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Wang W, Zhang ZQ, Zhang YC, Wu YQ, Yang Z, Zheng YZ, Lu JH, Tu PF, Zeng KW. Cayratia albifolia C.L.Li exerts anti-rheumatoid arthritis effect by inhibiting macrophage activation and neutrophil extracellular traps (NETs). Chin Med 2024; 19:42. [PMID: 38444022 PMCID: PMC10913656 DOI: 10.1186/s13020-024-00910-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 02/22/2024] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND Cayratia albifolia C.L.Li (CAC), commonly known as "Jiao-Mei-Gu" in China, has been extensively utilized by the Dong minority for several millennia to effectively alleviate symptoms associated with autoimmune diseases. CAC extract is believed to possess significant anti-inflammatory properties within the context of Dong medicine. However, an in-depth understanding of the specific pharmaceutical effects and underlying mechanisms through which CAC extract acts against rheumatoid arthritis (RA) has yet to be established. METHODS Twenty-four Sprague-Dawley rats were divided into four groups, with six rats in each group. To induce the collagen-induced arthritis (CIA) model, the rats underwent a process of double immunization with collagen and adjuvant. CAC extract (100 mg/kg) was orally administered to rats. The anti-RA effects were evaluated in CIA rats by arthritis score, hind paw volume and histopathology analysis. Pull-down assay was conducted to identify the potential targets of CAC extract from RAW264.7 macrophage lysates. Moreover, mechanism studies of CAC extract were performed by immunofluorescence assays, real-time PCR and Western blot. RESULTS CAC extract was found to obviously down-regulate hind paw volume of CIA rats, with diminished inflammation response and damage. 177 targets were identified from CAC extract by MS-based pull-down assay. Bioinformatics analysis found that these targets were mainly enriched in macrophage activation and neutrophils extracellular traps (NETs). Additionally, we reported that CAC extract owned significant anti-inflammatory activity by regulating PI3K-Akt-mTOR signal pathway, and inhibited NETosis in response to PMA. CONCLUSIONS We clarified that CAC extract significantly attenuated RA by inactivating macrophage and reducing NETosis via a multi-targets regulation.
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Affiliation(s)
- Wei Wang
- State Key Laboratory of Natural and Biomimetic Drugs, School of Pharmaceutical Sciences, Peking University, Beijing, 100191, China
| | - Zai-Qi Zhang
- Hunan Provincial Key Laboratory of Dong Medicine, Hunan University of Medicine, Huaihua, 41800, China.
| | - Yi-Chi Zhang
- State Key Laboratory of Natural and Biomimetic Drugs, School of Pharmaceutical Sciences, Peking University, Beijing, 100191, China
| | - Yi-Qiang Wu
- State Key Laboratory of Natural and Biomimetic Drugs, School of Pharmaceutical Sciences, Peking University, Beijing, 100191, China
| | - Zhuo Yang
- State Key Laboratory of Natural and Biomimetic Drugs, School of Pharmaceutical Sciences, Peking University, Beijing, 100191, China
| | - Yong-Zhe Zheng
- State Key Laboratory of Natural and Biomimetic Drugs, School of Pharmaceutical Sciences, Peking University, Beijing, 100191, China
| | - Jia-Hong Lu
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macau, 999078, SAR, China
| | - Peng-Fei Tu
- State Key Laboratory of Natural and Biomimetic Drugs, School of Pharmaceutical Sciences, Peking University, Beijing, 100191, China
| | - Ke-Wu Zeng
- State Key Laboratory of Natural and Biomimetic Drugs, School of Pharmaceutical Sciences, Peking University, Beijing, 100191, China.
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Carling RS, Emmett EC, Moat SJ. Evaluation of volumetric blood collection devices for the measurement of phenylalanine and tyrosine to monitor patients with phenylketonuria. Clin Chim Acta 2022; 535:157-166. [PMID: 35995273 DOI: 10.1016/j.cca.2022.08.005] [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: 06/22/2022] [Revised: 08/04/2022] [Accepted: 08/04/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Measurement of dried blood spot (DBS) phenylalanine (Phe) is central to the monitoring of patients with phenylketonuria. However, the volume and hematocrit (Hct) of the blood applied to conventional DBS cards significantly affects analytical results. Volumetric blood collection devices are reported to be more accurate, precise and less prone to Hct effects. METHODS Accuracy, imprecision, effect of blood volume and Hct were evaluated for measurement of Phe and tyrosine using three volumetric devices and compared with the conventional PerkinElmer-226 filter-paper collection devices. i.e. conventional DBS cards. Applicability for use in a clinical laboratory was assessed qualitatively. RESULTS Blood volume did not impact on the performance of the volumetric devices; however, significant biases were observed with the conventional DBS card. A higher Hct introduced unacceptable bias for Neoteryx-Mitra and conventional DBS card. All devices had a mean relative standard deviation (RSD) ≤ 4.1 %, except for the Neoteryx-Mitra (≤ 6.2 %). Relative to liquid blood, the mean biases of Phe for the various devices were -5.1 (HemaXis-DB10), -7.8 (Capitainer-qDBS), -12.0 (Neoteryx-Mitra) and -32.6 % (conventional DBS card). CONCLUSIONS Introducing volumetric collection devices will overcome the significant pre-analytical issues associated with conventional DBS collection and improve the biochemical monitoring of patients with PKU.
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Affiliation(s)
- Rachel S Carling
- GKT School Medical Education, Kings College London, UK; Biochemical Sciences, Viapath, Guys & St Thomas' NHSFT, London, UK.
| | - Erin C Emmett
- Biochemical Sciences, Viapath, Guys & St Thomas' NHSFT, London, UK
| | - Stuart J Moat
- Department of Medical Biochemistry, Immunology & Toxicology, University Hospital Wales, Cardiff, UK; School of Medicine, Cardiff University, University Hospital Wales, Cardiff, UK
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Tagwerker C, Baig I, Brunson EJ, Dutra-Smith D, Carias MJ, de Zoysa RS, Smith DJ. Multiplex Analysis of 230 Medications and 30 Illicit Compounds in Dried Blood Spots and Urine. J Anal Toxicol 2021; 45:581-592. [PMID: 32886782 DOI: 10.1093/jat/bkaa125] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 07/24/2020] [Accepted: 09/01/2020] [Indexed: 11/13/2022] Open
Abstract
Drugs of abuse and medication reconciliation testing can benefit from analysis methods capable of detecting a broader range of drug classes and analytes. Mass spectrometry analysis of a wide variety of commonly prescribed medications and over-the-counter drugs per sample also allows for application of a drug-drug interaction (DDI) algorithm to detect adverse drug reactions. In order to prevent adulteration of commonly collected clinical samples such as urine, dried blood spots (DBS) present a reliable alternative. A novel method is described for qualitative and quantitative multiplex analysis of 230 parent drugs, 30 illicit drugs and 43 confirmatory metabolites by HPLC-MS-MS This method is applicable to DBS specimens collected by volumetric absorptive microsamplers and confirmable in urine specimens. A patient cohort (n = 67) providing simultaneous urine specimens and DBS resulted in 100% positive predictive values of medications or illicits confirmed by detection of a parent drug and/or its metabolite during routine medication adherence analysis. An additional 5,508 DBS specimens screened (n = 5,575) showed 5,428 (97%) with an inconsistent positive compared to the provided medication list (including caffeine, cotinine or ethanol metabolites), 29 (0.5%) with no medication list and no unexpected positive results (consistent negative) and 22 (0.4%) showed all positive results matching the provided medication list (consistent positive). A DDI algorithm applied to all positive results revealed 17% with serious and 56% with moderate DDI warnings. Comprehensive DBS analysis proves a reliable alternative to urine drug testing for extended medication reconciliation, with the added advantage of detecting DDIs.
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Affiliation(s)
- Christian Tagwerker
- NRCC (CC/CT) - Alcala Testing and Analysis Services, 3703 Camino del Rio South #100-A, San Diego, CA, 92108
| | | | | | | | | | | | - David J Smith
- Laboratory and Medical Director - Alcala Testing and Analysis Services
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Brady K, Alexander RV, Stimson D, Rudolph M, Kammesheidt A. Capillary Blood Levels of Hydroxychloroquine and Methotrexate Are Stable for up to 5 Years When Collected on Volumetric Absorptive Microsamplers. J Appl Lab Med 2021; 6:858-867. [PMID: 33555010 DOI: 10.1093/jalm/jfaa221] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 10/30/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND Hydroxychloroquine (HCQ) and methotrexate (MTX) are common antirheumatic drugs used chronically by patients with systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) (1, 2). Therapeutic drug monitoring (TDM) of HCQ and MTX provides critical compliance information, but typically requires venipuncture and shipment of refrigerated blood samples to the clinical laboratory. Capillary blood collection by finger prick offers a convenient alternative to venipuncture. The long-term stability of capillary blood HCQ and MTX collected using volumetric absorptive microsamplers (VAMS) has not previously been evaluated. In this study, we evaluated the stability of capillary MTX and HCQ levels when stored on VAMS for up to 5 years. METHODS Samples of patients with RA and SLE were collected for HCQ or MTX monitoring as part of 2 clinical studies in 2015 (HCQ: n = 24 | MTX: n = 61) and 2017 (HCQ: n = 126). Venous and capillary blood samples were shipped to Exagen Inc.'s clinical laboratory. HCQ and MTXPG3 were measured using separate LC-MS/MS methodologies. Baseline venous blood levels of HCQ and MTXPG3 were determined within 1 week of draw and compared to capillary blood levels determined following 3 or 5 years of storage. RESULTS Venous blood HCQ and capillary blood MTXPG3 determinations made at baseline were significantly different from capillary blood determinations performed following 5 years of storage at -80 °C. However, these differences were within the specified limits of agreement [HCQ: Avg % change after storage (CI 95%) = -7.1% (-12.6, -1.6%), pt-test = 0.0205, interclass correlation coefficient (ICC) = 0.96 | MTXPG3: Avg % change after storage (CI 95%) = 13.3% (7.1, 19.4%), pt-test = 0.0001, ICC = 0.90]. CONCLUSION Dried capillary blood HCQ and MTXPG3 levels collected on VAMS are stable for up to 5 years.
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Affiliation(s)
- Kelley Brady
- Research and Development, Exagen Inc, 1261 Liberty Way, Suite C, Vista CA 92081
| | | | - Deborah Stimson
- Research and Development, Exagen Inc, 1261 Liberty Way, Suite C, Vista CA 92081
| | - Mark Rudolph
- Research and Development, Exagen Inc, 1261 Liberty Way, Suite C, Vista CA 92081
| | - Anja Kammesheidt
- Research and Development, Exagen Inc, 1261 Liberty Way, Suite C, Vista CA 92081
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Rajadhyaksha M, Londhe V. Microsampling: A role to play in Covid-19 diagnosis, surveillance, treatment and clinical trials. Drug Test Anal 2021; 13:1238-1248. [PMID: 34089576 DOI: 10.1002/dta.3107] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 05/29/2021] [Accepted: 06/01/2021] [Indexed: 12/13/2022]
Abstract
The outbreak of the new coronavirus disease changed the world upside down. Every day, millions of people were subjected to diagnostic testing for Covid-19, all over the world. Molecular tests helped in the diagnosis of current infection by detecting the presence of viral genome whereas serological tests helped in detecting the presence of antibody in blood as well as contributed to vaccine development. This testing helped in understanding the immunogenicity, community prevalence, geographical spread and conditions post-infection. However, with the contagious nature of the virus, biological specimen sampling involved the risk of transmission and spread of infection. Clinic or pathology visit was the most concerning part. Trained personnel and resources was another barrier. In this scenario, microsampling played an important role due to its most important advantage of remote, contactless, small volume and self-sampling. Minimum requirements for sample storage and ease of shipment added value in this situation. The highly sensitive instruments and validated assay formats assured the accuracy of results and stability of samples. Microsampling techniques are contributing effectively to the Covid-19 pandemic by reducing the demand for clinical staff in population-level testing. The validated and established applications supported the use of microsampling in diagnosis, therapeutic drug monitoring, development of treatment or vaccines and clinical trials for Covid-19.
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Affiliation(s)
- Madhura Rajadhyaksha
- SPPSPTM, SVKM's Narsee Monjee Institute of Management Studies, Mumbai, India.,Sitec Labs. Ltd., Navi Mumbai, India
| | - Vaishali Londhe
- SPPSPTM, SVKM's Narsee Monjee Institute of Management Studies, Mumbai, India
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Zhang Y, Sun L, Zhao L, Wang X, Zhao Z, Mei S. Methotrexate Polyglutamates Analysis by Chromatography Methods in Biological Matrices: A Review. ANAL SCI 2021; 37:1655-1664. [PMID: 34024867 DOI: 10.2116/analsci.21r001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Methotrexate (MTX) is used as an immunosuppressant and antineoplastic drug in clinical practice. MTX is a parent drug and converts to MTX polyglutamates (MTXPGs) to exhibit its biological activity. Clinical studies found that MTXPG levels were associated with MTX response and toxicities, especially at low doses. Due to huge variance of MTX response and toxicities between individuals, therapeutic drug monitoring is necessary for its use in individualized therapy. Various chromatography methods coupled with ultraviolet-visible detector, fluorescence detector and mass spectrometry have been reported for MTXPG analysis in various biological matrices. The aim of this paper is to review the chromatographic based methods for the measurement of total and/or individual MTXPGs. We searched Embase, Science Direct and PubMed databases using "methotrexate polyglutamate" and "chromatography" as search terms, and found 745 articles. Of those, 14 articles were extracted for this study. The key steps for method development (sample pretreatment, parameter optimization of liquid chromatography and mass spectrometry, selection of internal standard) and validation (lower limit of quantitation, accuracy, precision, recovery, matrix effect and stability) were analyzed and summarized, which might be helpful for researchers to develop their own methods.
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Affiliation(s)
- Yiming Zhang
- Department of Pharmacy, Beijing Tiantan Hospital, Capital Medical University.,Department of Clinical Pharmacology, College of Pharmaceutical Sciences, Capital Medical University
| | - Liyu Sun
- Department of Pharmacy, Beijing Tiantan Hospital, Capital Medical University.,Department of Clinical Pharmacology, College of Pharmaceutical Sciences, Capital Medical University
| | - Libo Zhao
- Department of Clinical Pharmacology, College of Pharmaceutical Sciences, Capital Medical University.,Department of Pharmacy, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health
| | - Xiaoling Wang
- Department of Clinical Pharmacology, College of Pharmaceutical Sciences, Capital Medical University.,Department of Pharmacy, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health
| | - Zhigang Zhao
- Department of Pharmacy, Beijing Tiantan Hospital, Capital Medical University.,Department of Clinical Pharmacology, College of Pharmaceutical Sciences, Capital Medical University
| | - Shenghui Mei
- Department of Pharmacy, Beijing Tiantan Hospital, Capital Medical University.,Department of Clinical Pharmacology, College of Pharmaceutical Sciences, Capital Medical University
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Studies on the intracellular accumulation process of methotrexate and its correlation with the key protein using an LC-MS/MS method: a novel way to realize prospective individualized medication. Anal Bioanal Chem 2021; 413:1799-1807. [PMID: 33564926 DOI: 10.1007/s00216-020-03125-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 12/08/2020] [Accepted: 12/14/2020] [Indexed: 10/22/2022]
Abstract
High-dose methotrexate (HDMTX) combined with leucovorin (LV) is the first-line drug therapy for many kinds of malignant tumors. However, the specific treatment plans, such as dosage and duration of administration, are usually formulated according to the clinician's experience and therapeutic drug monitoring (TDM) of methotrexate in patients' plasma, which are responsible for strong individual differences of drug usage. A large number of studies have shown that methotrexate targets the inside of the cell. The key cytotoxic component is the methotrexate polyglutamates (MTXPGs) in the cell. The concentration of methotrexate in plasma does not reflect the efficacy and side effects well. Based on mass spectrometry technology, we developed and validated an accurate, sensitive, and stable method to quantify the intracellular MTX (MTXPG1) and its metabolites MTXPG2-7 simultaneously. The lower limit of quantification was 0.100 ng/ml, and the run time was only 3 min. Moreover, our team has already developed two LC-MS/MS-based methods to respectively quantify methotrexate in plasma samples and two key proteins (γ-glutamyl hydrolase [GGH] and folylpolyglutamate synthetase [FPGS]) in peripheral blood mononuclear cells (PBMC). Through these highly sensitive and accurate approaches, we have gained a deep understanding of the whole pharmacokinetic process of MTX and explored the key factors affecting the accumulation process of intracellular active components (MTXPGs). Based on this research, it is possible to find a more effective way to provide an accurate reference for clinical drug use than traditional therapeutic drug monitoring (TDM).
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