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Kang DW, Kim JH, Choi GW, Cho SJ, Cho HY. PBPK model-based gender-specific risk assessment of N-nitrosodimethylamine (NDMA) using human biomonitoring data. Arch Toxicol 2024; 98:3269-3288. [PMID: 39096368 DOI: 10.1007/s00204-024-03828-w] [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: 05/09/2024] [Accepted: 07/24/2024] [Indexed: 08/05/2024]
Abstract
Despite several screening levels for NDMA reported in water, soil, air, and drugs, the human risk assessment using biomonitoring concentrations has not been performed. In this study, gender-specific exposure guidance values were determined in humans, then biomonitoring measurements in healthy Korean subjects (32 men and 40 women) were compared to the exposure guidance values to evaluate the current exposure level to NDMA. For the human risk assessment of NDMA, the gender-specific physiologically based pharmacokinetic (PBPK) model was developed in humans using proper physiological parameters, partition coefficients, and biochemical parameters. Using the PBPK model, a Monte Carlo simulation was performed to describe the magnitudes of inter-individual variability and uncertainty on the single model predictions. The PBPK modeling and Monte Carlo simulation allowed the estimation of the relationship between external dose and blood concentration for the risk assessment. The procedure for the human risk assessment was summarized as follows: (1) estimating a steady-state blood concentration (Cavg) corresponding to the daily no observed adverse effect level (NOAEL) administration in rats; (2) applying uncertainty factors (UFs) for deriving the human Cavg; (3) determining the exposure guidance values as screening criteria; (4) interpreting the human biomonitoring measurements by forward and reverse dosimetry approaches. Using the biomonitoring concentrations, current daily exposures to NDMA were estimated to be 3.95 μg/day/kg for men and 10.60 μg/day/kg for women, respectively. The result of the study could be used as a basis for implementing further risk management and regulatory decision-making for NDMA.
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Affiliation(s)
- Dong Wook Kang
- College of Pharmacy, CHA University, 335 Pangyo-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 13488, Republic of Korea
| | - Ju Hee Kim
- College of Pharmacy, CHA University, 335 Pangyo-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 13488, Republic of Korea
| | - Go-Wun Choi
- College of Pharmacy, CHA University, 335 Pangyo-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 13488, Republic of Korea
| | - Seok-Jin Cho
- College of Pharmacy, CHA University, 335 Pangyo-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 13488, Republic of Korea
| | - Hea-Young Cho
- College of Pharmacy, CHA University, 335 Pangyo-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 13488, Republic of Korea.
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2
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Manchuri KM, Shaik MA, Gopireddy VSR, Naziya Sultana, Gogineni S. Analytical Methodologies to Detect N-Nitrosamine Impurities in Active Pharmaceutical Ingredients, Drug Products and Other Matrices. Chem Res Toxicol 2024; 37:1456-1483. [PMID: 39158368 DOI: 10.1021/acs.chemrestox.4c00234] [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: 08/20/2024]
Abstract
Since 2018, N-nitrosamine impurities have become a widespread concern in the global regulatory landscape of pharmaceutical products. This concern arises due to their potential for contamination, toxicity, carcinogenicity, and mutagenicity and their presence in many active pharmaceutical ingredients, drug products, and other matrices. N-Nitrosamine impurities in humans can lead to severe chemical toxicity effects. These include carcinogenic effects, metabolic disruptions, reproductive harm, liver diseases, obesity, DNA damage, cell death, chromosomal alterations, birth defects, and pregnancy loss. They are particularly known to cause cancer (tumors) in various organs and tissues such as the liver, lungs, nasal cavity, esophagus, pancreas, stomach, urinary bladder, colon, kidneys, and central nervous system. Additionally, N-nitrosamine impurities may contribute to the development of Alzheimer's and Parkinson's diseases and type-2 diabetes. Therefore, it is very important to control or avoid them by enhancing effective analytical methodologies using cutting-edge analytical techniques such as LC-MS, GC-MS, CE-MS, SFC, etc. Moreover, these analytical methods need to be sensitive and selective with suitable precision and accuracy, so that the actual amounts of N-nitrosamine impurities can be detected and quantified appropriately in drugs. Regulatory agencies such as the US FDA, EMA, ICH, WHO, etc. need to focus more on the hazards of N-nitrosamine impurities by providing guidance and regular updates to drug manufacturers and applicants. Similarly, drug manufacturers should be more vigilant to avoid nitrosating agents and secondary amines during the manufacturing processes. Numerous review articles have been published recently by various researchers, focusing on N-nitrosamine impurities found in previously notified products, including sartans, metformin, and ranitidine. These impurities have also been detected in a wide range of other products. Consequently, this review aims to concentrate on products recently reported to contain N-nitrosamine impurities. These products include rifampicin, champix, famotidine, nizatidine, atorvastatin, bumetanide, itraconazole, diovan, enalapril, propranolol, lisinopril, duloxetine, rivaroxaban, pioglitazones, glifizones, cilostazol, and sunitinib.
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Affiliation(s)
- Krishna Moorthy Manchuri
- Department of Chemistry, Jawaharlal Nehru Technological University Anantapur, Ananthapuramu, Andhra Pradesh 515002, India
| | - Mahammad Ali Shaik
- Department of Chemistry, Jawaharlal Nehru Technological University Anantapur, Ananthapuramu, Andhra Pradesh 515002, India
| | - Venkata Subba Reddy Gopireddy
- Department of Chemistry, Jawaharlal Nehru Technological University Anantapur, Ananthapuramu, Andhra Pradesh 515002, India
| | - Naziya Sultana
- Analytical Research and Development, IPDO, Dr. Reddy's Laboratories Limited, Hyderabad 500090, India
| | - Sreenivasarao Gogineni
- Department of Chemistry, Acharya Nagarjuna University, Nagarjuna Nagar, Guntur, Andhra Pradesh 522510, India
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Charoenwoodhipong P, Zuelch ML, Keen CL, Hackman RM, Holt RR. Strawberry (Fragaria x Ananassa) intake on human health and disease outcomes: a comprehensive literature review. Crit Rev Food Sci Nutr 2024:1-31. [PMID: 39262175 DOI: 10.1080/10408398.2024.2398634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/13/2024]
Abstract
Strawberries provide a number of potential health promoting phytonutrients to include phenolics, polyphenols, fiber, micronutrients and vitamins. The objective of this review is to provide a comprehensive summary of recent human studies pertaining to the intake of strawberry and strawberry phytonutrients on human health. A literature search conducted through PubMed and Cochrane databases consolidated studies focusing on the effects of strawberry intake on human health. Articles were reviewed considering pre-determined inclusion and exclusion criteria, including experimental or observational studies that focused on health outcomes, and utilized whole strawberries or freeze-dried strawberry powder (FDSP), published between 2000-2023. Of the 60 articles included in this review, 47 were clinical trials, while 13 were observational studies. A majority of these studies reported on the influence of strawberry intake on cardiometabolic outcomes. Study designs included those examining the influence of strawberry intake during the postprandial period, short-term trials randomized with a control, or a single arm intake period controlling with a low polyphenolic diet or no strawberry intake. A smaller proportion of studies included in this review examined the influence of strawberry intake on additional outcomes of aging including bone and brain health, and cancer risk. Data support that the inclusion of strawberries into the diet can have positive impacts during the postprandial period, with daily intake improving outcomes of lipid metabolism and inflammation in those at increased cardiovascular risk.
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Affiliation(s)
- Prae Charoenwoodhipong
- Department of Nutrition, University of California Davis, Davis, California, USA
- Division of Food Science and Nutrition, Faculty of Agricultural Product Innovation and Technology, Srinakharinwirot University, Nakhon Nayok, Thailand
| | - Michelle L Zuelch
- Department of Nutrition, University of California Davis, Davis, California, USA
| | - Carl L Keen
- Department of Nutrition, University of California Davis, Davis, California, USA
| | - Robert M Hackman
- Department of Nutrition, University of California Davis, Davis, California, USA
| | - Roberta R Holt
- Department of Nutrition, University of California Davis, Davis, California, USA
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Martínez-Espinosa JA, Leyva-Ramos R, Medina DI, Aragón-Piña A, Villela-Martínez DE, Carrales-Alvarado DH. Chlorphenamine adsorption on commercial activated carbons: Effect of Operating Conditions and Surface Chemistry. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:113382-113393. [PMID: 37848799 DOI: 10.1007/s11356-023-30216-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 09/27/2023] [Indexed: 10/19/2023]
Abstract
Chlorphenamine (CPA) adsorption onto three activated carbons (ACs), namely, Megapol M (MM), Micro 10 (M10), and GAMA B (GB), was studied in this work. The textural properties, concentrations of active sites, surface charge and point of zero charge of the ACs were assessed. The surface areas (SBET) of MM, GB and M10 were 1107, 812 and 766 m2/g, respectively. The MM surface had an acidic character, while the surfaces of M10 and GB were basic. The adsorption capacity of MM, M10, and GB towards CPA was studied at pH 7 and 11, and the adsorption capacity decreased in the order MM > M10 ≈ GB, which was ascribed to the magnitude of SBET and the concentration of acidic sites. The solution pH significantly increased the adsorption capacity of MM towards CPA by raising the solution pH from 5 to 9, and this behavior was attributed to the electrostatic attraction between the negatively charged surface of MM and the cationic species of CPA. The maximum uptake of CPA adsorbed on MM was 574.6 mg/g at pH = 11 and T = 25 °C. The adsorption capacity of MM was slightly raised by incrementing the temperature. Lastly, the zeta potential measurements of pristine MM and MM saturated with CPA confirmed that the electrostatic attraction predominated in the pH range of 5-9, and the π-π stacking interactions were the principal mechanism of CPA adsorption on MM at pH 11.
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Affiliation(s)
| | - Roberto Leyva-Ramos
- Centro de Investigación y Estudios de Posgrado, Facultad de Ciencias Químicas, Universidad Autónoma de San Luis Potosí, Av. Dr. M. Nava No.6, San Luis Potosí, SLP, 78210, México.
| | - Dora Iliana Medina
- Tecnologico de Monterrey, Institute of Advanced Materials for Sustainable Manufacturing, Monterrey, 64849, Nuevo Leon, México
| | - Antonio Aragón-Piña
- Instituto de Metalurgia, Universidad Autónoma de San Luis Potosí, San Luis Potosí, SLP, 78210, México
| | - Diana Elizabeth Villela-Martínez
- Centro de Investigación y Estudios de Posgrado, Facultad de Ciencias Químicas, Universidad Autónoma de San Luis Potosí, Av. Dr. M. Nava No.6, San Luis Potosí, SLP, 78210, México
| | - Damarys Haidee Carrales-Alvarado
- Centro de Investigación y Estudios de Posgrado, Facultad de Ciencias Químicas, Universidad Autónoma de San Luis Potosí, Av. Dr. M. Nava No.6, San Luis Potosí, SLP, 78210, México
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5
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Ververs TF, Lobbezoo AFH, Hobbelink MG, Braat AJ. Patient Preparation with Esomeprazole Is Comparable to Ranitidine in Meckel Diverticulum Scintigraphy. J Nucl Med Technol 2023; 51:211-214. [PMID: 37316300 DOI: 10.2967/jnmt.123.265558] [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: 02/10/2023] [Revised: 04/20/2023] [Indexed: 06/16/2023] Open
Abstract
To localize ectopic gastric mucosa in patients with unexplained gastrointestinal bleeding and diagnose a Meckel diverticulum, 99mTc-pertechnetate imaging is the standard procedure. H2 inhibitor pretreatment enhances the sensitivity of the scan by reducing washout of 99mTc activity from the intestinal lumen. We aim to provide evidence of the effectiveness of the proton pump inhibitor esomeprazole as an ideal substitute for ranitidine. Methods: The scan quality for 142 patients who underwent a Meckel scan during a period of 10 y was evaluated. The patients were pretreated with ranitidine orally or intravenously before a switch to a proton pump inhibitor after ranitidine was no longer available. Good scan quality was characterized by the absence of 99mTc-pertechnetate activity in the gastrointestinal lumen. The effectiveness of esomeprazole to diminish 99mTc-pertechnetate release was compared with the standard treatment using ranitidine. Results: Pretreatment with intravenous esomeprazole resulted in 48% of scans with no 99mTc-pertechnetate release, 17% with release either in the intestine or in the duodenum, and 35% with 99mTc-pertechnetate activity both in the intestine and in the duodenum. Evaluation of scans obtained after oral ranitidine and intravenous ranitidine showed absence of activity in both intestine and duodenum in 16% and 23% of the cases, respectively. The indicated time to administer esomeprazole before starting the scan procedure was 30 min, but a delay of 15 min did not negatively influence the scan quality. Conclusion: This study confirms that esomeprazole, 40 mg, when administered intravenously 30 min before a Meckel scan, enhances the scan quality comparably to ranitidine. This procedure can be incorporated into protocols.
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Affiliation(s)
- Tessa F Ververs
- Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Utrecht, The Netherlands;
- Department of Clinical Pharmacy, University Medical Centre Utrecht, Utrecht, The Netherlands; and
| | | | - Monique G Hobbelink
- Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Arthur J Braat
- Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Utrecht, The Netherlands
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6
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Kang H, Nam CM, Choi DW, Park S. Effects of ranitidine and nizatidine on the risk of gastrointestinal cancer. Front Oncol 2023; 13:1182174. [PMID: 37576886 PMCID: PMC10415903 DOI: 10.3389/fonc.2023.1182174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 07/10/2023] [Indexed: 08/15/2023] Open
Abstract
Purpose Gastrointestinal (GI) cancer occurs in digestive organs such as the stomach, colon, liver, esophagus, and pancreas. About 83,034 cases occurred in Korea alone in 2020. Dietary factors, alcohol consumption, Helicobacter pylori (H. pylori), and lifestyle factors increase the incidence of diseases such as gastritis, peptic ulcer, pancreatitis, and gastroesophageal reflux disease (GERD), which can develop into GI cancer. However, in 2019, the US Food and Drug Administration announced that the drugs ranitidine and nizatidine, which are used for digestive disorders, contain carcinogens. In this study, we investigated the effects of ranitidine and nizatidine on the development of GI cancer. Materials and methods In this study, using National Health Insurance Service-National Sample Cohort (NHIS-NSC) version 2.5 (updated from 2002 to 2019), subjects who developed GI cancer were enrolled in the case group, and those who were at risk of, but did not develop, cancer were enrolled in the control group. Thereafter, risk-set matching was performed (1:3 ratio) by sex and age at the time of diagnosis of cancer in the case group. Through this procedure, 22,931 cases and 68,793 controls were identified. The associations of ranitidine and/or nizatidine with GI cancer were confirmed by adjusted odds ratios (aORs) and 95% confidence intervals (CIs) calculated through conditional logistic regression analysis. Results The aORs of ranitidine and/or nizatidine users were lower than those of nonusers in all average prescription days groups (< 30 days/year: aOR [95% CI] = 0.79 [0.75-0.82]; 30-59 days/year: aOR [95% CI] = 0.66 [0.59-0.73]; 60-89 days/year: aOR [95% CI] = 0.69 [0.59-0.81]; ≥ 90 days/year: aOR [95% CI] = 0.69 [0.59-0.79]). Sensitivity analyses were conducted with different lag periods for the onset of GI cancer after drug administration, and these analyses yielded consistent results. Additional analyses were also performed by dividing subjects into groups based on cancer types and CCI scores, and these analyses produced the same results. Conclusion Our study, using nationwide retrospective cohort data, did not find evidence suggesting that ranitidine and nizatidine increase the risk of GI cancer. In fact, we observed that the incidence of GI cancer was lower in individuals who used the drugs compared to nonusers. These findings suggest a potential beneficial effect of these drugs on cancer risk, likely attributed to their ability to improve digestive function.
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Affiliation(s)
- Hyejung Kang
- Department of Health Informatics and Biostatistics, Graduate School of Public Health, Yonsei University, Seoul, Republic of Korea
| | - Chung Mo Nam
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Dong-Woo Choi
- Cancer Big Data Center, National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea
| | - Sohee Park
- Department of Health Informatics and Biostatistics, Graduate School of Public Health, Yonsei University, Seoul, Republic of Korea
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Armijo AL, Thongararm P, Fedeles BI, Yau J, Kay J, Corrigan JJ, Chancharoen M, Chawanthayatham S, Samson L, Carrasco S, Engelward B, Fox J, Croy R, Essigmann J. Molecular origins of mutational spectra produced by the environmental carcinogen N-nitrosodimethylamine and S N1 chemotherapeutic agents. NAR Cancer 2023; 5:zcad015. [PMID: 36992846 PMCID: PMC10041537 DOI: 10.1093/narcan/zcad015] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 02/14/2023] [Accepted: 03/16/2023] [Indexed: 03/29/2023] Open
Abstract
DNA-methylating environmental carcinogens such as N-nitrosodimethylamine (NDMA) and certain alkylators used in chemotherapy form O 6-methylguanine (m6G) as a functionally critical intermediate. NDMA is a multi-organ carcinogen found in contaminated water, polluted air, preserved foods, tobacco products, and many pharmaceuticals. Only ten weeks after exposure to NDMA, neonatally-treated mice experienced elevated mutation frequencies in liver, lung and kidney of ∼35-fold, 4-fold and 2-fold, respectively. High-resolution mutational spectra (HRMS) of liver and lung revealed distinctive patterns dominated by GC→AT mutations in 5'-Pu-G-3' contexts, very similar to human COSMIC mutational signature SBS11. Commonly associated with alkylation damage, SBS11 appears in cancers treated with the DNA alkylator temozolomide (TMZ). When cells derived from the mice were treated with TMZ, N-methyl-N-nitrosourea, and streptozotocin (two other therapeutic methylating agents), all displayed NDMA-like HRMS, indicating mechanistically convergent mutational processes. The role of m6G in shaping the mutational spectrum of NDMA was probed by removing MGMT, the main cellular defense against m6G. MGMT-deficient mice displayed a strikingly enhanced mutant frequency, but identical HRMS, indicating that the mutational properties of these alkylators is likely owed to sequence-specific DNA binding. In sum, the HRMS of m6G-forming agents constitute an early-onset biomarker of exposure to DNA methylating carcinogens and drugs.
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Affiliation(s)
- Amanda L Armijo
- Department of Chemistry, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
- Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
- Center for Environmental Health Sciences, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
- Division of Comparative Medicine, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Pennapa Thongararm
- Department of Chemistry, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
- Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
- Center for Environmental Health Sciences, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Bogdan I Fedeles
- Department of Chemistry, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
- Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
- Center for Environmental Health Sciences, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Judy Yau
- Department of Chemistry, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
- Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
- Center for Environmental Health Sciences, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Jennifer E Kay
- Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
- Center for Environmental Health Sciences, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Joshua J Corrigan
- Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
- Center for Environmental Health Sciences, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Marisa Chancharoen
- Department of Chemistry, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
- Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
- Center for Environmental Health Sciences, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Supawadee Chawanthayatham
- Department of Chemistry, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
- Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
- Center for Environmental Health Sciences, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Leona D Samson
- Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
- Center for Environmental Health Sciences, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
- Department of Biology, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Sebastian E Carrasco
- Division of Comparative Medicine, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
- Laboratory of Comparative Pathology, Memorial Sloan Kettering Cancer Center, Weill Cornell Medicine, and The Rockefeller University, New York, NY 10065, USA
| | - Bevin P Engelward
- Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
- Center for Environmental Health Sciences, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - James G Fox
- Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
- Center for Environmental Health Sciences, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
- Division of Comparative Medicine, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Robert G Croy
- Department of Chemistry, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
- Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
- Center for Environmental Health Sciences, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - John M Essigmann
- Department of Chemistry, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
- Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
- Center for Environmental Health Sciences, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
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Sulay R, Mathew J, Krishnan A, Thomas DVI. Comprehensive computational study on reaction mechanism of N-Nitroso dimethyl amine formation from substituted hydrazine derivatives during ozonation. Heliyon 2023; 9:e14511. [PMID: 36967895 PMCID: PMC10033754 DOI: 10.1016/j.heliyon.2023.e14511] [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: 05/26/2022] [Revised: 03/09/2023] [Accepted: 03/09/2023] [Indexed: 03/18/2023] Open
Abstract
N- Nitrosodimethyl amine, the simplest member of the N-Nitrosamine family, is a carcinogenic and mutagenic agent that has gained considerable research interest owing to its toxic nature. Ozonation of industrially important hydrazines, such as unsymmetrical dimethylhydrazine (UDMH) or monomethylhydrazine (MMH), has been associated with NDMA formation and accumulation in the environment. UDMH/MMH - ozonation also leads to several other transformation products such as acetaldehyde dimethyl hydrazine (ADMH), tetramethyl tetra azene (TMT), diazomethane, methyl diazene, etc, which can be either precursors or competitors for NDMA formation. However, the relevant chemistry detailing the formation of these transformation products from UDMH/MMH -ozone reaction and their subsequent conversion to NDMA is not well understood. In this work, we explored the formation mechanism of ADMH and TMT from UDMH-ozonation and their further oxidation to NDMA using the second-order Moller Plesset perturbation theory employing the 6-311G(d) basis set. We have also investigated how MMH selectively forms methyl diazene and diazomethane under normal conditions and NDMA in the presence of excess ozone. Our calculations indicate that the reactions proceed via an initial H abstraction from the hydrazine -NH2 group, followed by the oxidation of the generated N-radical species. The formation of ADMH from the UDMH-ozone reaction involves an acetaldehyde intermediate, which then reacts with a second UDMH molecule to generate ADMH. The preferable attack of ozone molecule on N=C bond of ADMH generates DMAN intermediate, which subsequently undergoes oxidation to form NDMA. Unlike other transformation products, TMT formation occurs via the dimerization of DMAN. 1Though there exists an N=N bond in the TMT, which are preferable attacking sites for ozone, experimental studies show the lower yields of NDMA formation, which corroborates with the high activation barrier required for the process (42 kcal/mol). Overall, our calculated results agree well with the experimental observations and rate constants. Computational calculations bring new insights into the electronic nature and kinetics of the elementary reactions of this pathway, enabled by computed energies of structures that are not possible to access experimentally.
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Affiliation(s)
- Rehin Sulay
- Department of Chemistry, CMS College (Autonomous), Kottayam, 686001, Kerala, India
| | - Jintumol Mathew
- Department of Chemistry, CMS College (Autonomous), Kottayam, 686001, Kerala, India
| | - Anandhu Krishnan
- Department of Chemistry, CMS College (Autonomous), Kottayam, 686001, Kerala, India
| | - Dr. Vibin Ipe Thomas
- Department of Chemistry, CMS College (Autonomous), Kottayam, 686001, Kerala, India
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Prculovska M, Acevska J, Poceva Panovska A, Nakov N, Dimtirovska A, Brezovska K. Root causes for presence of nitrosamine impurities in active pharmaceutical substances and finished pharmaceutical products. MAKEDONSKO FARMACEVTSKI BILTEN 2022. [DOI: 10.33320/maced.pharm.bull.2022.68.03.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Affiliation(s)
- Milena Prculovska
- REPLEK FARM Ltd., Quality Control Department, Kozle No. 188, 1000 Skopje, R.N. Macedonia
| | - Jelena Acevska
- Institute of Applied Chemistry and Pharmaceutical Analysis, Faculty of Pharmacy, University Ss. Cyril and Methodius, Majka Tereza 47, 1000 Skopje, R.N. Macedonia
| | - Ana Poceva Panovska
- Institute of Applied Chemistry and Pharmaceutical Analysis, Faculty of Pharmacy, University Ss. Cyril and Methodius, Majka Tereza 47, 1000 Skopje, R.N. Macedonia
| | - Natalija Nakov
- Institute of Applied Chemistry and Pharmaceutical Analysis, Faculty of Pharmacy, University Ss. Cyril and Methodius, Majka Tereza 47, 1000 Skopje, R.N. Macedonia
| | - Aneta Dimtirovska
- Institute of Applied Chemistry and Pharmaceutical Analysis, Faculty of Pharmacy, University Ss. Cyril and Methodius, Majka Tereza 47, 1000 Skopje, R.N. Macedonia
| | - Katerina Brezovska
- Institute of Applied Chemistry and Pharmaceutical Analysis, Faculty of Pharmacy, University Ss. Cyril and Methodius, Majka Tereza 47, 1000 Skopje, R.N. Macedonia
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10
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Ziavrou KS, Noguera S, Boumba VA. Trends in counterfeit drugs and pharmaceuticals before and during COVID-19 pandemic. Forensic Sci Int 2022; 338:111382. [PMID: 35882074 PMCID: PMC9277998 DOI: 10.1016/j.forsciint.2022.111382] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 06/15/2022] [Accepted: 07/08/2022] [Indexed: 11/26/2022]
Abstract
Counterfeit, fake, adulterated or falsified drugs and pharmaceuticals, could be branded or generic drugs, excipients and active substances (in drugs and vaccines), medical supplies and devices, etc, intended to pass as the original. Counterfeits are always inferior in terms of quality, safety and efficacy compared to the original pharmaceuticals, and subsequently, they pose an unpredictable risk to public health and lead to loss of confidence in medicines, healthcare providers, and health systems. In the decades before the outbreak of the COVID-19 pandemic, a constant trend of increased trafficking was reported. However, the pandemic created a combination of public health emergency, economic distress, and misinformation-driven panic that made problematic the access and supply of high quality essential medicines and health products, and pushed consumers and vendors even more towards counterfeit pharmaceuticals. This contribution aims to review the trends in counterfeit drugs and pharmaceuticals trafficking, the health impact of their use, as well as, measures and actions implemented to restrict their proliferation, before and during COVID-19 pandemic; the relative recommendations, the expressed perspectives and the existing limitations are thoroughly discussed.
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Affiliation(s)
- Kalliroi S Ziavrou
- Unit of Toxicology, Department of Forensic Medicine & Toxicology, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece.
| | - Stephen Noguera
- George C. Marshall European Center for Security Studies, Garmisch-Partenkirchen, Germany.
| | - Vassiliki A Boumba
- Unit of Toxicology, Department of Forensic Medicine & Toxicology, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece.
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11
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Kumar S, Goldberg DS, Kaplan DE. Ranitidine Use and Gastric Cancer Among Persons with Helicobacter pylori. Dig Dis Sci 2022; 67:1822-1830. [PMID: 33856609 DOI: 10.1007/s10620-021-06972-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 03/24/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND The Food and Drug Administration requested withdrawal of ranitidine formulations, due to a potentially carcinogenic contaminant, N-nitrosodimethylamine. AIMS We evaluate whether ranitidine use is associated with gastric cancer. METHODS This is a retrospective multicenter, nationwide cohort study within the Veterans Health Administration, among patients with Helicobacter pylori (HP) prescribed long-term acid suppression with either: (1) ranitidine, (2) other histamine type 2 receptor blocker (H2RB), or (3) proton pump inhibitor (PPI)) between May 1, 1998, and December 31, 2018. Covariates included race, ethnicity, smoking, age, HP treatment, HP eradication. Primary outcome was non-proximal gastric adenocarcinomas, using multivariable Cox proportional hazards analysis. RESULTS We identified 279,505 patients with HP prescribed long-term acid suppression (median 53.4 years; 92.9% male). Compared to ranitidine, non-ranitidine H2RB users were more likely to develop cancer (HR 1.83, 95%CI 1.36-2.48); PPI users had no significant difference in future cancer risk (HR 0.92, 95% CI 0.82-1.04), p < 0.001. Demographics associated with future cancer included increasing age (HR 1.18, 95% CI 1.15-1.20, p < 0.001), Hispanic/Latino ethnicity (HR 1.46, 95% CI 1.21-1.75, p < 0.001), Black race (HR 1.89, 95% CI 1.68-2.14) or Asian race (HR 2.03, 95% CI 1.17-3.52), p < 0.001, and gender (female gender HR 0.64, 95% CI 0.48-0.85, p = 0.02). Smoking was associated with future cancer (HR 1.38, 95% CI 1.23-1.54, p < 0.001). Secondary analysis demonstrated decreased cancer risk in those with confirmed HP eradication (HR 0.24, 95% CI 0.14-0.40). No association between ranitidine and increased gastric cancer was found. CONCLUSION There is no demonstrable association between ranitidine use and future gastric cancer among individuals with HP on long-term acid suppression.
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Affiliation(s)
- Shria Kumar
- Division of Gastroenterology and Hepatology, Perelman School of Medicine, University of Pennsylvania, PCAM 7S GI, 3400 Civic Center Drive, Philadelphia, PA, 19104, USA.
| | - David S Goldberg
- Division of Digestive Health and Liver Diseases, Department of Medicine, University of Miami Miller School of Medicine, Miami, USA
| | - David E Kaplan
- Division of Gastroenterology and Hepatology, Perelman School of Medicine, University of Pennsylvania, PCAM 7S GI, 3400 Civic Center Drive, Philadelphia, PA, 19104, USA
- Division of Gastroenterology, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, USA
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12
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Milano L, Charlier CF, Andreguetti R, Cox T, Healing E, Thomé MP, Elliott RM, Samson LD, Masson JY, Lenz G, Henriques JAP, Nohturfft A, Meira LB. A DNA repair-independent role for alkyladenine DNA glycosylase in alkylation-induced unfolded protein response. Proc Natl Acad Sci U S A 2022; 119:e2111404119. [PMID: 35197283 PMCID: PMC8892324 DOI: 10.1073/pnas.2111404119] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 01/08/2022] [Indexed: 01/25/2023] Open
Abstract
Alkylating agents damage DNA and proteins and are widely used in cancer chemotherapy. While cellular responses to alkylation-induced DNA damage have been explored, knowledge of how alkylation affects global cellular stress responses is sparse. Here, we examined the effects of the alkylating agent methylmethane sulfonate (MMS) on gene expression in mouse liver, using mice deficient in alkyladenine DNA glycosylase (Aag), the enzyme that initiates the repair of alkylated DNA bases. MMS induced a robust transcriptional response in wild-type liver that included markers of the endoplasmic reticulum (ER) stress/unfolded protein response (UPR) known to be controlled by XBP1, a key UPR effector. Importantly, this response is significantly reduced in the Aag knockout. To investigate how AAG affects alkylation-induced UPR, the expression of UPR markers after MMS treatment was interrogated in human glioblastoma cells expressing different AAG levels. Alkylation induced the UPR in cells expressing AAG; conversely, AAG knockdown compromised UPR induction and led to a defect in XBP1 activation. To verify the requirements for the DNA repair activity of AAG in this response, AAG knockdown cells were complemented with wild-type Aag or with an Aag variant producing a glycosylase-deficient AAG protein. As expected, the glycosylase-defective Aag does not fully protect AAG knockdown cells against MMS-induced cytotoxicity. Remarkably, however, alkylation-induced XBP1 activation is fully complemented by the catalytically inactive AAG enzyme. This work establishes that, besides its enzymatic activity, AAG has noncanonical functions in alkylation-induced UPR that contribute to cellular responses to alkylation.
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Affiliation(s)
- Larissa Milano
- Department of Clinical and Experimental Medicine, Faculty of Health and Medical Sciences, University of Surrey, GU2 7WG Guildford, United Kingdom
- Center of Biotechnology, Federal University of Rio Grande do Sul, 91501-970 Porto Alegre, Brazil
- Genome Stability Laboratory, CHU de Quebec Research Center, HDQ Pavilion, Oncology Axis, Québec City, QC G1R 3S3, Canada
- Department of Molecular Biology, Medical Biochemistry and Pathology, Laval University Cancer Center, Quebec City, QC G1V 0A6, Canada
| | - Clara F Charlier
- Department of Clinical and Experimental Medicine, Faculty of Health and Medical Sciences, University of Surrey, GU2 7WG Guildford, United Kingdom
| | - Rafaela Andreguetti
- Department of Clinical and Experimental Medicine, Faculty of Health and Medical Sciences, University of Surrey, GU2 7WG Guildford, United Kingdom
| | - Thomas Cox
- Department of Clinical and Experimental Medicine, Faculty of Health and Medical Sciences, University of Surrey, GU2 7WG Guildford, United Kingdom
| | - Eleanor Healing
- Department of Nutritional Sciences, Faculty of Health and Medical Sciences, University of Surrey, GU2 7XH Guildford, United Kingdom
| | - Marcos P Thomé
- Department of Biophysics, Federal University of Rio Grande do Sul, 91501-970 Porto Alegre, Brazil
| | - Ruan M Elliott
- Department of Nutritional Sciences, Faculty of Health and Medical Sciences, University of Surrey, GU2 7XH Guildford, United Kingdom
| | - Leona D Samson
- Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139
- Department of Biology, Massachusetts Institute of Technology, Cambridge, MA 02139
| | - Jean-Yves Masson
- Genome Stability Laboratory, CHU de Quebec Research Center, HDQ Pavilion, Oncology Axis, Québec City, QC G1R 3S3, Canada
- Department of Molecular Biology, Medical Biochemistry and Pathology, Laval University Cancer Center, Quebec City, QC G1V 0A6, Canada
| | - Guido Lenz
- Center of Biotechnology, Federal University of Rio Grande do Sul, 91501-970 Porto Alegre, Brazil
- Department of Biophysics, Federal University of Rio Grande do Sul, 91501-970 Porto Alegre, Brazil
| | - João Antonio P Henriques
- Center of Biotechnology, Federal University of Rio Grande do Sul, 91501-970 Porto Alegre, Brazil
- Department of Biophysics, Federal University of Rio Grande do Sul, 91501-970 Porto Alegre, Brazil
| | - Axel Nohturfft
- Molecular and Clinical Sciences Research Institute, St. George's University of London, SW17 0RE London, United Kingdom
| | - Lisiane B Meira
- Department of Clinical and Experimental Medicine, Faculty of Health and Medical Sciences, University of Surrey, GU2 7WG Guildford, United Kingdom;
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13
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Muguruma Y, Nunome M, Inoue K. A Review on the Foodomics Based on Liquid Chromatography Mass Spectrometry. Chem Pharm Bull (Tokyo) 2022; 70:12-18. [PMID: 34980727 DOI: 10.1248/cpb.c21-00765] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Due to the globalization of food production and distribution, the food chain has become increasingly complex, making it more difficult to evaluate unexpected food changes. Therefore, establishing sensitive, robust, and cost-effective analytical platforms to efficiently extract and analyze the food-chemicals in complex food matrices is essential, however, challenging. LC/MS-based metabolomics is the key to obtain a broad overview of human metabolism and understand novel food science. Various metabolomics approaches (e.g., targeted and/or untargeted) and sample preparation techniques in food analysis have their own advantages and limitations. Selecting an analytical platform that matches the characteristics of the analytes is important for food analysis. This review highlighted the recent trends and applications of metabolomics based on "foodomics" by LC-MS and provides the perspectives and insights into the methodology and various sample preparation techniques in food analysis.
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Affiliation(s)
- Yoshio Muguruma
- Graduate School of Pharmaceutical Sciences, Ritsumeikan University
| | - Mari Nunome
- Graduate School of Pharmaceutical Sciences, Ritsumeikan University
| | - Koichi Inoue
- Graduate School of Pharmaceutical Sciences, Ritsumeikan University
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14
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White CM, Browne T, Nafziger AN. Inherent Dangers of Using Non-US Food and Drug Administration-Approved Substances of Abuse. J Clin Pharmacol 2021; 61 Suppl 2:S129-S141. [PMID: 34396559 DOI: 10.1002/jcph.1860] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 03/17/2021] [Indexed: 12/25/2022]
Abstract
Use of US Food and Drug Administration-approved substances of abuse has innate risks due to pharmacologic and pharmacokinetic properties of the medications, but the risk when using nonapproved drug products is much greater. Unbeknownst to the user, the dose of active ingredients in substances of abuse can vary substantially between different products because of manufacturing practices or improper storage. Even naturally occurring substances of abuse can have extensive dosage variability because of effects of the growing season and conditions, or differences in harvesting, storage, or manufacture of the finished products. Many illicit substances are adulterated, to make up for intentional underdosing or to enhance the effect of the intended active ingredient. These adulterants can be dangerous and produce direct cardiovascular, neurologic, hematologic, or dermatologic reactions or obscure adverse effects. Finally, an illicit substance can be contaminated or substituted for another one during its manufacture, leading to differences in adverse events, adverse event severity, or the drug interaction profile. Substances can be contaminated with microbes that induce infections or heavy metals that can damage organs or cause cancer. This milieu of undisclosed substances can also induce drug interactions. For reasons that are discussed, individuals who use substances of abuse are at increased risk of morbidity or mortality if they develop coronavirus disease 2019. Health professionals who treat patients with acute, urgent events associated with substances of abuse, or those treating the chronic manifestations of addiction, need to appreciate the complex and variable composition of substances of abuse and their potential health effects.
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Affiliation(s)
- C Michael White
- Pharmacy Practice, University of Connecticut School of Pharmacy, Storrs, Connecticut, USA.,HOPES Research Group, UConn and Hartford Hospital, Hartford, Connecticut, USA
| | - Thom Browne
- Rubicon Global Enterprises & Colombo Plan Secretariat, Huachuca City, Arizona, USA
| | - Anne N Nafziger
- Bertino Consulting, Schenectady, New York, USA.,Department of Pharmacy Practice, School of Pharmacy & Pharmaceutical Sciences, University at Buffalo, State University of New York, Buffalo, New York, USA
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15
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Influencing Factors in N-nitrosodimethylamine (NDMA) Impurity Detection in Ranitidine and Possible Reactivity of other Histamine H2 Receptor Antagonists. J Pharm Innov 2021. [DOI: 10.1007/s12247-021-09578-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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16
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Cardwell CR, McDowell RD, Hughes CM, Hicks B, Murchie P. Exposure to Ranitidine and Risk of Bladder Cancer: A Nested Case-Control Study. Am J Gastroenterol 2021; 116:1612-1619. [PMID: 34028367 DOI: 10.14309/ajg.0000000000001310] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 04/12/2021] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Ranitidine has been shown to contain the carcinogen N-nitrosodimethylamine and increase urinary N-nitrosodimethylamine in humans. We investigated whether ranitidine use is associated with increased bladder cancer risk. METHODS A nested case-control study was conducted within the Primary Care Clinical Informatics Unit Research database which contains general practice records from Scotland. Bladder cancer cases, diagnosed between 1999 and 2011, were identified and matched with up to 5 controls (based on age, sex, general practice, and date of registration). Ranitidine, other histamine-2 receptor agonists, and proton pump inhibitors were identified from prescribing records. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using conditional logistic regression after adjusting for comorbidities and smoking. RESULTS There were 3,260 cases and 14,037 controls. There was evidence of an increased risk of bladder cancer in ranitidine users, compared with nonusers (fully adjusted OR = 1.22; 95% CI 1.06-1.40), which was more marked with use for over 3 years of ranitidine (fully adjusted OR = 1.43; 95% CI 1.05-1.94). By contrast, there was little evidence of any association between proton pump inhibitor use and bladder cancer risk based on any use (fully adjusted OR = 0.98; 95% CI 0.88-1.11) or over 3 years of use (fully adjusted OR = 0.98; 95% CI 0.80-1.20). DISCUSSION In this large population-based study, the use of ranitidine particularly long-term use was associated with an increased risk of bladder cancer. Further studies are necessary to attempt to replicate this finding in other settings.
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Affiliation(s)
- Chris R Cardwell
- Center for Public Health, Queen's University, Belfast, County Antrim, UK
| | - Ronald D McDowell
- Center for Public Health, Queen's University, Belfast, County Antrim, UK
| | - Carmel M Hughes
- School of Pharmacy, Queen's University, Belfast, County Antrim, UK
| | - Blánaid Hicks
- Center for Public Health, Queen's University, Belfast, County Antrim, UK
| | - Peter Murchie
- Division of Applied Health Sciences Section, Academic Primary Care, Foresterhill, Aberdeen, UK
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17
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Affiliation(s)
- C Michael White
- Health Outcomes, Policy, and Evidence Synthesis (HOPES) Group, School of Pharmacy, University of Connecticut, Storrs
- Research Administration, Hartford Hospital, Hartford, Connecticut
| | - Adrian V Hernandez
- Health Outcomes, Policy, and Evidence Synthesis (HOPES) Group, School of Pharmacy, University of Connecticut, Storrs
- Research Administration, Hartford Hospital, Hartford, Connecticut
- Unidad de Revisiones Sistemáticas y Meta-análisis (URSIGET), Vicerrectorado de Investigación, Universidad San Ignacio de Loyola (USIL), Lima, Peru
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18
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Nasr NEH, Metwaly MG, Ahmed EO, Fares AR, ElMeshad AN. Investigating the root cause of N-nitrosodimethylamine formation in metformin pharmaceutical products. Expert Opin Drug Saf 2021; 20:855-862. [PMID: 33849366 DOI: 10.1080/14740338.2021.1917547] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND FDA limited N-nitrosodimethylamine (NDMA) - a carcinogenic impurity formed during metformin (MET) tablets manufacturing - level to 96 ng/day; a step which led to recall of MET products. This work aims to investigate the root cause of NDMA formation during MET tablets manufacturing. RESEARCH DESIGN AND METHODS We focused on three main contributing causes: use of water and heat during intra-granulation, and the nitrite/nitrate quantities in excipients. Thirteen MET tablet formulations (immediate or sustained-release) were manufactured, on batch level. Each batch was manufactured using one excipient and excluding one cause at a time and NDMA level was assayed. RESULTS NDMA traces were undetectable in MET tablets manufactured using polyvinyl pyrrolidone or hydroxypropyl cellulose SSL, even when water and/or heat were employed during intra-granulation. Levels of NDMA in MET tablets with hydroxypropyl methyl cellulose (HPMC) E5 or carboxymethyl cellulose sodium 4000 were 67.08 ± 2.3 and 66.21 ± 2.5 ng/day, in the presence of water and/or heat. No impact of employing extra-granular PolyoxTM, HPMC E5 or HPMC K15 on NDMA formation, despite the high nitrite and nitrate content in these excipients. CONCLUSIONS Water, heat, and excipients' nitrite and nitrate levels are the key players, which should collectively exist, to cause NDMA formation during MET tablets manufacturing.
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Affiliation(s)
- Nasr Eldin Hussein Nasr
- Research and Development Department, Al Esraa Pharmaceutical Optima, Badr City, Cairo, Egypt
| | - Metwaly Gamel Metwaly
- Research and Development Department, Al Esraa Pharmaceutical Optima, Badr City, Cairo, Egypt
| | - Eman Osama Ahmed
- Research and Development Department, Al Esraa Pharmaceutical Optima, Badr City, Cairo, Egypt
| | - Ahmed Roshdy Fares
- Pharmaceutics and Industrial Pharmacy Department, Faculty of Pharmacy, Cairo University, Cairo, Egypt
| | - Aliaa Nabil ElMeshad
- Pharmaceutics and Industrial Pharmacy Department, Faculty of Pharmacy, Cairo University, Cairo, Egypt.,Faculty of Nanotechnology for Postgraduate Studies, Cairo University, El-Sheikh Zayed, Giza, Egypt
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19
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Abstract
A product recall is the outcome of a careful pharmacovigilance; and it is an integral part of drug regulation. Among various reasons for product recall, the detection of unacceptable levels of carcinogenic impurities is one of the most serious concerns. The genotoxic and carcinogenic potential of N-nitrosamines raises a serious safety concern, and in September 2020, the FDA issued guidance for the pharmaceutical industry regarding the control of nitrosamines in drug products. The FDA database shows that >1400 product lots have been recalled from the market due to the presence of carcinogenic N-nitrosamine impurities at levels beyond the acceptable intake limit of 26.5 ng/day. The drugs that were present in recalled products include valsartan, irbesartan, losartan, metformin, ranitidine, and nizatidine. This perspective provides a critical account of these product recalls with an emphasis on the source and mechanism for the formation of N-nitrosamines in these products.
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Affiliation(s)
- Sonali S Bharate
- Shobhaben Pratapbhai Patel School of Pharmacy & Technology Management, SVKM's NMIMS, V.L. Mehta Road, Vile Parle (W), Mumbai 400056, India
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20
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Řemínek R, Foret F, Chung DS. Application of capillary electrophoresis-nano-electrospray ionization-mass spectrometry for the determination of N-nitrosodimethylamine in pharmaceuticals. Electrophoresis 2021; 42:334-341. [PMID: 33368407 DOI: 10.1002/elps.202000303] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 12/10/2020] [Accepted: 12/11/2020] [Indexed: 11/09/2022]
Abstract
After a presence of highly hepatotoxic and potentially carcinogenic N-nitrosodimethylamine was detected in certain lots of sartan, ranitidine, metformin, and other pharmaceuticals, local regulatory authorities issued recalls of suspected products, and concerns of the pharmacotherapy safety were widely discussed. Since then, testing of a representative sample of each produced lot of these pharmaceuticals is required as a part of quality control processes. Hence, an interface-free CE-nanoESI system coupled with MS detection was employed for the development of a simple and economical method for quantitative detection of this contaminant in the valsartan drug substances and finished formulations used as model matrices. In this arrangement, a fused-silica capillary was used as both a separation column and a nanoESI emitter providing high ionization efficiency and sensitivity. The optimized procedure was found to have sufficient selectivity, linearity, accuracy, and precision. The established LOD and LOQ values were 0.3 and 1.0 ng/mL, respectively. The practical applicability of the method was tested by analyses of commercially available Valsacor® tablets. The results obtained prove that the developed procedure represents a promising alternative to currently available GC- and LC-based methods. Furthermore, after an adjustment of the separation conditions, the CE-nanoESI/MS system can be conceptually used for the determination of NDMA in other suspected pharmaceuticals.
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Affiliation(s)
- Roman Řemínek
- Institute of Analytical Chemistry of the Czech Academy of Sciences, v. v. i., Brno, Czech Republic
| | - František Foret
- Institute of Analytical Chemistry of the Czech Academy of Sciences, v. v. i., Brno, Czech Republic
| | - Doo Soo Chung
- Department of Chemistry, Seoul National University, Seoul, Korea
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21
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Farmer KC. Stress and strain on the U.S. drug supply: The intersection of shortages, globalization, counterfeit products, and throw in a global COVID-19 pandemic. J Am Pharm Assoc (2003) 2021; 61:e85-e86. [PMID: 33419525 DOI: 10.1016/j.japh.2020.11.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 11/24/2020] [Indexed: 10/22/2022]
Affiliation(s)
- Kevin C Farmer
- College of Pharmacy, University of Oklahoma Health Sciences Center, University of Oklahoma, Oklahoma City, OK
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22
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Affiliation(s)
- C Michael White
- Pharmacy Practice, School of Pharmacy, University of Connecticut, Storrs
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23
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Hong M, Shcherbakova N. Comparison of Discounted and Undiscounted Cash Prices for Cardiovascular Medications by Type of US Community Pharmacy. J Gen Intern Med 2021; 36:114-120. [PMID: 32885368 PMCID: PMC7859140 DOI: 10.1007/s11606-020-06149-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 08/12/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Cash prices for prescription drugs vary among community pharmacies in the USA. GoodRx is a discount platform that provides coupons for use in community pharmacies without a membership requirement. Analytical pharmacy is a new type of pharmacy that tests drugs before dispensing to verify medication quality. OBJECTIVE To compare undiscounted and GoodRx-discounted cash prices for common cardiovascular (CV) drugs by pharmacy type. DESIGN A cross-sectional study. SETTING GoodRx-discounted and GoodRx-undiscounted cash price data; analytical pharmacy cash price data (all data collected in July 2020). MEASUREMENTS GoodRx cash price data for 30 units of 41 generic and 16 brand-name common cardiovascular medications at mass merchandiser, regional supermarket, two national chains, and analytical pharmacy (only one of its kind in the USA). RESULTS The average (SD) undiscounted generic CV medication cash price was $42.41 (44.1). The average GoodRx-discounted generic CV medication cash prices were $11.01 (8.6), $9.88 (6.7), $17.85 (10.5), and $21.73 (14.1) in mass merchandiser, supermarket, and two national chain pharmacies, respectively. The average generic CV medication cash price was $20.84 (25.7) at the analytical pharmacy. The average (SD) undiscounted brand-name CV medication cash price was $368.33 (127.00). The average GoodRx-discounted brand-name CV medication cash prices were $269.16 (118.1), $258.84 (108.6), $270.28 (118.4), and $274.60 (122.50) for mass merchandiser, supermarket, and two national chain pharmacies, respectively. The average (SD) brand-name CV medication cash price was $365.12 (116.20) at the analytical pharmacy. CONCLUSIONS GoodRx-discounted cash prices of generic CV medications were significantly lower than undiscounted cash prices at supermarket, mass merchandiser, and national chain pharmacies. Analytical pharmacy cash prices too were significantly lower than traditional pharmacy undiscounted cash prices. GoodRx-discounted prices for brand-name CV medications did not differ significantly from undiscounted cash prices and between pharmacy types.
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Affiliation(s)
- Minji Hong
- College of Pharmacy and Health Sciences, Western New England University, , 1215 Wilbraham Rd., Springfield, MA, 01119, USA
| | - Natalia Shcherbakova
- College of Pharmacy and Health Sciences, Western New England University, , 1215 Wilbraham Rd., Springfield, MA, 01119, USA.
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24
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White CM. Current System of Overseeing Drug Trials in Developing Countries by the FDA Is Dangerous. Ann Pharmacother 2020; 54:928-932. [PMID: 32037852 DOI: 10.1177/1060028020906484] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Clinical research used to substantiate Food and Drug Administration (FDA) drug approval is increasingly being conducted overseas. One of the enticements to move overseas is unequal oversight by the FDA, and these differences can result in poor quality research and human subject risk. Downstream, patients, clinicians, and payers of health care can be harmed by inaccuracies in the new drug approval process. The need of the hour is to bridge the gap in the standards by ensuring that the investigators in the developing countries adhere to the same quality standards as the domestic investigators.
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Affiliation(s)
- C Michael White
- University of Connecticut School of Pharmacy, Storrs, CT, and Hartford Hospital, USA
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