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Liu T, Wang L, Ji L, Mu L, Wang K, Xu G, Wang S, Ma Q. Plantaginis Semen Ameliorates Hyperuricemia Induced by Potassium Oxonate. Int J Mol Sci 2024; 25:8548. [PMID: 39126116 PMCID: PMC11313179 DOI: 10.3390/ijms25158548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2024] [Revised: 07/25/2024] [Accepted: 07/27/2024] [Indexed: 08/12/2024] Open
Abstract
Plantaginis semen is the dried ripe seed of Plantago asiatica L. or Plantago depressa Willd., which has a long history in alleviating hyperuricemia (HUA) and chronic kidney diseases. While the major chemical ingredients and mechanism remained to be illustrated. Therefore, this work aimed to elucidate the chemicals and working mechanisms of PS for HUA. UPLC-QE-Orbitrap-MS was applied to identify the main components of PS in vitro and in vivo. RNA sequencing (RNA-seq) was conducted to explore the gene expression profile, and the genes involved were further confirmed by real-time quantitative PCR (RT-qPCR). A total of 39 components were identified from PS, and 13 of them were detected in the rat serum after treating the rat with PS. The kidney tissue injury and serum uric acid (UA), xanthine oxidase (XOD), and cytokine levels were reversed by PS. Meanwhile, renal urate anion transporter 1 (Urat1) and glucose transporter 9 (Glut9) levels were reversed with PS treatment. RNA-seq analysis showed that the PPAR signaling pathway; glycine, serine, and threonine metabolism signaling pathway; and fatty acid metabolism signaling pathway were significantly modified by PS treatment. Further, the gene expression of Slc7a8, Pck1, Mgll, and Bhmt were significantly elevated, and Fkbp5 was downregulated, consistent with RNA-seq results. The PPAR signaling pathway involved Pparα, Pparγ, Lpl, Plin5, Atgl, and Hsl were elevated by PS treatment. URAT1 and PPARα proteins levels were confirmed by Western blotting. In conclusion, this study elucidates the chemical profile and working mechanisms of PS for prevention and therapy of HUA and provides a promising traditional Chinese medicine agency for HUA prophylaxis.
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Affiliation(s)
| | | | | | | | | | | | - Shifeng Wang
- Key Laboratory of TCM-Information Engineer of State Administration of TCM, School of Chinese Materia Medica, Beijing University of Chinese Medicine, Beijing 100029, China; (T.L.); (L.W.); (L.J.); (L.M.); (K.W.); (G.X.)
| | - Qun Ma
- Key Laboratory of TCM-Information Engineer of State Administration of TCM, School of Chinese Materia Medica, Beijing University of Chinese Medicine, Beijing 100029, China; (T.L.); (L.W.); (L.J.); (L.M.); (K.W.); (G.X.)
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Griffith Brookles C, Bianco M, Pizzimenti S, Gobello G, Biolè C, Destefanis P, Cerrato E, Chinaglia A. Management of acute coronary syndromes requiring coronary angiography in patients with drug reaction with eosinophilia and systemic symptoms syndrome induced by iodinated contrast media: two case reports and narrative review. Eur Heart J Case Rep 2024; 8:ytae259. [PMID: 38835993 PMCID: PMC11148818 DOI: 10.1093/ehjcr/ytae259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 05/07/2024] [Accepted: 05/16/2024] [Indexed: 06/06/2024]
Abstract
Background Hypersensitivity reactions to iodinated contrast media (ICM) are frequently encountered in clinical practice. Severe manifestations, despite being infrequent, can be life-threatening and represent an issue when re-administration of ICM is required. Clear recommendations on prevention and management of relapses are still lacking. Case summary We present the cases of two patients presenting with acute coronary syndrome requiring urgent coronary angiography, with an anamnesis of ICM-induced drug reaction with eosinophilia and systemic symptoms syndrome. Both patients safely underwent a coronary angiography with the use of a different ICM (iobitridol) to the one linked to hypersensitivity manifestations, after premedication with corticosteroids and H1 antagonists. Discussion Our experience highlights that in clinical situations in which the use of ICM is urgently needed, premedication with corticosteroids and H1 antagonists together with the choice of an alternative contrast agent (when the culprit is known) represents an effective strategy to perform a potentially life-saving procedure while avoiding serious systemic allergic reactions.
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Affiliation(s)
- Carola Griffith Brookles
- Cardiology Division, San Luigi Gonzaga University Hospital, Regione Gonzole 10, 10043 Orbassano, Turin, Italy
- Department of Medical Sciences, University of Turin, Turin, Italy
| | - Matteo Bianco
- Cardiology Division, San Luigi Gonzaga University Hospital, Regione Gonzole 10, 10043 Orbassano, Turin, Italy
| | - Stefano Pizzimenti
- Severe Asthma and Rare Lung Disease Unit, San Luigi Gonzaga University Hospital, Turin, Italy
| | - Giulia Gobello
- Cardiology Division, San Luigi Gonzaga University Hospital, Regione Gonzole 10, 10043 Orbassano, Turin, Italy
- Department of Medical Sciences, University of Turin, Turin, Italy
| | - Carloalberto Biolè
- Cardiology Division, San Luigi Gonzaga University Hospital, Regione Gonzole 10, 10043 Orbassano, Turin, Italy
| | - Paola Destefanis
- Cardiology Division, San Luigi Gonzaga University Hospital, Regione Gonzole 10, 10043 Orbassano, Turin, Italy
| | - Enrico Cerrato
- Cardiology Division, San Luigi Gonzaga University Hospital, Regione Gonzole 10, 10043 Orbassano, Turin, Italy
| | - Alessandra Chinaglia
- Cardiology Division, San Luigi Gonzaga University Hospital, Regione Gonzole 10, 10043 Orbassano, Turin, Italy
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Jia Y, Szewczyk-Bieda M, Greenhalgh R, Drinkwater K. Preventing post-contrast acute kidney injury and hypersensitivity reactions: UK national audit. Clin Radiol 2023; 78:e898-e907. [PMID: 37612224 DOI: 10.1016/j.crad.2023.07.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 07/06/2023] [Accepted: 07/23/2023] [Indexed: 08/25/2023]
Abstract
AIM To audit UK radiology departmental protocols related to the prevention of Iodine-based contrast media (ICM) adverse drug reactions (ADRs) and to assess their compliance with the Royal College of Radiologists (RCR) endorsed Royal Australian and New Zealand College of Radiologists' 2018 Iodinated Contrast Guidelines. MATERIALS AND METHODS Questionnaires were sent to all UK acute National Health Service (NHS) providers treating adult patients with an audit lead registered with the RCR (162 providers encompassing 211 hospital radiology departments). The questionnaire included three main sections: renal function screening, renal protection regimens, and hypersensitivity reactions prevention and follow-up. Data collection was conducted between April and July 2022. RESULTS Sixty-one per cent (129/211) of departments responded, representing 67% of eligible providers. An independent imaging services provider supplied one additional set of data (n=130 overall). Of the responding departments, for post-contrast acute kidney injury (PC-AKI), 41% and 56% had the recommended risk assessment for inpatients and outpatients, respectively. Renal function testing was often over-utilised, and their results were applied improperly. Sixty-eight per cent of departments used the advised threshold for considering renal protection. For hypersensitivity reactions, 9% of departments had the correct risk assessment. Thirty-six per cent of departments had the correct risk mitigation protocol for identified high-risk patients. The documentation and follow-up for hypersensitivity reactions were similarly inadequate. CONCLUSION Local protocols on preventing ICM ADRs were largely non-compliant with RCR guidelines. Departments need to update their protocols in line with current evidence to avoid iatrogenic morbidity or unnecessary tests and over-precaution.
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Affiliation(s)
- Y Jia
- Department of Medicine, Imperial College London, London, UK.
| | - M Szewczyk-Bieda
- Department of Clinical Radiology, Ninewells Hospital, NHS Tayside, Dundee, UK
| | - R Greenhalgh
- Department of Radiology, London North West University Healthcare NHS Trust, London, UK
| | - K Drinkwater
- Directorate of Education and Professional Practice, The Royal College of Radiologists, London, UK
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Kim S, Jeon KN, Jung JW, Park HK, Lee W, Lee J, Kang HR. Substitution with Low-Osmolar Iodinated Contrast Agent to Minimize Recurrent Immediate Hypersensitivity Reaction. Radiology 2023; 309:e222467. [PMID: 37906013 DOI: 10.1148/radiol.222467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2023]
Abstract
Background The recurrence of hypersensitivity reaction (HSR) to low-osmolar iodinated contrast media (LOCM) remains challenging despite premedication and substitution of the LOCM. Purpose To determine the optimal practical preventive strategy for LOCM substitution in patients with a history of prior immediate HSR to LOCM. Materials and Methods In a retrospective study, patients with an immediate HSR to LOCM before February 2020 and who underwent subsequent exposure to LOCM until March 2021 were enrolled in five tertiary referral hospitals in South Korea. The association of recurrence of an HSR after subsequent LOCM exposures was assessed using multivariate general estimating equation analysis according to age, sex, the severity of the index HSR, premedication, and substituting LOCM based on common carbamoyl side chains, including the N-(2,3-dihydroxypropyl)-carbamoyl and N-(2,3-dihydroxypropyl)-N-methyl-carbamoyl moieties. Results The evaluation included 3800 subsequent LOCM exposures in 1066 patients (mean age, 56.2 years ± 13.5 [SD]; 567 [53%] female and 499 [47%] male patients). The general estimating equation analysis, using 1:1 propensity score matched data for age, sex, HSR severity, and LOCM selection, showed that premedication with corticosteroids significantly reduced recurrent HSR (odds ratio [OR], 0.72; 95% CI: 0.52, 1.00; P = .049). The change to another LOCM with a common side chain had a similar recurrence rate as using the same LOCM (OR, 0.98; 95% CI: 0.64, 1.50; P = .93), whereas the use of a different LOCM without a common side chain significantly lowered HSR recurrence (OR, 0.51; 95% CI: 0.37, 0.69; P < .001) in multivariate general estimating equation analysis. Substitution of an LOCM without a common side chain was effective regardless of the index HSR severity but was more pronounced in moderate-to-severe reactions (OR, 0.30; 95% CI: 0.16, 0.55; P < .001). Conclusion For patients with a previous immediate HSR of any severity to LOCM, alternative LOCM without a common carbamoyl side chain reduced recurrent HSR during subsequent exposures. © RSNA, 2023 Supplemental material is available for this article. See also the editorial by McDonald in this issue.
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Affiliation(s)
- Sujeong Kim
- From the Division of Allergy and Clinical Immunology, Department of Internal Medicine (S.K.), and Department of Radiology (J.L.), School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Republic of Korea; Department of Radiology, Gyeongsang National University School of Medicine, Jinju, Republic of Korea (K.N.J.); Department of Radiology, Gyeonsang National University Changwon Hospital, Changwon, Republic of Korea (K.N.J.); Department of Internal Medicine, Chung-Ang University Hospital, Seoul, Republic of Korea (J.W.J.); Division of Allergy and Clinical Immunology, Department of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea (H.K.P.); Departments of Radiology (W.L.) and Internal Medicine (H.R.K.), Seoul National University College of Medicine, Seoul National University Hospital, 101, Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea; and Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Republic of Korea (H.R.K.)
| | - Kyung Nyeo Jeon
- From the Division of Allergy and Clinical Immunology, Department of Internal Medicine (S.K.), and Department of Radiology (J.L.), School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Republic of Korea; Department of Radiology, Gyeongsang National University School of Medicine, Jinju, Republic of Korea (K.N.J.); Department of Radiology, Gyeonsang National University Changwon Hospital, Changwon, Republic of Korea (K.N.J.); Department of Internal Medicine, Chung-Ang University Hospital, Seoul, Republic of Korea (J.W.J.); Division of Allergy and Clinical Immunology, Department of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea (H.K.P.); Departments of Radiology (W.L.) and Internal Medicine (H.R.K.), Seoul National University College of Medicine, Seoul National University Hospital, 101, Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea; and Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Republic of Korea (H.R.K.)
| | - Jae-Woo Jung
- From the Division of Allergy and Clinical Immunology, Department of Internal Medicine (S.K.), and Department of Radiology (J.L.), School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Republic of Korea; Department of Radiology, Gyeongsang National University School of Medicine, Jinju, Republic of Korea (K.N.J.); Department of Radiology, Gyeonsang National University Changwon Hospital, Changwon, Republic of Korea (K.N.J.); Department of Internal Medicine, Chung-Ang University Hospital, Seoul, Republic of Korea (J.W.J.); Division of Allergy and Clinical Immunology, Department of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea (H.K.P.); Departments of Radiology (W.L.) and Internal Medicine (H.R.K.), Seoul National University College of Medicine, Seoul National University Hospital, 101, Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea; and Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Republic of Korea (H.R.K.)
| | - Han-Ki Park
- From the Division of Allergy and Clinical Immunology, Department of Internal Medicine (S.K.), and Department of Radiology (J.L.), School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Republic of Korea; Department of Radiology, Gyeongsang National University School of Medicine, Jinju, Republic of Korea (K.N.J.); Department of Radiology, Gyeonsang National University Changwon Hospital, Changwon, Republic of Korea (K.N.J.); Department of Internal Medicine, Chung-Ang University Hospital, Seoul, Republic of Korea (J.W.J.); Division of Allergy and Clinical Immunology, Department of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea (H.K.P.); Departments of Radiology (W.L.) and Internal Medicine (H.R.K.), Seoul National University College of Medicine, Seoul National University Hospital, 101, Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea; and Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Republic of Korea (H.R.K.)
| | - Whal Lee
- From the Division of Allergy and Clinical Immunology, Department of Internal Medicine (S.K.), and Department of Radiology (J.L.), School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Republic of Korea; Department of Radiology, Gyeongsang National University School of Medicine, Jinju, Republic of Korea (K.N.J.); Department of Radiology, Gyeonsang National University Changwon Hospital, Changwon, Republic of Korea (K.N.J.); Department of Internal Medicine, Chung-Ang University Hospital, Seoul, Republic of Korea (J.W.J.); Division of Allergy and Clinical Immunology, Department of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea (H.K.P.); Departments of Radiology (W.L.) and Internal Medicine (H.R.K.), Seoul National University College of Medicine, Seoul National University Hospital, 101, Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea; and Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Republic of Korea (H.R.K.)
| | - Jongmin Lee
- From the Division of Allergy and Clinical Immunology, Department of Internal Medicine (S.K.), and Department of Radiology (J.L.), School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Republic of Korea; Department of Radiology, Gyeongsang National University School of Medicine, Jinju, Republic of Korea (K.N.J.); Department of Radiology, Gyeonsang National University Changwon Hospital, Changwon, Republic of Korea (K.N.J.); Department of Internal Medicine, Chung-Ang University Hospital, Seoul, Republic of Korea (J.W.J.); Division of Allergy and Clinical Immunology, Department of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea (H.K.P.); Departments of Radiology (W.L.) and Internal Medicine (H.R.K.), Seoul National University College of Medicine, Seoul National University Hospital, 101, Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea; and Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Republic of Korea (H.R.K.)
| | - Hye-Ryun Kang
- From the Division of Allergy and Clinical Immunology, Department of Internal Medicine (S.K.), and Department of Radiology (J.L.), School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Republic of Korea; Department of Radiology, Gyeongsang National University School of Medicine, Jinju, Republic of Korea (K.N.J.); Department of Radiology, Gyeonsang National University Changwon Hospital, Changwon, Republic of Korea (K.N.J.); Department of Internal Medicine, Chung-Ang University Hospital, Seoul, Republic of Korea (J.W.J.); Division of Allergy and Clinical Immunology, Department of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea (H.K.P.); Departments of Radiology (W.L.) and Internal Medicine (H.R.K.), Seoul National University College of Medicine, Seoul National University Hospital, 101, Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea; and Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Republic of Korea (H.R.K.)
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Fan M, Zheng X, Zhu S. Research progress on desensitization of hypersensitivity reaction to iodinated contrast media. Zhejiang Da Xue Xue Bao Yi Xue Ban 2023; 52:526-530. [PMID: 37643986 PMCID: PMC10641507 DOI: 10.3724/zdxbyxb-2023-0220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 07/27/2023] [Indexed: 08/12/2023]
Abstract
Desensitization therapy for iodinated contrast media (ICM) aims to induce drug tolerance in patients with a history of severe allergic reactions to ICM in a short time. Currently, there is no widely accepted consensus on inducing desensitization to avoid severe allergic responses to ICM. The clinically successful cases have shown that prophylactic use of antihistamines and glucocorticoids can increase the desensitization effect; repeatedly desensitizing and gradually increasing the dose can be conducive to establishing better tolerance to ICM. Most desensitization effects, including stress resistance, can endure 24-48 h. The mechanisms of desensitization therapy remain unclear, the initial dose, administration interval and dose gradient are largely based on clinical experiences and the reaction of patients. This article reviews the current research progress on ICM-related allergies, desensitization methods and related mechanisms, as well as the benefits and hazards of desensitization, to provide a reference for desensitization treatment of hypersensitivity to ICM .
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Affiliation(s)
- Miao Fan
- Department of Pharmacy, the First Affiliated Hospital of Ningbo University, Ningbo 315010, Zhejiang Province, China.
| | - Xiaomeng Zheng
- Department of Pharmacy, the First Affiliated Hospital of Ningbo University, Ningbo 315010, Zhejiang Province, China
| | - Suyan Zhu
- Department of Pharmacy, the First Affiliated Hospital of Ningbo University, Ningbo 315010, Zhejiang Province, China.
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Sáenz de Santa María R, Labella M, Bogas G, Doña I, Torres MJ. Hypersensitivity to gadolinium-based contrast. Curr Opin Allergy Clin Immunol 2023; 23:300-306. [PMID: 37357781 DOI: 10.1097/aci.0000000000000911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2023]
Abstract
PURPOSE OF REVIEW The use of contrast media is increasing in recent decades. Although gadolinium-based contrast agents (GBCAs) are generally well tolerated, adverse reactions, including hypersensitivity reactions (HSRs), although infrequent, may occur. It is important to perform a thorough allergological evaluation in patients with suspected GBCA-HSRs to avoid potentially serious reactions in subsequent exposures. RECENT FINDINGS Data on GBCA-HSRs are scarce. Most published articles dealing with skin tests and drug provocation tests (DPTs) with GBCAs are case series and small cohorts. Controversies exist about the role of premedication for preventing HSRs on subsequent exposures. Selection of well tolerated alternatives is based on potential cross-reactivity among GBCAs; however, the extent of cross-reactivity among them remains unclear. SUMMARY As premedication is not useful because breakthrough reactions are frequent in patients with GBCA-HSRs in subsequent exposures, an allergological evaluation is required. Available data suggest a high negative predictive value of skin tests, being crucial for guiding the selection of an alternative GBCA. However, DPTs are still necessary to confirm or exclude the diagnosis or find alternative GBCAs. Cross-reactivity is high among GBCAs belonging from the same group, mainly among macrocyclic compounds, so this must be taken into account for selecting alternatives.
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Affiliation(s)
- Rocío Sáenz de Santa María
- Allergy Unit, Hospital Regional Universitario de Málaga
- Allergy Research Group, Instituto de Investigación Biomédica de Málaga-IBIMA, Hospital Civil
| | - Marina Labella
- Allergy Unit, Hospital Regional Universitario de Málaga
- Allergy Research Group, Instituto de Investigación Biomédica de Málaga-IBIMA, Hospital Civil
| | - Gádor Bogas
- Allergy Unit, Hospital Regional Universitario de Málaga
- Allergy Research Group, Instituto de Investigación Biomédica de Málaga-IBIMA, Hospital Civil
| | - Inmaculada Doña
- Allergy Unit, Hospital Regional Universitario de Málaga
- Allergy Research Group, Instituto de Investigación Biomédica de Málaga-IBIMA, Hospital Civil
| | - María José Torres
- Allergy Unit, Hospital Regional Universitario de Málaga
- Allergy Research Group, Instituto de Investigación Biomédica de Málaga-IBIMA, Hospital Civil
- Nanostructures for Diagnosing and Treatment of Allergic Diseases Laboratory, Andalusian Center for Nanomedicine and Biotechnology-BIONAND, Parque Tecnológico de Andalucía
- Departamento de Medicina, Universidad de Málaga, Facultad de Medicina, Málaga, Spain
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Wu J, Li Y, He Q, Yang X. Exploration of the Use of Natural Compounds in Combination with Chemotherapy Drugs for Tumor Treatment. Molecules 2023; 28:molecules28031022. [PMID: 36770689 PMCID: PMC9920618 DOI: 10.3390/molecules28031022] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/13/2023] [Accepted: 01/16/2023] [Indexed: 01/20/2023] Open
Abstract
Currently, chemotherapy is the main treatment for tumors, but there are still problems such as unsatisfactory chemotherapy results, susceptibility to drug resistance, and serious adverse effects. Natural compounds have numerous pharmacological activities which are important sources of drug discovery for tumor treatment. The combination of chemotherapeutic drugs and natural compounds is gradually becoming an important strategy and development direction for tumor treatment. In this paper, we described the role of natural compounds in combination with chemotherapeutic drugs in synergizing, reducing drug resistance, mitigating adverse effects and related mechanisms, and providing new insights for future oncology research.
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Affiliation(s)
- Jianping Wu
- Center for Drug Safety Evaluation and Research, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, China
- Innovation Institute for Artificial Intelligence in Medicine of Zhejiang University, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, China
- Hangzhou Institute of Innovative Medicine, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, China
| | - Yunheng Li
- Center for Drug Safety Evaluation and Research, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, China
- Innovation Institute for Artificial Intelligence in Medicine of Zhejiang University, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, China
- Hangzhou Institute of Innovative Medicine, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, China
| | - Qiaojun He
- Center for Drug Safety Evaluation and Research, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, China
- Innovation Institute for Artificial Intelligence in Medicine of Zhejiang University, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, China
- Hangzhou Institute of Innovative Medicine, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, China
- Shandong (Linyi) Institute of Modern Agriculture, Zhejiang University, Linyi 276000, China
| | - Xiaochun Yang
- Center for Drug Safety Evaluation and Research, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, China
- Innovation Institute for Artificial Intelligence in Medicine of Zhejiang University, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, China
- Hangzhou Institute of Innovative Medicine, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, China
- Shandong (Linyi) Institute of Modern Agriculture, Zhejiang University, Linyi 276000, China
- Correspondence: ; Tel.: +86-571-8820-8076
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Mak HW, Yeung MH, Wong JC, Chiang V, Li PH. Differences in beta-lactam and penicillin allergy: Beyond the West and focusing on Asia-Pacific. FRONTIERS IN ALLERGY 2022; 3:1059321. [PMID: 36483185 PMCID: PMC9723361 DOI: 10.3389/falgy.2022.1059321] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Accepted: 11/07/2022] [Indexed: 04/29/2024] Open
Abstract
Beta-lactam (BL) antibiotic "allergy" labels are common, but often overdiagnosed. Although much research has been focused on the BL allergy and the delabelling process in the West, studies from other parts of the world remain sparse. This review outlines the contrasting global epidemiology, shifting clinical practices and disparities of BL allergy in the Asia-Pacific region compared with the West. Innovative strategies to overcome barriers in BL allergy workup are discussed and potential directions for future research and service development are also proposed.
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Affiliation(s)
- Hugo W.F. Mak
- Division of Rheumatology and Clinical Immunology, Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China
| | - Maegan H.Y. Yeung
- Division of Rheumatology and Clinical Immunology, Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China
| | - Jane C.Y. Wong
- Division of Rheumatology and Clinical Immunology, Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China
| | - Valerie Chiang
- Division of Clinical Immunology, Department of Pathology, Queen Mary Hospital, Hong Kong, China
| | - Philip H. Li
- Division of Rheumatology and Clinical Immunology, Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China
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Han J, Pan C, Tang X, Li Q, Zhu Y, Zhang Y, Liang A. Hypersensitivity reactions to small molecule drugs. Front Immunol 2022; 13:1016730. [PMID: 36439170 PMCID: PMC9684170 DOI: 10.3389/fimmu.2022.1016730] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 10/20/2022] [Indexed: 02/02/2024] Open
Abstract
Drug hypersensitivity reactions induced by small molecule drugs encompass a broad spectrum of adverse drug reactions with heterogeneous clinical presentations and mechanisms. These reactions are classified into allergic drug hypersensitivity reactions and non-allergic drug hypersensitivity reactions. At present, the hapten theory, pharmacological interaction with immune receptors (p-i) concept, altered peptide repertoire model, and altered T-cell receptor (TCR) repertoire model have been proposed to explain how small molecule drugs or their metabolites induce allergic drug hypersensitivity reactions. Meanwhile, direct activation of mast cells, provoking the complement system, stimulating or inhibiting inflammatory reaction-related enzymes, accumulating bradykinin, and/or triggering vascular hyperpermeability are considered as the main factors causing non-allergic drug hypersensitivity reactions. To date, many investigations have been performed to explore the underlying mechanisms involved in drug hypersensitivity reactions and to search for predictive and preventive methods in both clinical and non-clinical trials. However, validated methods for predicting and diagnosing hypersensitivity reactions to small molecule drugs and deeper insight into the relevant underlying mechanisms are still limited.
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Affiliation(s)
- Jiayin Han
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, China
| | - Chen Pan
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xuan Tang
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, China
| | - Qi Li
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yan Zhu
- Institute of Information on Traditional Chinese Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yushi Zhang
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, China
| | - Aihua Liang
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, China
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Ramsey A. Penicillin Allergy and Perioperative Anaphylaxis. FRONTIERS IN ALLERGY 2022; 3:903161. [PMID: 35769557 PMCID: PMC9234876 DOI: 10.3389/falgy.2022.903161] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 05/10/2022] [Indexed: 01/17/2023] Open
Abstract
Penicillin allergy is the most commonly reported drug allergy, while perioperative anaphylaxis is overall rare. This review covers the epidemiology of both penicillin allergy and perioperative anaphylaxis both separately and taken together. Considerations regarding anaphylaxis to penicillin during pregnancy are also discussed, since penicillin is the drug of choice for Group B Streptococcus prophylaxis. The minimal cross reactivity between penicillins and cephalosporins is addressed, since the vast majority of patients with a penicillin allergy label can receive perioperative cephalosporins. The management of the patient who has experienced perioperative anaphylaxis, including the importance of allergy referral is covered. Approaches to pre-operative penicillin allergy evaluations and opportunities for education are highlighted.
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Affiliation(s)
- Allison Ramsey
- Rochester Regional Health, Rochester, NY, United States
- Clinical Assistant Professor of Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY, United States
- *Correspondence: Allison Ramsey
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11
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Chiu TM, Chu SY. Hypersensitivity Reactions to Iodinated Contrast Media. Biomedicines 2022; 10:1036. [PMID: 35625773 PMCID: PMC9138609 DOI: 10.3390/biomedicines10051036] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 04/26/2022] [Accepted: 04/28/2022] [Indexed: 02/04/2023] Open
Abstract
At present, iodinated contrast media (ICM) are mostly non-ionic, have low osmolality, and are safe. Even if adverse drug reactions (ADRs) occur, most are chemo-toxic symptoms and require only observation or H1 antihistamines. However, rare, unpredictable, and even life-threatening hypersensitivity can still occur. The aim of this review is to summarize the issues that all relevant staff need to know about and be able to respond to. The most significant risk factor for ICM hypersensitivity is a history of ICM hypersensitivity. For high-risk populations, we must cautiously weigh the advantages and disadvantages of premedication and be aware that breakthrough reactions may still occur. The best policy for patients with a history of severe ICM hypersensitivity is to avoid the same ICM. If ICM are inevitable, skin tests, in vitro tests, and drug provocation tests may help to find a feasible alternative that is safer. The severity of the hypersensitivity is correlated with the positivity rate of these tests, so there is no need for further investigations for patients with only mild reactions. We should also keep in mind that even excipients in ICM may induce hypersensitivity. Detailed, standardized documentation is essential for correct diagnosis and the prevention of future occurrence.
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Affiliation(s)
- Tsu-Man Chiu
- Department of Dermatology, Changhua Christian Hospital, Changhua City 50073, Taiwan;
- Institute of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan
| | - Sung-Yu Chu
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 33305, Taiwan
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12
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Demoly P, Ramsey A. Drug Allergy Management on the Move. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2021; 9:3021-3022. [PMID: 34366095 DOI: 10.1016/j.jaip.2021.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 04/09/2021] [Indexed: 10/20/2022]
Affiliation(s)
- Pascal Demoly
- Division of Allergy, Department of Pulmonology, University Hospital of Montpellier, Montpellier, France; IDESP UA11 INSERM-Univ Montpellier, Montpellier, France.
| | - Allison Ramsey
- Rochester Regional Health, Rochester, NY; University of Rochester, Rochester, NY.
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