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Synthesis, in vitro and in silico screening of 2-amino-4-aryl-6-(phenylthio) pyridine-3,5-dicarbonitriles as novel α-glucosidase inhibitors. Bioorg Chem 2020; 100:103879. [PMID: 32413625 DOI: 10.1016/j.bioorg.2020.103879] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Revised: 04/16/2020] [Accepted: 04/22/2020] [Indexed: 12/23/2022]
Abstract
Inhibition of α-glucosidase enzyme is of prime importance for the treatment of diabetes mellitus (DM). Apart of many organic scaffolds, pyridine based compounds have previously been reported for wide range of bioactivities. The current study reports a series of pyridine based synthetic analogues for their α-glucosidase inhibitory potential assessed by in vitro, kinetics and in silico studies. For this purpose, 2-amino-4-aryl-6-(phenylthio)pyridine-3,5-dicarbonitriles 1-28 were synthesized and subjected to in vitro screening. Several analogs, including 1-3, 7, 9, 11-14, and 16 showed many folds increased inhibitory potential in comparison to the standard acarbose (IC50 = 750 ± 10 µM). Interestingly, compound 7 (IC50 = 55.6 ± 0.3 µM) exhibited thirteen-folds greater inhibition strength than the standard acarbose. Kinetic studies on most potent molecule 7 revealed a competitive type inhibitory mechanism. In silico studies have been performed to examine the binding mode of ligand (compound 7) with the active site residues of α-glucosidase enzyme.
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Sénat MV, Affres H, Letourneau A, Coustols-Valat M, Cazaubiel M, Legardeur H, Jacquier JF, Bourcigaux N, Simon E, Rod A, Héron I, Castera V, Sentilhes L, Bretelle F, Rolland C, Morin M, Deruelle P, De Carne C, Maillot F, Beucher G, Verspyck E, Desbriere R, Laboureau S, Mitanchez D, Bouyer J. Effect of Glyburide vs Subcutaneous Insulin on Perinatal Complications Among Women With Gestational Diabetes: A Randomized Clinical Trial. JAMA 2018; 319:1773-1780. [PMID: 29715355 PMCID: PMC6583037 DOI: 10.1001/jama.2018.4072] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
IMPORTANCE Randomized trials have not focused on neonatal complications of glyburide for women with gestational diabetes. OBJECTIVE To compare oral glyburide vs subcutaneous insulin in prevention of perinatal complications in newborns of women with gestational diabetes. DESIGN, SETTINGS, AND PARTICIPANTS The Insulin Daonil trial (INDAO), a multicenter noninferiority randomized trial conducted between May 2012 and November 2016 (end of participant follow-up) in 13 tertiary care university hospitals in France including 914 women with singleton pregnancies and gestational diabetes diagnosed between 24 and 34 weeks of gestation. INTERVENTIONS Women who required pharmacologic treatment after 10 days of dietary intervention were randomly assigned to receive glyburide (n=460) or insulin (n=454). The starting dosage for glyburide was 2.5 mg orally once per day and could be increased if necessary 4 days later by 2.5 mg and thereafter by 5 mg every 4 days in 2 morning and evening doses, up to a maximum of 20 mg/d. The starting dosage for insulin was 4 IU to 20 IU given subcutaneously 1 to 4 times per day as necessary and increased according to self-measured blood glucose concentrations. MAIN OUTCOMES AND MEASURES The primary outcome was a composite criterion including macrosomia, neonatal hypoglycemia, and hyperbilirubinemia. The noninferiority margin was set at 7% based on a 1-sided 97.5% confidence interval. RESULTS Among the 914 patients who were randomized (mean age, 32.8 [SD, 5.2] years), 98% completed the trial. In a per-protocol analysis, 367 and 442 women and their neonates were analyzed in the glyburide and insulin groups, respectively. The frequency of the primary outcome was 27.6% in the glyburide group and 23.4% in the insulin group, a difference of 4.2% (1-sided 97.5% CI, -∞ to 10.5%; P=.19). CONCLUSION AND RELEVANCE This study of women with gestational diabetes failed to show that use of glyburide compared with subcutaneous insulin does not result in a greater frequency of perinatal complications. These findings do not justify the use of glyburide as a first-line treatment. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT01731431.
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Affiliation(s)
- Marie-Victoire Sénat
- Assistance Publique–Hôpitaux de Paris, Department of Gynecology-Obstetrics, Bicêtre Hospital, Le Kremlin-Bicêtre, France
- University of Paris-Sud, University of Medicine Paris-Saclay, Le Kremlin-Bicêtre, France
- Centre for Research in Epidemiology and Population Health, Université Paris-Saclay, Université Paris-Sud, Université de Versailles Saint-Quentin-en-Yvelines, INSERM, Villejuif, France
| | - Helene Affres
- Assistance Publique–Hôpitaux de Paris, Department of Reproductive Endocrinology, Bicêtre Hospital, Le Kremlin-Bicêtre, France
| | - Alexandra Letourneau
- Assistance Publique–Hôpitaux de Paris, Department of Gynecology-Obstetrics, Béclère Hospital, Clamart, France
| | - Magali Coustols-Valat
- Department of Endocrinology-Obstetrics, Toulouse University Hospital, Toulouse, France
| | - Marie Cazaubiel
- Department of Endocrinology, Lille University Hospital EA 4489–Environnement Périnatal et Santé, Lille, France
| | - Helene Legardeur
- Assistance Publique–Hôpitaux de Paris, Department of Gynecology and Obstetrics, Hôpital Louis Mourier, Colombes, France
| | - Julie Fort Jacquier
- Department of Gynecology-Obstetrics, Poissy St-Germain Hospital, Poissy, France
| | - Nathalie Bourcigaux
- Assistance Publique–Hôpitaux de Paris, Department of Endocrinology, St Antoine Hospital Paris, France
| | - Emmanuel Simon
- Department of Obstetrics, Gynecology and Fetal Medicine, University Hospital Center of Tours, Tours, France
| | - Anne Rod
- Department of Endocrinology, Caen University Hospital, Caen, France, France
| | - Isabelle Héron
- Department of Endocrinology, Rouen University Hospital–Charles Nicolle, Rouen, France
| | - Virginie Castera
- Department of Endocrinology, St Joseph Hospital, Marseille, France
| | - Loic Sentilhes
- Department of Obstetrics and Gynecology, Angers University Hospital, Angers, France
- Department of Obstetrics and Gynecology, Bordeaux University Hospital, Bordeaux, France
| | - Florence Bretelle
- Assistance Publique–Hôpitaux de Marseille; AMU, Aix-Marseille Université, Department of Gynecology and Obstetrics, Pole Femme Enfant, Marseille, France
| | - Catherine Rolland
- Assistance Publique–Hôpitaux de Paris, Department of Hepato-Enterology-Gastroenteritis, Béclère Hospital, Clamart, France
| | - Mathieu Morin
- Department of Gynecology-Obstetrics, Toulouse University Hospital, Toulouse, France
| | - Philippe Deruelle
- Department of Gynecology-Obstetrics, Lille University, EA 4489–Environnement Périnatal et Santé, Lille, France
| | - Celine De Carne
- Assistance Publique–Hôpitaux de Paris, Department of Gynecology-Obstetrics, Trousseau Hospital, Paris, France
| | - François Maillot
- Department of Internal Medicine, François-Rabelais University, University Hospital Center of Tours, Tours, France
| | - Gael Beucher
- Department of Gynecology-Obstetrics, Caen University Hospital, Caen, France, France
| | - Eric Verspyck
- Department of Gynecology and Obstetrics, Rouen University Hospital–Charles Nicolle, Rouen, France
| | - Raoul Desbriere
- Department of Gynecology-Obstetrics, St Joseph Hospital, Marseille, France
| | | | - Delphine Mitanchez
- Assistance Publique–Hôpitaux de Paris, Sorbonne Universities, University Pierre and Marie Curie, University Paris 06, Department of Neonatology, Armand Trousseau Hospital, Paris, France
| | - Jean Bouyer
- Centre for Research in Epidemiology and Population Health, Université Paris-Saclay, Université Paris-Sud, Université de Versailles Saint-Quentin-en-Yvelines, INSERM, Villejuif, France
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Gante I, Melo L, Dores J, Ruas L, Almeida MDC. Metformin in gestational diabetes mellitus: predictors of poor response. Eur J Endocrinol 2018; 178:129-135. [PMID: 29070511 DOI: 10.1530/eje-17-0486] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Revised: 10/17/2017] [Accepted: 10/25/2017] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Metformin can be regarded as a first-line treatment in gestational diabetes mellitus (GDM) due to its safety and effectiveness. However, a proportion of women do not achieve adequate glycemic control with metformin alone. We aim to identify predictors of this poor response to metformin. DESIGN AND METHODS Retrospective multicentre cohort study of women with GDM who started metformin as first-line treatment. The assessed cohort was divided into a metformin group and metformin plus insulin group. Biometric and demographic characteristics, glycemic control data, obstetric, neonatal and postpartum outcomes were compared between groups and analysed in order to identify predictors of poor response to metformin. Data were analysed using STATA, version 13.1. RESULTS Of the 388 women enrolled in the study, 135 (34.8%) required additional insulin therapy to achieve the glycemic targets. Higher age (aOR: 1.08 (1.03-1.13), P = 0.003), higher pre-pregnancy body mass index (BMI) (1.06 (1.02-1.10), P = 0.003) and earlier introduction of metformin (0.89 (0.85-0.94), P < 0.001) were independent predictors for insulin supplementation. Regarding all the analysed outcomes, only cesarean delivery rates and postpartum glucose levels were higher in women requiring insulin supplementation. CONCLUSIONS Although almost 35% of women did not achieve adequate glycemic control with metformin, insulin supplementation was not associated with poor neonatal outcomes. Higher age, higher pre-pregnancy BMI and earlier introduction of metformin could be used as predictors of poor response to metformin.
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Affiliation(s)
- Inês Gante
- Department of Obstetrics, Coimbra Hospital and Universitary Centre, Coimbra, Portugal
| | - Luís Melo
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Jorge Dores
- Department of Endocrinology, Porto Hospital Centre, Porto, Portugal
- Diabetes and Pregnancy Study Group of the Portuguese Society of Diabetology, Lisbon, Portugal
| | - Luísa Ruas
- Diabetes and Pregnancy Study Group of the Portuguese Society of Diabetology, Lisbon, Portugal
- Department of Endocrinology, Coimbra Hospital and Universitary Centre, Coimbra, Portugal
| | - Maria do Céu Almeida
- Department of Obstetrics, Coimbra Hospital and Universitary Centre, Coimbra, Portugal
- Diabetes and Pregnancy Study Group of the Portuguese Society of Diabetology, Lisbon, Portugal
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Koren R, Ashwal E, Hod M, Toledano Y. Insulin detemir versus glyburide in women with gestational diabetes mellitus. Gynecol Endocrinol 2016; 32:916-919. [PMID: 27597308 DOI: 10.1080/09513590.2016.1209479] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
AIM To evaluate the safety, efficacy and pregnancy outcomes of insulin detemir (IDet) versus glyburide treatment in women with gestational diabetes mellitus (GDM). METHODS We conducted a retrospective cohort study of women with GDM who were treated with either glyburide or IDet for GDM in a university-affiliated tertiary hospital. RESULTS Ninety-one patients with GDM were enrolled, 62 were administered glyburide and 29 IDet. Maternal age, pregestational body mass index (BMI) and rate of abnormal oral glucose tolerance test (OGTT) blood glucose values were not significantly different between groups. Good glycemic control rates were comparable. Hypoglycemic episodes were reported only in the glyburide group (19.4% versus 0%, p = 0.01). Maternal weight gain during pregnancy was significantly higher among women in the glyburide group (8.8 ± 5.1 kg, p < 0.001) compared to those in the IDet group (2.1 ± 19.9 kg, p = 0.71). CONCLUSIONS To the best of our knowledge, this is the first study on IDet treatment in patients with GDM. By our preliminary results, IDet is a viable treatment option in women with GDM. Further large prospective studies are needed to determine the efficacy and safety of IDet in GDM patients.
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Affiliation(s)
- Ronit Koren
- a Institute of Endocrinology, Rabin Medical Center, Beilinson Hospital , Petah Tikva , Israel
- b Sackler Faculty of Medicine, Tel-Aviv University , Tel-Aviv , Israel
| | - Eran Ashwal
- c Division of Maternal Fetal Medicine , Helen Schneider Women's Hospital, Rabin Medical Center , Petah Tikva , Israel
| | - Moshe Hod
- b Sackler Faculty of Medicine, Tel-Aviv University , Tel-Aviv , Israel
- c Division of Maternal Fetal Medicine , Helen Schneider Women's Hospital, Rabin Medical Center , Petah Tikva , Israel
| | - Yoel Toledano
- c Division of Maternal Fetal Medicine , Helen Schneider Women's Hospital, Rabin Medical Center , Petah Tikva , Israel
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