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Zhao X, Zhao X, Di W, Wang C. Inhibitors of Cyclophilin A: Current and Anticipated Pharmaceutical Agents for Inflammatory Diseases and Cancers. Molecules 2024; 29:1235. [PMID: 38542872 PMCID: PMC10974348 DOI: 10.3390/molecules29061235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 03/02/2024] [Accepted: 03/05/2024] [Indexed: 04/07/2024] Open
Abstract
Cyclophilin A, a widely prevalent cellular protein, exhibits peptidyl-prolyl cis-trans isomerase activity. This protein is predominantly located in the cytosol; additionally, it can be secreted by the cells in response to inflammatory stimuli. Cyclophilin A has been identified to be a key player in many of the biological events and is therefore involved in several diseases, including vascular and inflammatory diseases, immune disorders, aging, and cancers. It represents an attractive target for therapeutic intervention with small molecule inhibitors such as cyclosporin A. Recently, a number of novel inhibitors of cyclophilin A have emerged. However, it remains elusive whether and how many cyclophilin A inhibitors function in the inflammatory diseases and cancers. In this review, we discuss current available data about cyclophilin A inhibitors, including cyclosporin A and its derivatives, quinoxaline derivatives, and peptide analogues, and outline the most recent advances in clinical trials of these agents. Inhibitors of cyclophilin A are poised to enhance our comprehension of the molecular mechanisms that underpin inflammatory diseases and cancers associated with cyclophilin A. This advancement will aid in the development of innovative pharmaceutical treatments in the future.
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Affiliation(s)
- Xuemei Zhao
- School of Pharmaceutical Sciences, Shandong First Medical University & Shandong Academy of Medical Sciences, Ji’nan 250000, China; (X.Z.); (W.D.)
| | - Xin Zhao
- School of Pharmaceutical Sciences, Shandong First Medical University & Shandong Academy of Medical Sciences, Ji’nan 250000, China; (X.Z.); (W.D.)
| | - Weihua Di
- School of Pharmaceutical Sciences, Shandong First Medical University & Shandong Academy of Medical Sciences, Ji’nan 250000, China; (X.Z.); (W.D.)
| | - Chang Wang
- School of Pharmaceutical Sciences, Shandong First Medical University & Shandong Academy of Medical Sciences, Ji’nan 250000, China; (X.Z.); (W.D.)
- Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Ji’nan 250000, China
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2
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Drillet G, Pastoret C, Moignet A, Lamy T, Marchand T. Large granular lymphocyte leukemia: An indolent clonal proliferative disease associated with an array of various immunologic disorders. Rev Med Interne 2023:S0248-8663(23)00119-4. [PMID: 37087371 DOI: 10.1016/j.revmed.2023.03.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 02/15/2023] [Accepted: 03/31/2023] [Indexed: 04/24/2023]
Abstract
Large granular lymphocyte leukemia (LGLL) is a chronic lymphoproliferative disorder characterized by the proliferation of T or NK cytotoxic cells in the peripheral blood, the spleen and the bone marrow. Neutropenia leading to recurrent infections represents the main manifestation of LGLL. One specificity of LGLL is its frequent association with auto-immune disorders, among them first and foremost rheumatoid arthritis, and other hematologic diseases, including pure red cell aplasia and bone marrow failure. The large spectrum of manifestations and the classical indolent course contribute to the diagnosis difficulties and the frequency of underdiagnosed cases. Of importance, the dysimmune manifestations disappear with the treatment of LGLL as the blood cell counts normalize, giving a strong argument for a pathological link between the two entities. The therapeutic challenge results from the high rate of relapses following the first line of immunosuppressive drugs. New targeted agents, some of which are currently approved in autoimmune diseases, appear to be relevant therapeutic strategies to treat LGLL, by targeting key activated pathways involved in the pathogenesis of the disease, including JAK-STAT signaling.
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Affiliation(s)
- G Drillet
- Service d'hématologie clinique, centre hospitalier universitaire de Rennes, Rennes, France.
| | - C Pastoret
- Laboratoire d'hématologie, centre hospitalier universitaire de Rennes, Rennes, France
| | - A Moignet
- Service d'hématologie clinique, centre hospitalier universitaire de Rennes, Rennes, France
| | - T Lamy
- Service d'hématologie clinique, centre hospitalier universitaire de Rennes, Rennes, France; Université Rennes 1, Rennes, France; CIC 1414, Rennes, France; Institut national de la santé et de la recherche médicale (INSERM) U1236, Rennes, France
| | - T Marchand
- Service d'hématologie clinique, centre hospitalier universitaire de Rennes, Rennes, France; Université Rennes 1, Rennes, France; Institut national de la santé et de la recherche médicale (INSERM) U1236, Rennes, France
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3
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Wang M, Meng R, Gao Y, Huang J, Li T, Mao C, Liu S, Xu Y, Xu H, Feng X. Cyclosporine A therapy of chronic lymphoblastic leukemia-related pancytopenia: A case report. Clin Case Rep 2022; 10:e05538. [PMID: 35310307 PMCID: PMC8908086 DOI: 10.1002/ccr3.5538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 01/28/2022] [Accepted: 02/16/2022] [Indexed: 11/25/2022] Open
Abstract
To explore the clinical characteristics, diagnosis, and treatment of chronic lymphocytic leukemia with secondary pancytopenia. Here, a case of pancytopenia secondary to chronic lymphocytic leukemia is reported. Additionally, a review of relevant chronic lymphocytic leukemia literature was conducted to summarize its diagnosis, clinical characteristics, treatment history, and experience. After treatment with cyclosporine A, the patient's chronic lymphocytic leukemia continued to resolve, and hematopoiesis returned to normal. Cyclosporine A therapy resulted in improved patient outcomes. However, the mechanism by which cyclosporine A rebuilds the immune microenvironment and its antileukemia effect in the body remains to be studied.
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Affiliation(s)
- Mengying Wang
- Department of HematologyFaculty of MedicineQingdao UniversityThe Affiliated Hospital of Qingdao UniversityQingdaoChina
- Department of HematologyThe Affiliated Hospital of Qingdao UniversityQingdaoChina
| | - Ruoyu Meng
- Department of PhysiologyChonbuk National University Medical SchoolJeonjuKorea
| | - Yan Gao
- Department of HematologyThe Affiliated Hospital of Qingdao UniversityQingdaoChina
| | - Junxia Huang
- Department of HematologyThe Affiliated Hospital of Qingdao UniversityQingdaoChina
| | - Tianlan Li
- Department of HematologyThe Affiliated Hospital of Qingdao UniversityQingdaoChina
| | - Chunxia Mao
- Department of HematologyThe Affiliated Hospital of Qingdao UniversityQingdaoChina
| | - Shanshan Liu
- Department of HematologyThe Affiliated Hospital of Qingdao UniversityQingdaoChina
| | - Yujie Xu
- Department of HematologyThe Affiliated Hospital of Qingdao UniversityQingdaoChina
| | - Han Xu
- Department of HematologyFaculty of MedicineQingdao UniversityThe Affiliated Hospital of Qingdao UniversityQingdaoChina
- Department of HematologyThe Affiliated Hospital of Qingdao UniversityQingdaoChina
| | - Xianqi Feng
- Department of HematologyThe Affiliated Hospital of Qingdao UniversityQingdaoChina
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4
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Qiu ZY, Qin R, Tian GY, Wang Y, Zhang YQ. Pathophysiologic Mechanisms And Management Of Large Granular Lymphocytic Leukemia Associated Pure Red Cell Aplasia. Onco Targets Ther 2019; 12:8229-8240. [PMID: 31632073 PMCID: PMC6781944 DOI: 10.2147/ott.s222378] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 09/13/2019] [Indexed: 12/31/2022] Open
Abstract
Large granular lymphocytic leukemia (LGLL) is a chronic clonal lymphoproliferative disease of mature T or NK cells, and produces a variety of hematological abnormalities. Pure red cell aplasia (PRCA) is a rare haematological disease and is one of the most common complications of LGLL. LGLL-associated PRCA may represent a relatively indolent type and may be more common than reported, but its natural history and clinical course have not been well described. The ethnic origin of the patients is an important consideration in determining the relationship between PRCA and LGLL. Guidelines and progresses for management of LGLL-associated PRCA rely on accumulation of empirical experiences, integrative analyses of several cases and clinical trials. The purpose of this review is to evaluate occurrence, possible mechanisms, diagnosis, clinical features, treatments and outcomes of LGLL-associated PRCA.
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Affiliation(s)
- Zhi-Yuan Qiu
- Department of Oncology, The Affiliated People's Hospital of Jiangsu University, Zhenjiang 212002, Jiangsu, People's Republic of China
| | - Rong Qin
- Department of Oncology, The Affiliated People's Hospital of Jiangsu University, Zhenjiang 212002, Jiangsu, People's Republic of China
| | - Guang-Yu Tian
- Department of Oncology, The Affiliated People's Hospital of Jiangsu University, Zhenjiang 212002, Jiangsu, People's Republic of China
| | - Yan Wang
- Department of Oncology, The Affiliated People's Hospital of Jiangsu University, Zhenjiang 212002, Jiangsu, People's Republic of China
| | - Ye-Qing Zhang
- Department of Vascular Surgery, The Second Affiliated Hospital of Soochow University, Suzhou 215004, Jiangsu, People's Republic of China
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Peng G, Yang W, Zhang L, Zhou K, Li Y, Li Y, Ye L, Li J, Fan H, Song L, Zhao X, Wu Z, Zhang F, Jing L. Moderate-dose cyclophosphamide in the treatment of relapsed/refractory T-cell large granular lymphocytic leukemia-associated pure red cell aplasia. Hematology 2016; 21:138-43. [PMID: 27077768 DOI: 10.1080/10245332.2015.1101977] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Affiliation(s)
- Guangxin Peng
- Department of Anemia Therapeutic Centre, Institute of Hematology and Blood Diseases Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences (CAMS & PUMC), Tianjin, China
| | - Wenrui Yang
- Department of Anemia Therapeutic Centre, Institute of Hematology and Blood Diseases Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences (CAMS & PUMC), Tianjin, China
| | - Li Zhang
- Department of Anemia Therapeutic Centre, Institute of Hematology and Blood Diseases Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences (CAMS & PUMC), Tianjin, China
| | - Kang Zhou
- Department of Anemia Therapeutic Centre, Institute of Hematology and Blood Diseases Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences (CAMS & PUMC), Tianjin, China
| | - Yang Li
- Department of Anemia Therapeutic Centre, Institute of Hematology and Blood Diseases Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences (CAMS & PUMC), Tianjin, China
| | - Yuan Li
- Department of Anemia Therapeutic Centre, Institute of Hematology and Blood Diseases Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences (CAMS & PUMC), Tianjin, China
| | - Lei Ye
- Department of Anemia Therapeutic Centre, Institute of Hematology and Blood Diseases Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences (CAMS & PUMC), Tianjin, China
| | - Jianping Li
- Department of Anemia Therapeutic Centre, Institute of Hematology and Blood Diseases Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences (CAMS & PUMC), Tianjin, China
| | - Huihui Fan
- Department of Anemia Therapeutic Centre, Institute of Hematology and Blood Diseases Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences (CAMS & PUMC), Tianjin, China
| | - Lin Song
- Department of Anemia Therapeutic Centre, Institute of Hematology and Blood Diseases Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences (CAMS & PUMC), Tianjin, China
| | - Xin Zhao
- Department of Anemia Therapeutic Centre, Institute of Hematology and Blood Diseases Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences (CAMS & PUMC), Tianjin, China
| | - Zhijie Wu
- Department of Anemia Therapeutic Centre, Institute of Hematology and Blood Diseases Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences (CAMS & PUMC), Tianjin, China
| | - Fengkui Zhang
- Department of Anemia Therapeutic Centre, Institute of Hematology and Blood Diseases Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences (CAMS & PUMC), Tianjin, China
| | - Liping Jing
- Department of Anemia Therapeutic Centre, Institute of Hematology and Blood Diseases Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences (CAMS & PUMC), Tianjin, China
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Guada M, Beloqui A, Kumar MNVR, Préat V, Dios-Viéitez MDC, Blanco-Prieto MJ. Reformulating cyclosporine A (CsA): More than just a life cycle management strategy. J Control Release 2016; 225:269-82. [PMID: 26829101 DOI: 10.1016/j.jconrel.2016.01.056] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2015] [Revised: 01/27/2016] [Accepted: 01/28/2016] [Indexed: 01/01/2023]
Abstract
Cyclosporine A (CsA) is a well-known immunosuppressive agent that gained considerable importance in transplant medicine in the late 1970s due to its selective and reversible inhibition of T-lymphocytes. While CsA has been widely used to prevent graft rejection in patients undergoing organ transplant it was also used to treat several systemic and local autoimmune disorders. Currently, the neuro- and cardio-protective effects of CsA (CiCloMulsion®; NeuroSTAT®) are being tested in phase II and III trials respectively and NeuroSTAT® received orphan drug status from US FDA and Europe in 2010. The reformulation strategies focused on developing Cremophor® EL free formulations and address variable bioavailability and toxicity issues of CsA. This review is an attempt to highlight the progress made so far and the room available for further improvements to realize the maximum benefits of CsA.
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Affiliation(s)
- Melissa Guada
- Department of Pharmacy and Pharmaceutical Technology, School of Pharmacy, University of Navarra, C/Irunlarrea 1, E-31008 Pamplona, Spain; Instituto de Investigación Sanitaria de Navarra, IdiSNA, C/Irunlarrea 3, E-31008 Pamplona, Spain
| | - Ana Beloqui
- Université catholique de Louvain, Louvain Drug Research Institute, Advanced Drug Delivery and Biomaterials, Brussels, Belgium
| | - M N V Ravi Kumar
- Department of Pharmaceutical Sciences, Texas A&M Health Science Center, College Station, TX 77845, USA
| | - Véronique Préat
- Université catholique de Louvain, Louvain Drug Research Institute, Advanced Drug Delivery and Biomaterials, Brussels, Belgium
| | - Maria Del Carmen Dios-Viéitez
- Department of Pharmacy and Pharmaceutical Technology, School of Pharmacy, University of Navarra, C/Irunlarrea 1, E-31008 Pamplona, Spain; Instituto de Investigación Sanitaria de Navarra, IdiSNA, C/Irunlarrea 3, E-31008 Pamplona, Spain
| | - Maria J Blanco-Prieto
- Department of Pharmacy and Pharmaceutical Technology, School of Pharmacy, University of Navarra, C/Irunlarrea 1, E-31008 Pamplona, Spain; Instituto de Investigación Sanitaria de Navarra, IdiSNA, C/Irunlarrea 3, E-31008 Pamplona, Spain.
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Tees MT, Whitehurst MT, Sokol L. Treating rare lymphoproliferative malignancies: a focus on indolent large granular lymphocytic leukemia. Int J Hematol Oncol 2014. [DOI: 10.2217/ijh.14.42] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
SUMMARY Large granular lymphocyte leukemia is a heterogeneous group of lymphoproliferative disorders that arises from mature T cells or NK cells. These disorders are relatively uncommon and usually present with cytopenias and/or autoimmune disorders. As patients often do not have symptoms warranting therapy upfront, surveillance is often employed. Common frontline therapies include cyclosphosphamide, methotrexate or cyclosporine A, however, no controlled trials or retrospective analyses have demonstrated one superior therapeutic strategy. Mechanisms of pathogenesis and survival have been identified that include abnormalities in the cell surface receptors halting apoptotic signals, dysregulation of prosurvival and apoptotic signaling pathways, and somatic mutations of the STAT3 and STAT5b genes, among others. Investigating novel therapies that target pathways shared by other neoplastic processes, as well as the identification of new agents directed toward the aberrant cellular mechanisms of large granular lymphocyte leukemia, are fundamental to moving from empiric chemotherapy to targeted therapies in the future.
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Affiliation(s)
- Michael T Tees
- Department of Malignant Hematology, H Lee Moffitt Cancer Center & Research Institute, 12902 Magnolia Drive, Tampa, FL 33612, USA
| | - Matthew T Whitehurst
- Department of Malignant Hematology, H Lee Moffitt Cancer Center & Research Institute, 12902 Magnolia Drive, Tampa, FL 33612, USA
| | - Lubomir Sokol
- Department of Malignant Hematology, H Lee Moffitt Cancer Center & Research Institute, 12902 Magnolia Drive, Tampa, FL 33612, USA
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