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Cui H, Yang J, Yang B, Hao Y, Shi X, Zhang D, Yang X, Zhang T, Zhao D, Yuan X, Chen X, Liu X, Zheng H, Zhang K. Cyproheptadine hydrochloride inhibits African swine fever viral replication in vitro. Microb Pathog 2023; 175:105957. [PMID: 36572196 DOI: 10.1016/j.micpath.2022.105957] [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: 04/30/2022] [Revised: 09/16/2022] [Accepted: 12/20/2022] [Indexed: 12/24/2022]
Abstract
African swine fever (ASF) is an infectious disease caused by the African swine fever virus (ASFV), and has a high mortality rate. It has caused serious socioeconomic consequences worldwide. Currently, there are no available commercial vaccines or antiviral drug interventions. D1133L is one of the key genes for ASFV replication and antiviral drug screening. In this study, a virtual screening software program, PyRx, was used to screen libraries of compounds against the potential drug target D1133L. Twelve compounds with a high affinity for ASFV D1133L were screened, and cyproheptadine hydrochloride (periactin) was identified as a candidate drug. The periactin has little cytotoxicity, and which dose-dependently inhibited ASFV replication in vitro. Further research indicated that periactin could significantly down-regulate D1133L at the transcriptional and protein levels with RT-qPCR and western blot methods. This study has provided important candidate drugs for the prevention and treatment of ASF, as well as biological materials and new fields of view for the research and development of vaccines and drugs for ASFV.
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Affiliation(s)
- Huimei Cui
- State Key Laboratory of Veterinary Etiological Biology, College of Veterinary Medicine, Lanzhou University, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, 730000, PR China
| | - Jinke Yang
- State Key Laboratory of Veterinary Etiological Biology, College of Veterinary Medicine, Lanzhou University, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, 730000, PR China
| | - Bo Yang
- State Key Laboratory of Veterinary Etiological Biology, College of Veterinary Medicine, Lanzhou University, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, 730000, PR China
| | - Yu Hao
- State Key Laboratory of Veterinary Etiological Biology, College of Veterinary Medicine, Lanzhou University, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, 730000, PR China
| | - Xijuan Shi
- State Key Laboratory of Veterinary Etiological Biology, College of Veterinary Medicine, Lanzhou University, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, 730000, PR China
| | - Dajun Zhang
- State Key Laboratory of Veterinary Etiological Biology, College of Veterinary Medicine, Lanzhou University, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, 730000, PR China
| | - Xing Yang
- State Key Laboratory of Veterinary Etiological Biology, College of Veterinary Medicine, Lanzhou University, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, 730000, PR China
| | - Ting Zhang
- State Key Laboratory of Veterinary Etiological Biology, College of Veterinary Medicine, Lanzhou University, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, 730000, PR China
| | - DengShuai Zhao
- State Key Laboratory of Veterinary Etiological Biology, College of Veterinary Medicine, Lanzhou University, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, 730000, PR China
| | - Xingguo Yuan
- State Key Laboratory of Veterinary Etiological Biology, College of Veterinary Medicine, Lanzhou University, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, 730000, PR China
| | - Xuehui Chen
- State Key Laboratory of Veterinary Etiological Biology, College of Veterinary Medicine, Lanzhou University, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, 730000, PR China
| | - Xiangtao Liu
- State Key Laboratory of Veterinary Etiological Biology, College of Veterinary Medicine, Lanzhou University, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, 730000, PR China
| | - Haixue Zheng
- State Key Laboratory of Veterinary Etiological Biology, College of Veterinary Medicine, Lanzhou University, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, 730000, PR China.
| | - Keshan Zhang
- State Key Laboratory of Veterinary Etiological Biology, College of Veterinary Medicine, Lanzhou University, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, 730000, PR China.
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Muacevic A, Adler JR, Madabushi J. Off-Label Cyproheptadine in Children and Adolescents: Psychiatric Comorbidities, Interacting Variables, Safety, and Risks of Hepatotoxicity. Cureus 2023; 15:e33745. [PMID: 36788882 PMCID: PMC9922522 DOI: 10.7759/cureus.33745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/13/2023] [Indexed: 01/15/2023] Open
Abstract
Cyproheptadine is a widely prescribed first-generation antihistamine, and due to its unique chemical structure, it has a popular off-label choice for a range of clinical conditions. Its efficacy is widely debated in the literature, but there are reports of hepatotoxicity as a rare adverse effect. Its benefits in migraine prophylaxis and appetite stimulation also underscore a highly overlapping clinical pathway that requires additional assessment and evaluation. The evidence suggests a baseline metabolic profile before initiation and assessment for co-occurring mental health conditions may improve overall response with evidence-based mental health interventions.
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Cokyaman T, Cetin H. Pediatric vestibular migraine: Diagnosis according to ICHD-3 criteria and the effectiveness of short-term CH prophylaxis. Eur J Paediatr Neurol 2022; 39:19-24. [PMID: 35636099 DOI: 10.1016/j.ejpn.2022.05.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 03/04/2022] [Accepted: 05/09/2022] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Vestibular migraine (VM) is a rare migraine variant with limited information about its treatment in children. This study, it was aimed to evaluate the diagnostic characteristics of VM in children and the effectiveness of cyproheptadine hydrochloride (CH) prophylaxis. METHODS Patients aged 6-18 years who were diagnosed with VM and other primary headaches (OPHs) according to ICHD-3 diagnostic criteria and given oral CH prophylaxis for at least 3 months were included in the study. Response to CH prophylaxis was defined by the change in symptoms (worsening, no change, and improvement) monthly. RESULTS A total of 64 cases diagnosed with primary headache and given CH prophylaxis were identified. 40.6% (29) migraine without aura of patients, 34.4% (22) VM, 14.1% (9) tension type headache, 4.7% (3) benign paroxysmal vertigo, 3.1% (2) migraine with aura and 3.1% (2) were diagnosed with abdominal migraine. Compared to OPHs, it was found that the duration of headache attack was shorter (p .013) and vomiting, which is one of the associated symptoms, was observed less in pediatric VM (p .032). The positive response of the whole study population to CH prophylaxis was 85.9%. However, CH prophylaxis responses were higher in VM compared to OPHs at the end of 1 month (63.6%) and 2 months (86.3%). CONCLUSION In the pediatric population, the migrainous characters of VM may show differences, but its response to short-term CH prophylaxis is quite good.
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Affiliation(s)
- Turgay Cokyaman
- Çanakkale Onsekiz Mart University, Faculty of Medicine, Department of Pediatrics, Division of Pediatric Neurology, Turkey.
| | - Huriye Cetin
- Çanakkale Onsekiz Mart University, Faculty of Medicine, Department of Pediatrics, Turkey.
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Di Lorenzo C. Functional Nausea Is Real and Makes You Sick. Front Pediatr 2022; 10:848659. [PMID: 35281225 PMCID: PMC8914080 DOI: 10.3389/fped.2022.848659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 01/24/2022] [Indexed: 11/13/2022] Open
Abstract
Functional nausea is a condition that severely impairs the quality of life of affected individuals. Only recently, it has been added to the pediatric list of disorders of gut-brain interaction. In most cases, only minimal testing is needed to diagnose functional nausea. Hypnotherapy has been shown to be a very effective treatment and there are several other medical and non-medical interventions which have the potential to benefit sub-groups of patients with chronic nausea.
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Affiliation(s)
- Carlo Di Lorenzo
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Nationwide Children's Hospital, Columbus, OH, United States
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Bertrand V, Massy N, Vegas N, Gras V, Chalouhi C, Tavolacci MP, Abadie V. Safety of Cyproheptadine, an Orexigenic Drug. Analysis of the French National Pharmacovigilance Data-Base and Systematic Review. Front Pediatr 2021; 9:712413. [PMID: 34676184 PMCID: PMC8525494 DOI: 10.3389/fped.2021.712413] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 09/06/2021] [Indexed: 11/20/2022] Open
Abstract
Objectives: Cyproheptadine is a first-generation H1-antihistamine drug first that was distributed in the 1960s. While its orexigenic effect was observed early, cyproheptadine is not yet authorized for this indication in all countries today. There is an increasing medical interest and demand for the orexigenic effect of cyproheptadine, especially in children with poor appetite. As cyproheptadine might be evaluated in future clinical trials, we wanted to assess its safety profile. Methods: Using the French national pharmacovigilance database, we retrospectively analyzed all pediatric and adult reports of adverse effects of cyproheptadine recorded since its first distribution in France. Next, we performed a systematic review of the literature of cyproheptadine adverse effects. Results: Since 1985, 93 adverse effects were reported in the French pharmacovigilance database (adults 81.7%, children 18.3%); these were mainly neurological symptoms (n = 38, adults 71%, children 28.9%), and hepatic complications (n = 15, adults 86.7%, children 13.3%). In the literature, the most frequent adverse effect reported was drowsiness in adults or children, and five case reports noted liver complications in adults. We estimated the frequency of hepatic adverse effects at 0.27 to 1.4/1000, regardless of age. Conclusion: Cyproheptadine can be considered a safe drug. Mild neurological effects appear to be frequent, and hepatotoxicity is uncommon to rare. Randomized controlled trials are needed to evaluate the safety and efficacy of cyproheptadine before authorization for appetite stimulation, especially in young children as studies at this age are lacking. Possible hepatic complications should be monitored, as very rare cases of liver failure have been reported.
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Affiliation(s)
| | - Nathalie Massy
- Regional Center of Pharmacovigilance, Rouen University Hospital, Rouen, France
| | - Nancy Vegas
- General Pediatrics Unit, Necker University Hospital, Paris, France.,Refferal Center for Rare Disease ≪ Pierre Robin Sequence and Sucking and Swallowing Congenital Disorders ≫, Necker University Hospital, Paris, France
| | - Valérie Gras
- Regional Center of Pharmacovigilance, Amiens University Hospital, Amiens, France
| | - Christel Chalouhi
- General Pediatrics Unit, Necker University Hospital, Paris, France.,Refferal Center for Rare Disease ≪ Pierre Robin Sequence and Sucking and Swallowing Congenital Disorders ≫, Necker University Hospital, Paris, France
| | | | - Véronique Abadie
- General Pediatrics Unit, Necker University Hospital, Paris, France.,Refferal Center for Rare Disease ≪ Pierre Robin Sequence and Sucking and Swallowing Congenital Disorders ≫, Necker University Hospital, Paris, France.,Paris University, Paris, France
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Spasov AA, Yakovlev DS, Brigadirova AA, Maltsev DV, Agatsarskaya YV. Novel Approaches to the Development of Antimigraine Drugs: A Focus on 5-HT2A Receptor Antagonists. RUSSIAN JOURNAL OF BIOORGANIC CHEMISTRY 2019. [DOI: 10.1134/s1068162019020146] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Abstract
Chronic nausea is a highly prevalent, bothersome, and difficult-to-treat symptom among adolescents. When chronic nausea presents as the predominant symptom and is not associated with any underlying disease, it may be considered a functional gastrointestinal disorder and named "functional nausea." The clinical features of functional nausea and its association with comorbid conditions provide clues to the underlying pathophysiological mechanisms. These may include gastrointestinal motor and sensory disturbances, autonomic imbalance, altered central nervous system pathways, or a combination of these. This review summarizes the current knowledge on mechanisms and treatment strategies for chronic, functional nausea in children.
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Prophylactic Drug Treatment of Migraine in Children and Adolescents: An Update. Curr Pain Headache Rep 2015; 20:1. [DOI: 10.1007/s11916-015-0536-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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Vécsei L, Majláth Z, Szok D, Csáti A, Tajti J. Drug safety and tolerability in prophylactic migraine treatment. Expert Opin Drug Saf 2015; 14:667-81. [DOI: 10.1517/14740338.2015.1014797] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Affiliation(s)
- László Vécsei
- 1University of Szeged, Department of Neurology, Semmelweis u. 6, H-6725 Szeged, Hungary ;
- 2University of Szeged, Department of Neurology, Semmelweis u. 6, H-6725 Szeged, Hungary
- 3MTA – SZTE Neuroscience Research Group, Semmelweis u. 6, H-6725 Szeged, Hungary
| | - Zsófia Majláth
- 4University of Szeged, Department of Neurology, Semmelweis u. 6, H-6725 Szeged, Hungary
| | - Délia Szok
- 5University of Szeged, Department of Neurology, Semmelweis u. 6, H-6725 Szeged, Hungary
| | - Anett Csáti
- 4University of Szeged, Department of Neurology, Semmelweis u. 6, H-6725 Szeged, Hungary
| | - János Tajti
- 5University of Szeged, Department of Neurology, Semmelweis u. 6, H-6725 Szeged, Hungary
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Abstract
Chronic nausea is an increasingly acknowledged complaint in children. It is commonly encountered in association with functional gastrointestinal (GI) disorders but can also occur in isolation. As such, there is no pediatric diagnostic classification for chronic idiopathic nausea. The pathophysiology appears complex, from foregut motor and sensory disturbances to autonomic imbalance and CNS influences. Also, there is scarcity of specific treatments that target this highly bothersome symptom. Treatment is mainly empiric or aimed at other functional complaints. Our retrospective data indicate a high prevalence of comorbid conditions in children with chronic nausea. These include migraines, autonomic disturbances, sleep problems, fatigue, and anxiety. Identifying specific features and targeting these therapeutically may be essential for improved treatment outcomes.
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Affiliation(s)
- Katja Kovacic
- Center for Pediatric Neurogastroenterology, Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI, 53226, USA,
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Johnson A, Bickel J, Lebel A. Pediatric migraine prescription patterns at a large academic hospital. Pediatr Neurol 2014; 51:706-12. [PMID: 25240258 DOI: 10.1016/j.pediatrneurol.2014.06.018] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2014] [Revised: 06/25/2014] [Accepted: 06/26/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND Here we report the prescription patterns by drug type, age, and sex of patients at a large academic pediatric hospital. Because there are few guidelines based on outcome studies in pediatric migraine, physician treatment approaches in children vary. METHODS Using the i2b2 query tool, we determined that over an approximately 4 year period, 4839 patients between the ages of 2 and 17 years were observed at Boston Children's Hospital for migraine with or without aura, 59% women and 41% men. RESULTS The most common medications prescribed to this population were sumatriptan, amitriptyline, topiramate, ondansetron, and cyproheptadine. CONCLUSIONS Our findings support recent data regarding choices of medication in the pediatric population and additionally support current studies and future investigation into controlled trials in the pediatric population.
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Affiliation(s)
- Adriana Johnson
- P.A.I.N. Group, Department of Anesthesia, Boston Children's Hospital, Harvard Medical School, Waltham, Massachusetts; Headache Program, Departments of Anesthesia and Neurology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts.
| | - Jonathan Bickel
- Department of Information Services, Boston Children's Hospital, Boston, Massachusetts; Division of Emergency Medicine, Department of Medicine, Boston Children's Hospital, Boston, Massachusetts
| | - Alyssa Lebel
- P.A.I.N. Group, Department of Anesthesia, Boston Children's Hospital, Harvard Medical School, Waltham, Massachusetts; Headache Program, Departments of Anesthesia and Neurology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
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Abstract
The perception of pain in children is easily influenced by environmental factors and psychological comorbidities that are known to play an important role in its origin and response to therapy. Chronic abdominal pain is one of the most commonly treated conditions in modern pediatric gastroenterology and is the hallmark of 'functional' disorders that include irritable bowel syndrome, functional dyspepsia, and functional abdominal pain. The development of pharmacological therapies for these disorders in adults and children has been limited by the lack of understanding of the putative, pathophysiological mechanisms that underlie them. Peripheral and central pain-signaling mechanisms are known to be involved in chronic pain originating from the gastrointestinal tract, but few therapies have been developed to target specific pathways or enhance correction of the underlying pathophysiology. The responses to therapy have been variable, potentially reflecting the heterogeneity of the disorders for which they are used. Only a few small, randomized clinical trials have evaluated the benefit of pain medications for chronic abdominal pain in children and thus, the decision on the most appropriate treatment is often based on adult studies and empirical data. This review discusses the most common, non-narcotic pharmacological treatments for chronic abdominal pain in children and includes a thorough review of the literature to support or refute their use. Because of the dearth of pediatric studies, the focus is on pharmacological and alternative therapies where there is sufficient evidence of benefit in either adults or children with chronic abdominal pain.
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Affiliation(s)
- Adrian Miranda
- Division of Gastroenterology and Hepatology, Department of Pediatrics, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI, 53226, USA,
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Abstract
Chronic nausea is a prevalent but poorly described symptom in adolescents. It often co-occurs with other functional gastrointestinal disorders (FGIDs) but may also present in isolation. A multitude of triggers and complex neural pathways underlie the sensation of nausea. These include gastrointestinal and blood-borne insults, dysmotility, vestibular or central nervous system pathways, an aberrant autonomic nervous system, and psychosocial factors. Although clinical algorithms are lacking, diagnosis is typically made on the basis of a thorough clinical history and without extensive testing. Treatment is mainly empiric and may be directed at comorbid symptoms such as migraine, delayed gastric emptying, orthostatic intolerance, and visceral hypersensitivity. Chronic idiopathic nausea is an increasingly prevalent symptom that needs careful clinical assessment and individualized treatment plans.
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