetics and pharmacodynamics of SHR0534, a potent G protein-coupled receptor 40 (GPR40) agonist, at single- and multiple-ascending oral doses in healthy Chinese subjects. Xenobiotica 2020; 51:297-306. [PMID: 33331206 DOI: 10.1080/00498254.2020.1864510] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
SHR0534 is being developed for type-2 diabetes mellitus. Herein the tolerability, safety, pharmacokinetics and pharmacodynamics of SHR0534 in healthy Chinese subjects were assessed in a phase-I, randomized, double-blind, placebo-controlled, single- and multiple-ascending dose study. Forty subjects were randomized 4:1 to receive SHR0534 at the dose of 10, 25, 50 or 100 mg, or placebo, and another eleven subjects were allocated to either the 5 mg group or the placebo group at an 8:3 ratio. All subjects received a single dose on day 1, followed by a 9-day washout and once-daily administrations for 14 consecutive days. Serial samples were collected, and vital signs, electrocardiograms, laboratory tests, urinalysis and adverse events (AEs) were recorded. All doses of SHR0534 were safe and well tolerated with infrequent, generally mild-to-moderate AEs and no serious AEs in the study. SHR0534 was absorbed with a T max of approximately 4 hours, and systemic exposure increased with dose. Accumulation was minimal (2- to 3-fold) and steady state was reached after seven days of dosing. For pharmacodynamics, no significant hypoglycaemic effects were seen in healthy adults. Good pharmacokinetics and safety were demonstrated but no obvious effect was found.
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Affiliation(s)
- Yuqing Zhao
- Phase I Clinical Trial Unit, Jiangsu Province Hospital and the First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Lijun Xie
- Phase I Clinical Trial Unit, Jiangsu Province Hospital and the First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Ning Ou
- Phase I Clinical Trial Unit, Jiangsu Province Hospital and the First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Jie Wu
- Jiangsu Hengrui Medicine Co., Ltd., Lianyungang, China
| | - Hongwen Zhang
- Phase I Clinical Trial Unit, Jiangsu Province Hospital and the First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Sufeng Zhou
- Phase I Clinical Trial Unit, Jiangsu Province Hospital and the First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Yun Liu
- Phase I Clinical Trial Unit, Jiangsu Province Hospital and the First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Juan Chen
- Phase I Clinical Trial Unit, Jiangsu Province Hospital and the First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Lu Wang
- Phase I Clinical Trial Unit, Jiangsu Province Hospital and the First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Libin Wang
- Phase I Clinical Trial Unit, Jiangsu Province Hospital and the First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Jingjing Wang
- Jiangsu Hengrui Medicine Co., Ltd., Lianyungang, China
| | - Feng Shao
- Phase I Clinical Trial Unit, Jiangsu Province Hospital and the First Affiliated Hospital with Nanjing Medical University, Nanjing, China.,Pharmacy College, Nanjing Medical University, Nanjing, China
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Kashyap H, Gupta S, Bist R. Impact of Active Antihyperglycemic Components as Herbal Therapy for Preventive Health Care Management of Diabetes. Curr Mol Med 2020; 19:12-19. [PMID: 30806316 DOI: 10.2174/1566524019666190219124301] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 01/24/2019] [Accepted: 01/24/2019] [Indexed: 01/21/2023]
Abstract
Diabetes is a metabolic hyperglycemic condition that progressively develops, effect small and large sensory fibers in the affected population. It has various complications as hypertension, coronary artery disease, stroke, blindness, kidney disease as well as peripheral neuropathy. Sulfonylureas, thiazolidinediones, metformin, biguanidine, acarbose and insulin are commonly used drugs for diabetic patients, but these all have certain side effects. Even metformin, that is known as the miracle drug for diabetes has been found to be associated with side effects, as during treatment it involves complications with eyes, kidneys, peripheral nerves, heart and vasculature. In the present article, we hypothesize recent discoveries with respect to active ingredients from Indian medicinal plants i.e., polypeptide-p (protein analogue act as artificial insulin), charantin (a steroidal saponin), momordicin (an alkaloid) and osmotin (ubiquitous plant protein and animal analogue of human adeponectin) possessing anti-hyperglycemic potential for diabetes type II. Therefore, plants as herbal therapy have preventive care of hyperglycemia accompanied with healthy lifestyle which can provide significant decline in the incidences of diabetes in future.
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Affiliation(s)
- Harsha Kashyap
- Department of Bioscience and Biotechnology, Banasthali Vidyapith, Rajasthan, 304022, India
| | - Sarika Gupta
- Department of Bioscience and Biotechnology, Banasthali Vidyapith, Rajasthan, 304022, India
| | - Renu Bist
- Department of Bioscience and Biotechnology, Banasthali Vidyapith, Rajasthan, 304022, India
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Arts RJW, Novakovic B, Ter Horst R, Carvalho A, Bekkering S, Lachmandas E, Rodrigues F, Silvestre R, Cheng SC, Wang SY, Habibi E, Gonçalves LG, Mesquita I, Cunha C, van Laarhoven A, van de Veerdonk FL, Williams DL, van der Meer JWM, Logie C, O'Neill LA, Dinarello CA, Riksen NP, van Crevel R, Clish C, Notebaart RA, Joosten LAB, Stunnenberg HG, Xavier RJ, Netea MG. Glutaminolysis and Fumarate Accumulation Integrate Immunometabolic and Epigenetic Programs in Trained Immunity. Cell Metab 2016; 24:807-819. [PMID: 27866838 PMCID: PMC5742541 DOI: 10.1016/j.cmet.2016.10.008] [Citation(s) in RCA: 559] [Impact Index Per Article: 69.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2016] [Revised: 05/23/2016] [Accepted: 10/12/2016] [Indexed: 12/13/2022]
Abstract
Induction of trained immunity (innate immune memory) is mediated by activation of immune and metabolic pathways that result in epigenetic rewiring of cellular functional programs. Through network-level integration of transcriptomics and metabolomics data, we identify glycolysis, glutaminolysis, and the cholesterol synthesis pathway as indispensable for the induction of trained immunity by β-glucan in monocytes. Accumulation of fumarate, due to glutamine replenishment of the TCA cycle, integrates immune and metabolic circuits to induce monocyte epigenetic reprogramming by inhibiting KDM5 histone demethylases. Furthermore, fumarate itself induced an epigenetic program similar to β-glucan-induced trained immunity. In line with this, inhibition of glutaminolysis and cholesterol synthesis in mice reduced the induction of trained immunity by β-glucan. Identification of the metabolic pathways leading to induction of trained immunity contributes to our understanding of innate immune memory and opens new therapeutic avenues.
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Affiliation(s)
- Rob J W Arts
- Department of Internal Medicine, Radboud University Medical Center, 6525 GA Nijmegen, the Netherlands.
| | - Boris Novakovic
- Department of Molecular Biology, Faculty of Science, Radboud University, 6525 HP Nijmegen, the Netherlands
| | - Rob Ter Horst
- Department of Internal Medicine, Radboud University Medical Center, 6525 GA Nijmegen, the Netherlands
| | - Agostinho Carvalho
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, 4710-057 Braga, Portugal; ICVS/3B's - PT Government Associate Laboratory, 4806-909 Braga/Guimarães, Portugal
| | - Siroon Bekkering
- Department of Internal Medicine, Radboud University Medical Center, 6525 GA Nijmegen, the Netherlands
| | - Ekta Lachmandas
- Department of Internal Medicine, Radboud University Medical Center, 6525 GA Nijmegen, the Netherlands
| | - Fernando Rodrigues
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, 4710-057 Braga, Portugal; ICVS/3B's - PT Government Associate Laboratory, 4806-909 Braga/Guimarães, Portugal
| | - Ricardo Silvestre
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, 4710-057 Braga, Portugal; ICVS/3B's - PT Government Associate Laboratory, 4806-909 Braga/Guimarães, Portugal
| | - Shih-Chin Cheng
- Department of Internal Medicine, Radboud University Medical Center, 6525 GA Nijmegen, the Netherlands; Institute of Molecular Medicine, National Tsing Hua University, 300 Hsinchu City, Taiwan
| | - Shuang-Yin Wang
- Department of Molecular Biology, Faculty of Science, Radboud University, 6525 HP Nijmegen, the Netherlands
| | - Ehsan Habibi
- Department of Molecular Biology, Faculty of Science, Radboud University, 6525 HP Nijmegen, the Netherlands
| | - Luís G Gonçalves
- Instituto de Tecnologia Química e Biológica António Xavier, Universidade Nova de Lisboa, 2780-157 Oeiras, Portugal
| | - Inês Mesquita
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, 4710-057 Braga, Portugal; ICVS/3B's - PT Government Associate Laboratory, 4806-909 Braga/Guimarães, Portugal
| | - Cristina Cunha
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, 4710-057 Braga, Portugal; ICVS/3B's - PT Government Associate Laboratory, 4806-909 Braga/Guimarães, Portugal
| | - Arjan van Laarhoven
- Department of Internal Medicine, Radboud University Medical Center, 6525 GA Nijmegen, the Netherlands
| | - Frank L van de Veerdonk
- Department of Internal Medicine, Radboud University Medical Center, 6525 GA Nijmegen, the Netherlands
| | - David L Williams
- Department of Surgery, Quillen College of Medicine and Center for Inflammation, Infectious Disease and Immunity, East Tennessee State University, Johnson City, TN 37604, USA
| | - Jos W M van der Meer
- Department of Internal Medicine, Radboud University Medical Center, 6525 GA Nijmegen, the Netherlands
| | - Colin Logie
- Department of Molecular Biology, Faculty of Science, Radboud University, 6525 HP Nijmegen, the Netherlands
| | - Luke A O'Neill
- Trinity Biomedical Sciences Institute, Trinity College, Dublin 2, Ireland
| | - Charles A Dinarello
- Department of Internal Medicine, Radboud University Medical Center, 6525 GA Nijmegen, the Netherlands; Department of Medicine, University of Colorado Denver, Aurora, CO 80045, USA
| | - Niels P Riksen
- Department of Internal Medicine, Radboud University Medical Center, 6525 GA Nijmegen, the Netherlands
| | - Reinout van Crevel
- Department of Internal Medicine, Radboud University Medical Center, 6525 GA Nijmegen, the Netherlands
| | - Clary Clish
- Broad Institute of Harvard University and Massachusetts Institute of Technology, Cambridge, MA 02142, USA
| | - Richard A Notebaart
- Department of Internal Medicine, Radboud University Medical Center, 6525 GA Nijmegen, the Netherlands
| | - Leo A B Joosten
- Department of Internal Medicine, Radboud University Medical Center, 6525 GA Nijmegen, the Netherlands
| | - Hendrik G Stunnenberg
- Department of Molecular Biology, Faculty of Science, Radboud University, 6525 HP Nijmegen, the Netherlands
| | - Ramnik J Xavier
- Broad Institute of Harvard University and Massachusetts Institute of Technology, Cambridge, MA 02142, USA; Center for Computational and Integrative Biology and Gastrointestinal Unit and Center for the Study of Inflammatory Bowel Disease, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Mihai G Netea
- Department of Internal Medicine, Radboud University Medical Center, 6525 GA Nijmegen, the Netherlands
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Lee CMY, Woodward M, Colagiuri S. Triple therapy combinations for the treatment of type 2 diabetes - A network meta-analysis. Diabetes Res Clin Pract 2016; 116:149-58. [PMID: 27321330 DOI: 10.1016/j.diabres.2016.04.037] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Revised: 02/01/2016] [Accepted: 04/21/2016] [Indexed: 12/12/2022]
Abstract
AIM To estimate and compare the results from all randomised trials of triple combinations of anti-diabetes therapies that reported the reduction of glycated haemoglobin (HbA1c) and associated effects on body weight and hypoglycaemia. METHODS PubMed and the Cochrane Library were searched for trials with at least one study arm on triple therapy and which reported the differences in mean change in HbA1c between two study arms. These were included in a network meta-analysis. RESULTS Altogether, 15,182 participants from 40 trials with treatment duration of 6-12months were included. Compared with none/placebo added to dual therapy, the addition of a drug therapy from six of eight drug classes to existing dual therapy resulted in significant additional mean reductions in HbA1c from -0.56% (-6.2mmol/mol; dipeptidyl peptidase 4 inhibitors) to -0.94% (-10.3mmol/mol; thiazolidinediones). Of the six drug classes, three were associated with less favourable weight change and two were associated with more favourable weight change when compared with none/placebo added to dual therapy. Furthermore, five drug classes were associated with greater odds of hypoglycaemia. Similar results were observed in analyses of studies with a 6month treatment duration and after excluding study arms that contained insulin. CONCLUSIONS Overall triple therapy combinations were similar in improving diabetes control although there were some differences in adverse effects. By balancing the risks and benefits of each therapy, the estimates of pairwise comparisons of triple therapies for HbA1c, body weight and hypoglycaemia provided in this study may further inform evidence based practice.
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Affiliation(s)
- Crystal Man Ying Lee
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Level 2 Charles Perkins Centre D17, University of Sydney, NSW 2006, Australia.
| | - Mark Woodward
- The George Institute for Global Health, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK; The George Institute for Global Health, PO Box M201, Missenden Road, Camperdown, NSW 2050, Australia
| | - Stephen Colagiuri
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Level 2 Charles Perkins Centre D17, University of Sydney, NSW 2006, Australia
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