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Wang J, Yu J, Huang X. Pellagra and peripheral neuropathy secondary to tuberculosis treatment. QJM 2023; 116:696-698. [PMID: 37129558 DOI: 10.1093/qjmed/hcad077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Indexed: 05/03/2023] Open
Affiliation(s)
- J Wang
- M.D. Program, Peking Union Medical College, Chinese Academy of Medical Science, No. 9 Dongdansantiao, Dongcheng District, 100730 Beijing, China
| | - J Yu
- Department of Internal Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science, No. 1, Shuaifuyuan, Wangfujing Street, Dongcheng District, 100730 Beijing, China
| | - X Huang
- Department of General Internal Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science, No. 1, Shuaifuyuan, Wangfujing Street, Dongcheng District, 100730 Beijing, China
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Li J, Cai X, Chen Y, Wang C, Jiao Z. Parametric population pharmacokinetics of isoniazid: a systematic review. Expert Rev Clin Pharmacol 2023; 16:467-489. [PMID: 36971782 DOI: 10.1080/17512433.2023.2196401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
Abstract
INTRODUCTION Isoniazid (INH) plays an important role in prevention and treatment of tuberculosis (TB). However, large pharmacokinetic (PK) variations are observed in patients receiving standard INH dosages. Considering the influence of PK variations on INH efficacy or adverse reactions, we reviewed the population PK studies of INH and explored significant covariates that influence INH PK. METHODS The PubMed and Embase databases were systematically searched from their inception to 30 January 2023. PPK studies on INH using a parametric nonlinear mixed-effect approach were included in this review. The characteristics and identified significant covariates of the included studies were summarized. RESULTS Twenty-one studies conducted in adults, and seven in pediatrics were included. A two-compartment model with first-order absorption and elimination was the frequently used structural model for INH. NAT2 genotype, body size, and age were identified as significant covariates affecting INH PK variation. The median clearance (CL) value in the fast metabolizers was 2.55-fold higher than that in the slow metabolizers. Infants and children had higher CL per weight values than adults with the same metabolic phenotype. In pediatric patients, CL value increased with postnatal age. CONCLUSIONS Compared with slow metabolizers, the daily dose of INH should be increased by 200-600 mg in fast metabolizers. To achieve effective treatment, pediatric patients need a higher dose per kilogram than adults. Further PPK studies of anti-tuberculosis drugs are needed to comprehensively understand the covariates that affect their PK characteristics and to achieve accurate dose adjustments.
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Sun W, Wu Z, Zhou Y, Xia F, Tang Q, Wang J, Yang J, Yu F, Yang H, Xiao H, Fan L. A highly effective and inexpensive standardized treatment of multidrug-resistant tuberculosis: a multicenter prospective study in China. BMC Infect Dis 2021; 21:834. [PMID: 34412615 PMCID: PMC8374408 DOI: 10.1186/s12879-021-06553-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 08/08/2021] [Indexed: 11/16/2022] Open
Abstract
Background To verify the efficacy and safety of an inexpensive standardized regimen for multidrug-resistant tuberculosis (MDR-TB) with low resistance to isoniazid (INH), a multicenter prospective study was conducted in eastern China. Methods Patients diagnosed as MDR-TB with low concentration INH resistance and rifampicin resistance, second-line/injectable agents sensitive were prospectively enrolled, given the regimen of Amikacin (Ak)–Fluoroquinolones (FQs)–Cycloserine (Cs)–Protionamide (Pto)–PasiniaZid (Pa)–Pyrazinamide (Z) for 6 months followed by 12 months of FQs–Cs–Pto–Pa–Z, and then followed up for treatment outcomes and adverse events (AEs). Results A total of 114 patients were enrolled into the study. The overall favorable treatment rate was 79.8% (91/114). Among 91 cases with favorable treatment, 75.4% (86/114) were cured and 4.4% (5/114) were completed treatment. Regarding to unfavorable outcomes, among 23 cases, 8.8% (10/114) had failures, 8.8% (10/114) losing follow up, 0.9% (1/114) had treatment terminated due to intolerance to drugs and 1.8% (2/114) died. Treatment favorable rate was significantly higher in newly treated MDR-TB (91.7%, 33/36) than that in retreated MDR-TB (74.4%, 58/78, p 0.03). The investigators recorded 42 AEs occurrences in 30 of 114 patients (26.3%). Clinicians rated most AEs as mild or moderate (95.24%, 40/42). Conclusions The regimen was proved to be effective, safe and inexpensive. It is suitable for specific drug resistant population, especially for newly-treated patients, which could be expected to be developed into a short-course regimen. Clinical trials registration China Clinical Trial Registry ChiCTR-OPC-16009380
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Affiliation(s)
- Wenwen Sun
- Department of Tuberculosis, Shanghai Pulmonary Hospital, Shanghai Clinical Research Center for Tuberculosis, Tongji University School of Medicine, Shanghai, 200433, China
| | - Zheyuan Wu
- Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Ying Zhou
- Shanghai Xuhui District Central Hospital, Shanghai, China
| | - Fan Xia
- Department of Pulmonary Disease, PLA 905 Hospital, Shanghai, China
| | - Qin Tang
- Department of Tuberculosis, Shanghai Pulmonary Hospital, Shanghai Clinical Research Center for Tuberculosis, Tongji University School of Medicine, Shanghai, 200433, China
| | - Jie Wang
- Shanghai Key Lab of Tuberculosis, Shanghai Pulmonary Hospital, Shanghai Clinical Research Center for Tuberculosis, Tongji University School of Medicine, Shanghai, China
| | - Jinghui Yang
- Department of Clinical Laboratory, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Fangyou Yu
- Department of Clinical Laboratory, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Hua Yang
- Shanghai Key Lab of Tuberculosis, Shanghai Pulmonary Hospital, Shanghai Clinical Research Center for Tuberculosis, Tongji University School of Medicine, Shanghai, China
| | - Heping Xiao
- Department of Tuberculosis, Shanghai Pulmonary Hospital, Shanghai Clinical Research Center for Tuberculosis, Tongji University School of Medicine, Shanghai, 200433, China.
| | - Lin Fan
- Department of Tuberculosis, Shanghai Pulmonary Hospital, Shanghai Clinical Research Center for Tuberculosis, Tongji University School of Medicine, Shanghai, 200433, China.
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Sundararajan S, Muniyan R. Latent tuberculosis: interaction of virulence factors in Mycobacterium tuberculosis. Mol Biol Rep 2021; 48:6181-6196. [PMID: 34351540 DOI: 10.1007/s11033-021-06611-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 07/29/2021] [Indexed: 11/28/2022]
Abstract
Tuberculosis (TB) remains a prominent health concern worldwide. Besides extensive research and vaccinations available, attempts to control the pandemic are cumbersome due to the complex physiology of Mycobacterium tuberculosis (Mtb). Alongside the emergence of drug-resistant TB, latent TB has worsened the condition. The tubercle bacilli are unusually behaved and successful with its strategies to modulate genes to evade host immune system and persist within macrophages. Under latent/unfavorable conditions, Mtb conceals itself from immune system and modulates its genes. Among many intracellular modulated genes, important are those involved in cell entry, fatty acid degradation, mycolic acid synthesis, phagosome acidification inhibition, inhibition of phagosome-lysosome complex and chaperon protein modulation. Though the study on these genes date back to early times of TB, an insight on their inter-relation within and to newly evolved genes are still required. This review focuses on the findings and discussions on these genes, possible mechanism, credibility as target for novel drugs and repurposed drugs and their interaction that enables Mtb in survival, pathogenesis, resistance and latency.
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Affiliation(s)
- Sadhana Sundararajan
- School of Biosciences and Technology, Vellore Institute of Technology, Vellore, Tamil Nadu, 632014, India
| | - Rajiniraja Muniyan
- School of Biosciences and Technology, Vellore Institute of Technology, Vellore, Tamil Nadu, 632014, India.
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Nascimento Botelho C, Pavão e Pavão D, Santos Damos F, Cássia Silva Luz R. Photoelectrochemical Sensor for Isoniazid: Application in Drugs Used in the Treatment of Tuberculosis. ELECTROANAL 2021. [DOI: 10.1002/elan.202100023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Affiliation(s)
| | | | - Flávio Santos Damos
- Department of Chemistry Federal University of Maranhão 65080-805 São Luís MA Brazil
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