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Hassanein EHM, Kamel EO, Ali FEM, Ahmed MAR. Berberine and/or zinc protect against methotrexate-induced intestinal damage: Role of GSK-3β/NRF2 and JAK1/STAT-3 signaling pathways. Life Sci 2021; 281:119754. [PMID: 34174323 DOI: 10.1016/j.lfs.2021.119754] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 06/14/2021] [Accepted: 06/15/2021] [Indexed: 01/11/2023]
Abstract
AIM The present study was undertaken to elucidate the potential protective mechanism of berberine (BBR) and/or zinc (Zn) against methotrexate (MTX)-induced intestinal injury. METHODS Five groups of rats were assigned; normal group (received vehicle), MTX group (20 mg/kg; i.p. single dose), and the other three groups received a single daily oral dose of BBR (50 mg/kg), Zn (5 mg/kg), and BBR plus Zn respectively, for 5 days before MTX and 5 days after. RESULTS Our results emphasized the toxic effect of MTX on rat's intestine as shown by disturbance of oxidant/antioxidant status, down-regulation of NRF2, SIRT1, FOXO-3, Akt, and mTOR expressions, along with up-regulation of GSK-3β, JAK1, and STAT-3 expressions. Besides, severe intestinal histopathological changes were also observed. On the contrary, BBR and/or Zn produced marked protection against MTX-induced intestinal toxicity via amelioration of oxidative stress, improving NRF2, SIRT1, FOXO-3, GSK-3β, Akt, mTOR, JAK1, and STAT-3 alterations. Moreover, our treatments significantly restored histopathological abnormalities. Interestingly, combination therapy of BBR plus Zn exhibited higher effectiveness than mono-therapy. SIGNIFICANCE BBR plus Zn could be used as a novel therapy for the treatment of MTX-induced intestinal damage through modulation of GSK-3β/NRF2, Akt/mTOR, JAK1/STAT-3, and SIRT1/FOXO-3 signaling pathways.
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Affiliation(s)
- Emad H M Hassanein
- Department of Pharmacology & Toxicology, Faculty of Pharmacy, Al-Azhar University, Assiut Branch, Assiut 71524, Egypt
| | - Esam Omar Kamel
- Department of Medical Histology and Cell Biology, Faculty of Medicine, Al-Azhar University, Assiut Branch, Assiut 71524, Egypt
| | - Fares E M Ali
- Department of Pharmacology & Toxicology, Faculty of Pharmacy, Al-Azhar University, Assiut Branch, Assiut 71524, Egypt.
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2
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McGrath KH. Parenteral nutrition use in children with cancer. Pediatr Blood Cancer 2019; 66:e28000. [PMID: 31535458 DOI: 10.1002/pbc.28000] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 09/03/2019] [Accepted: 09/04/2019] [Indexed: 12/28/2022]
Abstract
Multiple disease and treatment-related factors contribute to intestinal insult and influence the nutritional status of children with cancer. Many children with cancer will experience intestinal dysfunction during their cancer journey and children with cancer are a common referral group for inpatient parenteral nutrition. Appropriate use of parenteral nutrition in children with cancer and intestinal failure may alleviate malnutrition and associated risks. However, proper selection of patients, correct parenteral nutrition prescription, and close monitoring is important to avoid unnecessary intestinal failure or parenteral nutrition-related complications, minimize long-term nutritional sequelae or additional costs to health services, and optimize intestinal rehabilitation.
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Affiliation(s)
- Kathleen H McGrath
- Department of Gastroenterology and Clinical Nutrition, The Royal Children's Hospital, Melbourne, Australia.,Intestinal Failure and Clinical Nutrition Group, Murdoch Children's Research Institute, Melbourne, Australia
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Rodrigues D, Souza T, Jennen DG, Lemmens L, Kleinjans JC, de Kok TM. Drug-induced gene expression profile changes in relation to intestinal toxicity: State-of-the-art and new approaches. Cancer Treat Rev 2019; 77:57-66. [DOI: 10.1016/j.ctrv.2019.06.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Accepted: 06/26/2019] [Indexed: 12/22/2022]
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Yazbeck R, Jaenisch S, Squire M, Abbott CA, Parkinson-Lawrence E, Brooks DA, Butler RN. Development of a 13C Stable Isotope Assay for Dipeptidyl Peptidase-4 Enzyme Activity A New Breath Test for Dipeptidyl Peptidase Activity. Sci Rep 2019; 9:4906. [PMID: 30894647 PMCID: PMC6427020 DOI: 10.1038/s41598-019-41375-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 03/07/2019] [Indexed: 01/15/2023] Open
Abstract
Dipeptidyl peptidase-4 inhibitors (DPP4i) are a class of orally available, small molecule inhibitors for the management of Type-II diabetes. A rapid, real-time, functional breath test for DPP4 enzyme activity could help to define DPP4i efficacy in patients that are refractory to treatment. We aimed to develop a selective, non-invasive, stable-isotope 13C-breath test for DPP4. In vitro experiments were performed using high (Caco-2) and low (HeLa) DPP4 expressing cells. DPP gene expression was determined in cell lines by qRT-PCR. A DPP4 selective 13C-tripeptide was added to cells in the presence and absence of the DPP4 inhibitor Sitagliptin. Gas samples were collected from the cell headspace and 13CO2 content quantified by isotope ratio mass spectrometry (IRMS). DPP4 was highly expressed in Caco-2 cells compared to HeLa cells and using the 13C-tripeptide, we detected a high 13CO2 signal from Caco2 cells. Addition of Sitaglitpin to Caco2 cells significantly inhibited this 13CO2 signal. 13C-assay DPP4 activity correlated positively with the enzyme activity detected using a colorimetric substrate. We have developed a selective, non-invasive, 13C-assay for DPP4 that could have broad translational applications in diabetes and gastrointestinal disease.
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Affiliation(s)
- Roger Yazbeck
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia. .,Flinders Centre for Innovation in Cancer, Flinders University, Adelaide, South Australia, Australia.
| | - Simone Jaenisch
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia.,Flinders Centre for Innovation in Cancer, Flinders University, Adelaide, South Australia, Australia
| | - Michelle Squire
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Catherine A Abbott
- Flinders Centre for Innovation in Cancer, Flinders University, Adelaide, South Australia, Australia.,College of Science and Engineering, Flinders University, Adelaide, South Australia, Australia
| | - Emma Parkinson-Lawrence
- School of Pharmacy and Medical Science, University of South Australia Cancer Research Institute, Adelaide, South Australia, Australia
| | - Douglas A Brooks
- School of Pharmacy and Medical Science, University of South Australia Cancer Research Institute, Adelaide, South Australia, Australia.,School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Ross N Butler
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia.,School of Pharmacy and Medical Science, University of South Australia Cancer Research Institute, Adelaide, South Australia, Australia
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Shin S, Jeong HM, Chung SE, Kim TH, Thapa SK, Lee DY, Song CH, Lim JY, Cho SM, Nam KY, Kang WH, Choi YW, Shin BS. Simultaneous analysis of acetylcarnitine, proline, hydroxyproline, citrulline, and arginine as potential plasma biomarkers to evaluate NSAIDs-induced gastric injury by liquid chromatography–tandem mass spectrometry. J Pharm Biomed Anal 2019; 165:101-111. [DOI: 10.1016/j.jpba.2018.11.051] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 11/20/2018] [Accepted: 11/22/2018] [Indexed: 12/14/2022]
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Butler RN, Kosek M, Krebs NF, Loechl CU, Loy A, Owino VO, Zimmermann MB, Morrison DJ. Stable Isotope Techniques for the Assessment of Host and Microbiota Response During Gastrointestinal Dysfunction. J Pediatr Gastroenterol Nutr 2017; 64:8-14. [PMID: 27632432 PMCID: PMC5214897 DOI: 10.1097/mpg.0000000000001373] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The International Atomic Energy Agency convened a technical meeting on environmental enteric dysfunction (EED) in Vienna (October 28-30, 2015; https://nucleus.iaea.org/HHW/Nutrition/EED_Technical_Meeting/index.html) to bring together international experts in the fields of EED, nutrition, and stable isotope technologies. Advances in stable isotope-labeling techniques open up new possibilities to improve our understanding of gastrointestinal dysfunction and the role of the microbiota in host health. In the context of EED, little is known about the role gut dysfunction may play in macro- and micronutrient bioavailability and requirements and what the consequences may be for nutritional status and linear growth. Stable isotope labeling techniques have been used to assess intestinal mucosal injury and barrier function, carbohydrate digestion and fermentation, protein-derived amino acid bioavailability and requirements, micronutrient bioavailability and to track microbe-microbe and microbe-host interactions at the single cell level. The noninvasive nature of stable isotope technologies potentially allow for low-hazard, field-deployable tests of gut dysfunction that are applicable across all age groups. The purpose of this review is to assess the state-of-the-art use of stable isotope technologies and to provide a perspective on where these technologies can be exploited to further our understanding of gut dysfunction in EED.
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Affiliation(s)
- Ross N Butler
- *School of Pharmacy and Medical Sciences, Division of Health Sciences, University of South Australia, Adelaide, Australia †Bloomberg School of Public Health, John Hopkins University, Baltimore, MD ‡Department of Pediatrics, School of Medicine, University of Colorado, Aurora §Nutrition and Health-Related Environmental Studies Section, Division of Human Health, International Atomic Energy Agency ||Division of Microbial Ecology, Department of Microbial and Ecosystem Science, Research Network Chemistry meets Microbiology, University of Vienna, Vienna, Austria ¶Institute of Food, Nutrition and Health, Department of Health Sciences and Technology, ETH Zürich, Zurich, Switzerland #Scottish Universities Environmental Research Centre, University of Glasgow, East Kilbride, Scotland, UK
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Kalabat DY, Vitsky A, Scott W, Kindt E, Hayes K, John-Baptiste A, Huang W, Yang AH. Identification and Evaluation of Novel MicroRNA Biomarkers in Plasma and Feces Associated with Drug-induced Intestinal Toxicity. Toxicol Pathol 2016; 45:302-320. [PMID: 27189632 DOI: 10.1177/0192623316644992] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Gastrointestinal toxicity is dose limiting with many therapeutic and anticancer agents. Real-time, noninvasive detection of markers of toxicity in biofluids is advantageous. Ongoing research has revealed microRNAs as potential diagnostic and predictive biomarkers for the detection of select organ toxicities. To study the potential utility of microRNA biomarkers of intestinal injury in a preclinical toxicology species, we evaluated 3 rodent models of drug-induced intestinal toxicity, each with a distinct mechanism of toxicity. MiR-215 and miR-194 were identified as putative intestinal toxicity biomarkers. Both were evaluated in plasma and feces and compared to plasma citrulline, an established intestinal injury biomarker. Following intestinal toxicant dosing, microRNA changes in feces and plasma were detected noninvasively and correlated with histologic evidence of intestinal injury. Fecal miR-215 and miR-194 levels increased, and plasma miR-215 decreased in a dose- and time-dependent manner. Dose-dependent decreases in plasma miR-215 levels also preceded and correlated positively with plasma citrulline modulation, suggesting miR-215 is a more sensitive biomarker. Moreover, during the drug-free recovery phase, plasma miR-215 returned to predose levels, supporting a corresponding recovery of histologic lesions. Despite limitations, this study provides preliminary evidence that select microRNAs have the potential to act as noninvasive, sensitive, and quantitative biomarkers of intestinal injury.
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Affiliation(s)
- Dalia Y Kalabat
- 1 Drug Safety R&D, Pfizer Global R&D, San Diego, California, USA
| | - Allison Vitsky
- 1 Drug Safety R&D, Pfizer Global R&D, San Diego, California, USA
| | - Wesley Scott
- 1 Drug Safety R&D, Pfizer Global R&D, San Diego, California, USA
| | - Erick Kindt
- 2 Pharmacokinetics, Dynamics and Metabolism, Pfizer Global R&D, San Diego, California, USA
| | - Kyle Hayes
- 1 Drug Safety R&D, Pfizer Global R&D, San Diego, California, USA
| | | | - Wenhu Huang
- 1 Drug Safety R&D, Pfizer Global R&D, San Diego, California, USA
| | - Amy H Yang
- 1 Drug Safety R&D, Pfizer Global R&D, San Diego, California, USA
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Advances in understanding and improving gastrointestinal symptoms during supportive and palliative care: a decade of progress. Curr Opin Support Palliat Care 2016; 10:149-51. [PMID: 27054289 DOI: 10.1097/spc.0000000000000215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Al-Saffar A, Nogueira da Costa A, Delaunois A, Leishman DJ, Marks L, Rosseels ML, Valentin JP. Gastrointestinal Safety Pharmacology in Drug Discovery and Development. Handb Exp Pharmacol 2015; 229:291-321. [PMID: 26091645 DOI: 10.1007/978-3-662-46943-9_12] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Although the basic structure of the gastrointestinal tract (GIT) is similar across species, there are significant differences in the anatomy, physiology, and biochemistry between humans and laboratory animals, which should be taken into account when conducting a gastrointestinal (GI) assessment. Historically, the percentage of cases of drug attrition associated with GI-related adverse effects is small; however, this incidence has increased over the last few years. Drug-related GI effects are very diverse, usually functional in nature, and not limited to a single pharmacological class. The most common GI signs are nausea and vomiting, diarrhea, constipation, and gastric ulceration. Despite being generally not life-threatening, they can greatly affect patient compliance and quality of life. There is therefore a real need for improved and/or more extensive GI screening of candidate drugs in preclinical development, which may help to better predict clinical effects. Models to identify drug effects on GI function cover GI motility, nausea and emesis liability, secretory function (mainly gastric secretion), and absorption aspects. Both in vitro and in vivo assessments are described in this chapter. Drug-induced effects on GI function can be assessed in stand-alone safety pharmacology studies or as endpoints integrated into toxicology studies. In silico approaches are also being developed, such as the gut-on-a-chip model, but await further optimization and validation before routine use in drug development. GI injuries are still in their infancy with regard to biomarkers, probably due to their greater diversity. Nevertheless, several potential blood, stool, and breath biomarkers have been investigated. However, additional validation studies are necessary to assess the relevance of these biomarkers and their predictive value for GI injuries.
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Affiliation(s)
- Ahmad Al-Saffar
- Faculty of Medicine, Department of Medical Sciences, Uppsala University, 751 85, Uppsala, Sweden
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John-Baptiste A, Huang W, Kindt E, Wu A, Vitsky A, Scott W, Gross C, Yang AH, Schaiff WT, Ramaiah SK. Evaluation of Potential Gastrointestinal Biomarkers in a PAK4 Inhibitor-treated Preclinical Toxicity Model to Address Unmonitorable Gastrointestinal Toxicity. Toxicol Pathol 2012; 40:482-90. [DOI: 10.1177/0192623311432289] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- Annette John-Baptiste
- Pfizer Global Research and Development, Drug Safety Research and Development, San Diego, California, USA
| | - Wenhu Huang
- Pfizer Global Research and Development, Drug Safety Research and Development, San Diego, California, USA
| | - Erick Kindt
- Pfizer Global Research and Development, Pharmacokinetics, Dynamics, and Metabolism, San Diego, California, USA
| | - Annette Wu
- Pfizer Global Research and Development, Pharmacokinetics, Dynamics, and Metabolism, San Diego, California, USA
| | - Allison Vitsky
- Pfizer Global Research and Development, Drug Safety Research and Development, San Diego, California, USA
| | - Wes Scott
- Pfizer Global Research and Development, Drug Safety Research and Development, San Diego, California, USA
| | - Cindy Gross
- Pfizer Global Research and Development, Drug Safety Research and Development, Cambridge, Massachusetts, USA
| | - Amy H. Yang
- Pfizer Global Research and Development, Drug Safety Research and Development, San Diego, California, USA
| | - W. Timothy Schaiff
- Pfizer Global Research and Development, Drug Safety Research and Development, Cambridge, Massachusetts, USA
| | - Shashi K. Ramaiah
- Pfizer Global Research and Development, Drug Safety Research and Development, Cambridge, Massachusetts, USA
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A physiological approach to modernize the management of cancer chemotherapy-induced gastrointestinal toxicity. Curr Opin Support Palliat Care 2010; 4:19-25. [PMID: 20009760 DOI: 10.1097/spc.0b013e32833575cc] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
PURPOSE OF REVIEW Gastrointestinal toxicity during chemotherapy is frequent. Symptomatic therapies for gastrointestinal toxicity, which do not address the underlying cause, may result in inadequate symptom control. With advances in curative treatment regimens, it becomes more important to minimize treatment toxicity which otherwise may compromise optimal chemotherapy and the chance of cure. RECENT FINDINGS For decades, oncologists have concentrated on delineating the pathological processes, which occur within the gastrointestinal tract during chemotherapy treatment. However, pathological change does not in itself cause symptoms. Symptoms only arise when physiological functions are altered. In immunosuppressed patients, it is a priority to exclude infection as a cause for symptoms. In the presence of diarrhoea, the best investigative paradigm for this is stool culture, upper gastrointestinal endoscopy with duodenal biopsies and duodenal aspirate combined with flexible sigmoidoscopy and left colonic biopsies. Once infection has been excluded, although large studies have not been performed, case series repeatedly suggest that gastrointestinal symptoms arising during cancer chemotherapy can often be cured if newly acquired, gastrointestinal physiological deficits are identified. SUMMARY Although many physiological changes induced by chemotherapy may be relatively transient and settle weeks or months after the end of treatment, during chemotherapy, their manifestations can be protean and severe. A systematic failure to research the frequency with which physiological causes of the symptoms are amenable to treatment has denied many patients' logical therapies for their chemotherapy-induced symptoms, and as a result, it is likely that symptomatic treatments are frequently suboptimal.
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Current World Literature. Curr Opin Support Palliat Care 2010; 4:46-51. [DOI: 10.1097/spc.0b013e3283372479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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