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Malalana F. Chemotherapeutics in Equine Practice. Vet Clin North Am Equine Pract 2024:S0749-0739(24)00053-1. [PMID: 39155164 DOI: 10.1016/j.cveq.2024.07.004] [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: 08/20/2024] Open
Abstract
Chemotherapy is the treatment of cancerous cells through the use of cytotoxic drugs. Whilst the use of systemic (intravenous) chemotherapy in equine practice is generally limited to the management of lymphoma, cytotoxic drugs are commonly used in the treatment of accessible skin tumors, either by topical application in the form of ointments or injected intralesionally. These drugs should be employed with caution due to the risk of serious adverse effects. In addition, extreme caution should be followed when preparing, handling, administering, and disposing them, due to their carcinogenic, mutagenic, and teratogenic properties.
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Affiliation(s)
- Fernando Malalana
- Philip Leverhulme Equine Hospital, University of Liverpool, Leahurst Campus, Chester High Road, Neston CH64 7TE, United Kingdom.
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Kirthiga Devi SS, Singh S, Joga R, Patil SY, Meghana Devi V, Chetan Dushantrao S, Dwivedi F, Kumar G, Kumar Jindal D, Singh C, Dhamija I, Grover P, Kumar S. Enhancing cancer immunotherapy: Exploring strategies to target the PD-1/PD-L1 axis and analyzing the associated patent, regulatory, and clinical trial landscape. Eur J Pharm Biopharm 2024; 200:114323. [PMID: 38754524 DOI: 10.1016/j.ejpb.2024.114323] [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: 12/06/2023] [Revised: 03/10/2024] [Accepted: 05/13/2024] [Indexed: 05/18/2024]
Abstract
Cancer treatment modalities and their progression is guided by the specifics of cancer, including its type and site of localization. Surgery, radiation, and chemotherapy are the most often used conventional treatments. Conversely, emerging treatment techniques include immunotherapy, hormone therapy, anti-angiogenic therapy, dendritic cell-based immunotherapy, and stem cell therapy. Immune checkpoint inhibitors' anticancer properties have drawn considerable attention in recent studies in the cancer research domain. Programmed Cell Death Protein-1 (PD-1) and its ligand (PD-L1) checkpoint pathway are key regulators of the interactions between activated T-cells and cancer cells, protecting the latter from immune destruction. When the ligand PD-L1 attaches to the receptor PD-1, T-cells are prevented from destroying cells that contain PD-L1, including cancer cells. The PD-1/PD-L1 checkpoint inhibitors block them, boosting the immune response and strengthening the body's defenses against tumors. Recent years have seen incredible progress and tremendous advancement in developing anticancer therapies using PD-1/PD-L1 targeting antibodies. While immune-related adverse effects and low response rates significantly limit these therapies, there is a need for research on methods that raise their efficacy and lower their toxicity. This review discusses various recent innovative nanomedicine strategies such as PLGA nanoparticles, carbon nanotubes and drug loaded liposomes to treat cancer targeting PD-1/PD-L1 axis. The biological implications of PD-1/PD-L1 in cancer treatment and the fundamentals of nanotechnology, focusing on the novel strategies used in nanomedicine, are widely discussed along with the corresponding guidelines, clinical trial status, and the patent landscape of such formulations.
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Affiliation(s)
- S S Kirthiga Devi
- Department of Regulatory Affairs, National Institute of Pharmaceutical Education and Research, Hyderabad, Telangana 500037, India
| | - Sidhartha Singh
- Department of Natural Products, National Institute of Pharmaceutical Education and Research, Hyderabad, Telangana 500037, India
| | - Ramesh Joga
- Department of Regulatory Affairs, National Institute of Pharmaceutical Education and Research, Hyderabad, Telangana 500037, India
| | - Sharvari Y Patil
- Department of Regulatory Affairs, National Institute of Pharmaceutical Education and Research, Hyderabad, Telangana 500037, India
| | - Vakalapudi Meghana Devi
- Department of Regulatory Affairs, National Institute of Pharmaceutical Education and Research, Hyderabad, Telangana 500037, India
| | - Sabnis Chetan Dushantrao
- Department of Regulatory Affairs, National Institute of Pharmaceutical Education and Research, Hyderabad, Telangana 500037, India
| | - Falguni Dwivedi
- School of Bioscience and Bioengineering, D Y Patil International University, Akurdi, Pune 411044, India
| | - Gautam Kumar
- School of Bioscience and Bioengineering, D Y Patil International University, Akurdi, Pune 411044, India; Department of Pharmacy, Birla Institute of Technology and Science Pilani, Pilani campus, Rajasthan 333031, India
| | - Deepak Kumar Jindal
- Department of Pharmaceutical Sciences, Guru Jambheshwar University of Science & Technology, Hisar, 125001, India
| | - Charan Singh
- Department of Pharmaceutical Sciences, School of Sciences, Hemvati Nandan Bahuguna Garhwal University (A Central University), Srinagar, Garhwal, Uttarakhand 246174, India
| | - Isha Dhamija
- Department of Biological Sciences, National Institute of Pharmaceutical Education and Research, Hyderabad, Telangana 500037, India
| | - Parul Grover
- KIET School of Pharmacy, KIET Group of Institutions, Delhi-NCR, Ghaziabad 201206, India; Department of Pharmaceutics, NIMS Institute of Pharmacy, NIMS University Rajasthan, Jaipur, Rajasthan 303121, India
| | - Sandeep Kumar
- Department of Regulatory Affairs, National Institute of Pharmaceutical Education and Research, Hyderabad, Telangana 500037, India; Department of Pharmaceutics, NIMS Institute of Pharmacy, NIMS University Rajasthan, Jaipur, Rajasthan 303121, India.
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3
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Qu M, Chen J, Xu B, Shi Q, Zhao S, Wang Z, Li Z, Ma B, Xu H, Ye Q, Xie J. Assessing genotoxic effects of chemotherapy agents by a robust in vitro assay based on mass spectrometric quantification of γ-H2AX in HepG2 cells. Front Pharmacol 2024; 15:1356753. [PMID: 38962306 PMCID: PMC11219945 DOI: 10.3389/fphar.2024.1356753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Accepted: 06/03/2024] [Indexed: 07/05/2024] Open
Abstract
Chemotherapy has already proven widely effective in treating cancer. Chemotherapeutic agents usually include DNA damaging agents and non-DNA damaging agents. Assessing genotoxic effect is significant during chemotherapy drug development, since the ability to attack DNA is the major concern for DNA damaging agents which relates to the therapeutic effect, meanwhile genotoxicity should also be evaluated for chemotherapy agents' safety especially for non-DNA damaging agents. However, currently applicability of in vitro genotoxicity assays is hampered by the fact that genotoxicity results have comparatively high false positive rates. γ-H2AX has been shown to be a bifunctional biomarker reflecting both DNA damage response and repair. Previously, we developed an in vitro genotoxicity assay based on γ-H2AX quantification using mass spectrometry. Here, we employed the assay to quantitatively assess the genotoxic effects of 34 classic chemotherapy agents in HepG2 cells. Results demonstrated that the evaluation of cellular γ-H2AX could be an effective approach to screen and distinguish types of action of different classes of chemotherapy agents. In addition, two crucial indexes of DNA repair kinetic curve, i.e., k (speed of γ-H2AX descending) and t50 (time required for γ-H2AX to drop to half of the maximum value) estimated by our developed online tools were employed to further evaluate nine representative chemotherapy agents, which showed a close association with therapeutic index or carcinogenic level. The present study demonstrated that mass spectrometric quantification of γ-H2AX may be an appropriate tool to preliminarily evaluate genotoxic effects of chemotherapy agents.
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Affiliation(s)
- Minmin Qu
- Department of Medical Molecular Biology, Beijing Institute of Biotechnology, Beijing, China
- Beijing Institute of Pharmacology and Toxicology, Beijing, China
| | - Jia Chen
- Beijing Institute of Pharmacology and Toxicology, Beijing, China
| | - Bin Xu
- Beijing Institute of Pharmacology and Toxicology, Beijing, China
| | - Qinyun Shi
- Beijing Institute of Pharmacology and Toxicology, Beijing, China
| | - Shujing Zhao
- Beijing Institute of Pharmacology and Toxicology, Beijing, China
| | - Zhaoxia Wang
- Beijing Institute of Pharmacology and Toxicology, Beijing, China
| | - Zhi Li
- Beijing Institute of Pharmacology and Toxicology, Beijing, China
| | - Bo Ma
- Beijing Institute of Pharmacology and Toxicology, Beijing, China
| | - Hua Xu
- Beijing Institute of Pharmacology and Toxicology, Beijing, China
| | - Qinong Ye
- Department of Medical Molecular Biology, Beijing Institute of Biotechnology, Beijing, China
| | - Jianwei Xie
- Beijing Institute of Pharmacology and Toxicology, Beijing, China
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Bahrami K, Lee E, Morse B, Lanier OL, Peppas NA. Design of nanoparticle-based systems for the systemic delivery of chemotherapeutics: Alternative potential routes via sublingual and buccal administration for systemic drug delivery. Drug Deliv Transl Res 2024; 14:1173-1188. [PMID: 38151650 DOI: 10.1007/s13346-023-01493-7] [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] [Accepted: 12/06/2023] [Indexed: 12/29/2023]
Abstract
Conventional therapeutic approaches for cancer generally involve chemo- and radiation therapies that often exhibit low efficacy and induce toxic side effects. Recent years have seen significant advancements in the use of protein biologics as a promising alternative treatment option. Nanotechnology-based systems have shown great potential in providing more specific and targeted cancer treatments, thus improving upon many of the limitations associated with current treatments. The unique properties of biomaterial carriers at the nanoscale have been proven to enhance both the performance of the incorporated therapeutic agent and tumor targeting; however, many of these systems are delivered intravenously, which can cause hazardous side effects. Buccal and sublingual delivery systems offer an alternative route for more efficient delivery of nanotechnologies and drug absorption into systemic circulation. This review concentrates on emerging buccal and sublingual nanoparticle delivery systems for chemo- and protein therapeutics, their development, efficacy, and potential areas of improvement in the field. Several factors contribute to the development of effective buccal or sublingual nanoparticle delivery systems, including targeting efficiency of the nanoparticulate carriers, drug release, and carrier biocompatibility. Furthermore, the potential utilization of buccal and sublingual multilayer films combined with nanoparticle chemotherapeutic systems is outlined as a future avenue for in vitro and in vivo research.
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Affiliation(s)
- Kiana Bahrami
- Department of Biomedical Engineering, University of Texas at Austin, Austin, TX, USA
- Institute of Biomaterials, Drug Delivery and Regenerative Medicine, University of Texas at Austin, Austin, TX, USA
- Department of Chemical and Biomolecular Engineering, New York University, Brooklyn, NY, USA
| | - Elaine Lee
- Department of Biomedical Engineering, University of Texas at Austin, Austin, TX, USA
- Institute of Biomaterials, Drug Delivery and Regenerative Medicine, University of Texas at Austin, Austin, TX, USA
- School of Molecular Engineering, University of Chicago, Chicago, IL, USA
| | - Brinkley Morse
- Institute of Biomaterials, Drug Delivery and Regenerative Medicine, University of Texas at Austin, Austin, TX, USA
- Department of Molecular Biosciences, University of Texas at Austin, Austin, TX, USA
- Department of Neurology, Dell Medical School, University of Texas, Austin, USA
| | - Olivia L Lanier
- Department of Biomedical Engineering, University of Texas at Austin, Austin, TX, USA
- Institute of Biomaterials, Drug Delivery and Regenerative Medicine, University of Texas at Austin, Austin, TX, USA
| | - Nicholas A Peppas
- Department of Biomedical Engineering, University of Texas at Austin, Austin, TX, USA.
- Institute of Biomaterials, Drug Delivery and Regenerative Medicine, University of Texas at Austin, Austin, TX, USA.
- Department of Chemical Engineering, University of Texas at Austin, Austin, TX, USA.
- Department of Surgery and Perioperative Care, Dell Medical School, University of Texas at Austin, Austin, TX, USA.
- Department of Pediatrics, Dell Medical School, University of Texas at Austin, Austin, TX, USA.
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5
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Almehizia AA, Aboulthana WM, Naglah AM, Hassan AS. In vitro biological studies and computational prediction-based analyses of pyrazolo[1,5- a]pyrimidine derivatives. RSC Adv 2024; 14:8397-8408. [PMID: 38476172 PMCID: PMC10928850 DOI: 10.1039/d4ra00423j] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 02/24/2024] [Indexed: 03/14/2024] Open
Abstract
There is a need for new pharmaceutical discoveries from bioactive nitrogenous derivatives due to the emergence of scourges, numerous pandemics, and diverse health problems. In this context, pyrazolo[1,5-a]pyrimidine derivatives 12a and 12b were synthesized and screened to evaluate their biological potentials in vitro as antioxidants, anti-diabetics, anti-Alzheimer's, anti-arthritics, and anti-cancer agents. Additionally, the computational pharmacokinetic and toxicity properties of the two pyrazolo[1,5-a]pyrimidines 12a and 12b were calculated and analyzed. The preliminary studies and results of this work represent the initial steps toward more advanced studies and define the bioactive chemical structure of pyrazolo[1,5-a]pyrimidine derivatives with the goal of exploring new drugs to address numerous health problems.
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Affiliation(s)
- Abdulrahman A Almehizia
- Drug Exploration & Development Chair (DEDC), Department of Pharmaceutical Chemistry, College of Pharmacy, King Saud University Riyadh 11451 Saudi Arabia
| | - Wael M Aboulthana
- Biochemistry Department, Biotechnology Research Institute, National Research Centre Dokki 12662 Cairo Egypt
| | - Ahmed M Naglah
- Drug Exploration & Development Chair (DEDC), Department of Pharmaceutical Chemistry, College of Pharmacy, King Saud University Riyadh 11451 Saudi Arabia
| | - Ashraf S Hassan
- Organometallic and Organometalloid Chemistry Department, National Research Centre Dokki 12622 Cairo Egypt
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6
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Pathak S, Zajac KK, Annaji M, Govindarajulu M, Nadar RM, Bowen D, Babu RJ, Dhanasekaran M. Clinical outcomes of chemotherapy in cancer patients with different ethnicities. Cancer Rep (Hoboken) 2023; 6 Suppl 1:e1830. [PMID: 37150853 PMCID: PMC10440845 DOI: 10.1002/cnr2.1830] [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: 12/31/2022] [Revised: 04/18/2023] [Accepted: 04/21/2023] [Indexed: 05/09/2023] Open
Abstract
BACKGROUND Choosing the most effective chemotherapeutic agent with safest side effect profile is a common challenge in cancer treatment. Although there are standardized chemotherapy protocols in place, protocol changes made after extensive clinical trials demonstrate significant improvement in the efficacy and tolerability of certain drugs. The pharmacokinetics, pharmacodynamics, and tolerance of anti-cancer medications are all highly individualized. A driving force behind these differences lies within a person's genetic makeup. RECENT FINDINGS Pharmacogenomics, the study of how an individual's genes impact the processing and action of a drug, can optimize drug responsiveness and reduce toxicities by creating a customized medication regimen. However, these differences are rarely considered in the initial determination of standardized chemotherapeutic protocols and treatment algorithms. Because pharmacoethnicity is influenced by both genetic and nongenetic variables, clinical data highlighting disparities in the frequency of polymorphisms between different ethnicities is steadily growing. Recent data suggests that ethnic variations in the expression of allelic variants may result in different pharmacokinetic properties of the anti-cancer medication. In this article, the clinical outcomes of various chemotherapy classes in patients of different ethnicities were reviewed. CONCLUSION Genetic and nongenetic variables contribute to the interindividual variability in response to chemotherapeutic drugs. Considering pharmacoethnicity in the initial determination of standard chemotherapeutic protocols and treatment algorithms can lead to better clinical outcomes of patients of different ethnicities.
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Affiliation(s)
- Suhrud Pathak
- Department of Drug Discovery and Development, Harrison College of PharmacyAuburn UniversityAuburnAlabamaUSA
| | - Kelsee K. Zajac
- Department of Pharmacology and Experimental Therapeutics, College of Pharmacy and Pharmaceutical SciencesUniversity of ToledoToledoOhioUSA
| | - Manjusha Annaji
- Department of Drug Discovery and Development, Harrison College of PharmacyAuburn UniversityAuburnAlabamaUSA
| | - Manoj Govindarajulu
- Department of Drug Discovery and Development, Harrison College of PharmacyAuburn UniversityAuburnAlabamaUSA
| | - Rishi M. Nadar
- Department of Drug Discovery and Development, Harrison College of PharmacyAuburn UniversityAuburnAlabamaUSA
| | - Dylan Bowen
- Department of Drug Discovery and Development, Harrison College of PharmacyAuburn UniversityAuburnAlabamaUSA
| | - R. Jayachandra Babu
- Department of Drug Discovery and Development, Harrison College of PharmacyAuburn UniversityAuburnAlabamaUSA
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Arachchige DL, Dwivedi SK, Jaeger S, Olowolagba AM, Mahmoud M, Tucker DR, Fritz DR, Werner T, Tanasova M, Luck RL, Liu H. Highly Sensitive Cyanine Dyes for Rapid Sensing of NAD(P)H in Mitochondria and First-Instar Larvae of Drosophila melanogaster. ACS APPLIED BIO MATERIALS 2023; 6:3199-3212. [PMID: 37556116 PMCID: PMC10584401 DOI: 10.1021/acsabm.3c00320] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/10/2023]
Abstract
We have developed two highly sensitive cyanine dyes, which we refer to as probes A and B. These dyes are capable of quick and sensitive sensing of NAD(P)H. The dyes were fabricated by connecting benzothiazolium and 2,3-dimethylnaphtho[1,2-d]thiazol-3-ium units to 3-quinolinium through a vinyl bond. In the absence of NAD(P)H, both probes have low fluorescence and absorption peaks at 370 and 400 nm, correspondingly. This is because of their two electron-withdrawing acceptor systems with high charge densities. However, when NAD(P)H reduces the probes' electron-withdrawing 3-quinolinium units to electron-donating 1,4-dihydroquinoline units, the probes absorb at 533 and 535 nm and fluoresce at 572 and 586 nm for A and B correspondingly. This creates well-defined donor-π-acceptor cyanine dyes. We successfully used probe A to monitor NAD(P)H levels in live cells during glycolysis, under hypoxic conditions induced by CoCl2 treatment and after treatment with cancer drugs, including cisplatin, camptothecin, and gemcitabine. Probe A was also employed to visualize NAD(P)H in Drosophila melanogaster first-instar larvae. We observed an increase in NAD(P)H levels in A549 cancer cells both under hypoxic conditions and after treatment with cancer drugs, including cisplatin, camptothecin, and gemcitabine.
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Affiliation(s)
- Dilka Liyana Arachchige
- Department of Chemistry, Michigan Technological University, Houghton, Michigan 49931, United States
- Department of Chemistry, and Health Research Institute, Michigan Technological University, Houghton, Michigan 49931, United States
| | - Sushil K Dwivedi
- Department of Chemistry, Michigan Technological University, Houghton, Michigan 49931, United States
- Department of Chemistry, and Health Research Institute, Michigan Technological University, Houghton, Michigan 49931, United States
| | - Sophia Jaeger
- Department of Chemistry, Michigan Technological University, Houghton, Michigan 49931, United States
- Department of Chemistry, and Health Research Institute, Michigan Technological University, Houghton, Michigan 49931, United States
| | - Adenike Mary Olowolagba
- Department of Chemistry, Michigan Technological University, Houghton, Michigan 49931, United States
- Department of Chemistry, and Health Research Institute, Michigan Technological University, Houghton, Michigan 49931, United States
| | - Mohamed Mahmoud
- Department of Chemistry, Michigan Technological University, Houghton, Michigan 49931, United States
- Department of Chemistry, and Health Research Institute, Michigan Technological University, Houghton, Michigan 49931, United States
| | - Daniel R Tucker
- Department of Chemistry, Michigan Technological University, Houghton, Michigan 49931, United States
| | - Delaney Raine Fritz
- Department of Biological Sciences, and Health Research Institute, Michigan Technological University, Houghton, Michigan 49931, United States
| | - Thomas Werner
- Department of Biological Sciences, and Health Research Institute, Michigan Technological University, Houghton, Michigan 49931, United States
| | - Marina Tanasova
- Department of Chemistry, Michigan Technological University, Houghton, Michigan 49931, United States
| | - Rudy L Luck
- Department of Chemistry, Michigan Technological University, Houghton, Michigan 49931, United States
| | - Haiying Liu
- Department of Chemistry, Michigan Technological University, Houghton, Michigan 49931, United States
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Castellano-Hinojosa A, Gallardo-Altamirano MJ, González-López J, González-Martínez A. Anticancer drugs in wastewater and natural environments: A review on their occurrence, environmental persistence, treatment, and ecological risks. JOURNAL OF HAZARDOUS MATERIALS 2023; 447:130818. [PMID: 36680899 DOI: 10.1016/j.jhazmat.2023.130818] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 01/15/2023] [Accepted: 01/16/2023] [Indexed: 06/17/2023]
Abstract
The consumption of anticancer drugs (also known as chemotherapy drugs or antineoplastic drugs) has augmented over the last decades due to increased cancer incidence. Although there is an increasing concern about the presence of pharmaceutical compounds in natural environments and urban/domestic wastewater, anticancer drugs used in chemotherapy and anticancer medication have received less attention. In this review, the occurrence, environmental persistence, and known and potential ecological impacts of anticancer drugs is discussed. This review shows that these compounds are being increasingly detected in effluents of hospitals, influents and effluents of wastewater treatment plants, river surface water and sediments, groundwater, and even drinking water. Anticancer drugs can impact aquatic organisms such as algae, crustaceans, rotifers, and fish and may promote changes in soil and water microbial communities that may alter ecosystem functioning. Our knowledge of technologies for the removal of anticancer drugs is still limited, and these drugs can be dispersed in nature in a diffuse way in an uncontrolled manner. For this reason, an improved understanding of the presence, persistence, and ecological impacts of anticancer drugs in wastewater and natural environments is needed to help design management strategies, protect aquatic microorganisms, and mitigate potential ecological impacts.
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Affiliation(s)
| | | | - Jesús González-López
- Institute of Water Research, University of Granada, C/Ramon y Cajal, 4, 18071 Granada, Spain
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9
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Kate A, Shanbhag SS, Donthineni PR, Amescua G, Quinones VLP, Basu S. Role of topical and systemic immunosuppression in aqueous-deficient dry eye disease. Indian J Ophthalmol 2023; 71:1176-1189. [PMID: 37026249 PMCID: PMC10276741 DOI: 10.4103/ijo.ijo_2818_22] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 12/19/2022] [Accepted: 01/27/2023] [Indexed: 04/08/2023] Open
Abstract
Immunosuppression in aqueous-deficient dry eye disease (ADDE) is required not only to improve the symptoms and signs but also to prevent further progression of the disease and its sight-threatening sequelae. This immunomodulation can be achieved through topical and/or systemic medications, and the choice of one drug over the other is determined by the underlying systemic disease. These immunosuppressive agents require a minimum of 6-8 weeks to achieve their beneficial effect, and during this time, the patient is usually placed on topical corticosteroids. Antimetabolites such as methotrexate, azathioprine, and mycophenolate mofetil, along with calcineurin inhibitors, are commonly used as first-line medications. The latter have a pivotal role in immunomodulation since T cells contribute significantly to the pathogenesis of ocular surface inflammation in dry eye disease. Alkylating agents are largely limited to controlling acute exacerbations with pulse doses of cyclophosphamide. Biologic agents, such as rituximab, are particularly useful in patients with refractory disease. Each group of drugs has its own side-effect profiles and requires a stringent monitoring schedule that must be followed to prevent systemic morbidity. A customized combination of topical and systemic medications is usually required to achieve adequate control, and this review aims to help the clinician choose the most appropriate modality and monitoring regimen for a given case of ADDE.
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Affiliation(s)
- Anahita Kate
- Shantilal Shanghvi Cornea Institue, LV Prasad Eye Institute, Vijayawada, Andhra Pradesh, India
| | - Swapna S Shanbhag
- Shantilal Shanghvi Cornea Institue, LV Prasad Eye Institute, Hyderabad, Telengana, India
| | - Pragnya R Donthineni
- Shantilal Shanghvi Cornea Institue, LV Prasad Eye Institute, Hyderabad, Telengana, India
| | - Guillermo Amescua
- Department of Ophthalmology, Duke Eye Center, Duke University School of Medicine, Durham 27705, NC, USA
| | - Victor L Perez Quinones
- Foster Center for Ocular Immunology, Department of Ophthalmology, Duke Eye Center, Duke University School of Medicine, Durham, North Carolina, USA
| | - Sayan Basu
- Shantilal Shanghvi Cornea Institue, LV Prasad Eye Institute, Hyderabad, Telengana, India
- Center for Ocular Regeneration (CORE), L. V. Prasad Eye Institute, Hyderabad, Telangana, India
- Brien Holden Eye Research Centre, L. V. Prasad Eye Institute, Hyderabad, Telangana, India
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10
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Kalantri S, Singh I, Yang L, Abuelgasim KA. Relapsed Waldenstrom's Macroglobulinemia and Therapy-Related Myelodysplastic Syndrome with Complex Cytogenetics: A Treatment Dilemma. Case Rep Oncol 2023; 16:351-356. [PMID: 37384207 PMCID: PMC10293938 DOI: 10.1159/000530328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 03/10/2023] [Indexed: 06/30/2023] Open
Abstract
Waldenstrom's macroglobulinemia (WM) is a lymphoplasmacytic lymphoma characterized by the infiltration of the bone marrow by clonal lymphoplasmacytic cells that produce monoclonal immunoglobulin M as defined by the World Health Organization Classification of hematological malignancies. Historically, the treatment options for WM were limited to alkylating agents and purine analogs. The introduction of immune therapy, including CD20 targeted therapy, proteasome inhibitors, and immune modulators, has provided benefit to those patients and has now become the standard of care. As WM patients become long-term survivors, treatment's late toxicities have become more apparent. Here, we report a case of a 74-year-old female who presented to the hospital with fatigue and was diagnosed with WM. She was treated with bortezomib, doxorubicin, and bendamustine, followed by rituximab. After a remission period of 15 years, the patient had a relapse of WM, and bone marrow biopsy findings were consistent with intermediate-risk t-MDS with complex cytogenetics, presenting us with a treatment dilemma. We decided to treat WM, and the patient went into VGPR with residual lymphoma cells. Despite having dysplasia and complex cytogenetics, she did not have any cytopenia. Currently, she is under observation anticipating the progression of her MDS, given her intermediate I risk status. This case features the occurrence of t-MDS after therapy with bendamustine, cladribine, and doxorubicin. This highlights the need for closer monitoring and consideration of long-term adverse effects when treating patients with indolent lymphomas, especially WM. Late complications need to be considered, and risk versus benefit analysis needs to be carefully evaluated, especially in younger patients with WM.
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Affiliation(s)
- Shreyas Kalantri
- Internal Medicine, Sinai Hospital of Baltimore, Baltimore, MD, USA
| | - Inderpreet Singh
- Internal Medicine, Sinai Hospital of Baltimore, Baltimore, MD, USA
| | - Long Yang
- Pathology, Sinai Hospital of Baltimore, Baltimore, MD, USA
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11
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Kovalev IS, Zyryanov GV, Santra S, Majee A, Varaksin MV, Charushin VN. Folic Acid Antimetabolites (Antifolates): A Brief Review on Synthetic Strategies and Application Opportunities. Molecules 2022; 27:molecules27196229. [PMID: 36234766 PMCID: PMC9573478 DOI: 10.3390/molecules27196229] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 09/16/2022] [Accepted: 09/19/2022] [Indexed: 11/30/2022] Open
Abstract
Antimetabolites of folic acid represent a large group of drugs and drug candidates, including those for cancer chemotherapy. In this current review, the most common methods and approaches are presented for the synthesis of therapeutically significant antimetabolites of folic acid, which are Methotrexate (MTX), Raltitrexed (Tomudex, ZD1694), Pralatrexate, Pemetrexed, TNP-351, and Lometrexol. In addition, the applications or uses of these folic acid antimetabolites are also discussed.
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Affiliation(s)
- Igor S. Kovalev
- Department of Organic & Biomolecular Chemistry, Ural Federal University, 620002 Yekaterinburg, Russia
| | - Grigory V. Zyryanov
- Department of Organic & Biomolecular Chemistry, Ural Federal University, 620002 Yekaterinburg, Russia
- I. Ya. Postovskiy Institute of Organic Synthesis, Ural Branch, Russian Academy of Sciences, 620219 Yekaterinburg, Russia
- Correspondence: or (G.V.Z.); (A.M.)
| | - Sougata Santra
- Department of Organic & Biomolecular Chemistry, Ural Federal University, 620002 Yekaterinburg, Russia
| | - Adinath Majee
- Department of Chemistry, Visva-Bharati (A Central University), Santiniketan 731235, India
- Correspondence: or (G.V.Z.); (A.M.)
| | - Mikhail V. Varaksin
- Department of Organic & Biomolecular Chemistry, Ural Federal University, 620002 Yekaterinburg, Russia
- I. Ya. Postovskiy Institute of Organic Synthesis, Ural Branch, Russian Academy of Sciences, 620219 Yekaterinburg, Russia
| | - Valery N. Charushin
- Department of Organic & Biomolecular Chemistry, Ural Federal University, 620002 Yekaterinburg, Russia
- I. Ya. Postovskiy Institute of Organic Synthesis, Ural Branch, Russian Academy of Sciences, 620219 Yekaterinburg, Russia
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DFF40 deficiency in cancerous T cells is implicated in chemotherapy drug sensitivity and resistance through the regulation of the apoptotic pathway. Biochem Pharmacol 2021; 194:114801. [PMID: 34678222 DOI: 10.1016/j.bcp.2021.114801] [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: 07/20/2021] [Revised: 09/27/2021] [Accepted: 09/29/2021] [Indexed: 02/07/2023]
Abstract
The regulation of the apoptotic pathway is one of the most studied mechanisms regarding cancer cell resistance. Many mutations have been linked to drug resistance. The DNA fragmentation factor 40 (DFF40) has been gaining interest regarding cancer cell response to chemotherapy and patient outcomes. Glioblastomas and uterine leiomyosarcomas have been shown to have a downregulation of DFF40 expression, conferring a poor patient prognosis. In concordance with these observations, in this study, we showed that DFF40 gene is also downregulated in breast, endocervical, ovarian, lung, pancreas and glioblastomas. DFF40 is the endonuclease responsible of DNA fragmentation during apoptosis. In this study, we sought to determine if a DFF40 deficiency in Jurkat T cells could impact the sensitivity to conventional chemotherapy drugs. CRISPR-cas9 generated DFF40 knockout (DFF40 KO) stable Jurkat cells and wild-type (DFF40 WT) cells were treated with different antimetabolites and topoisomerase II (TOP2) inhibitors, and cell viability was subsequently assessed. DFF40 deficient cells show chemoresistance to antimetabolites (e.g. methotrexate, 6-mercaptopurine and cytarabine) and surprisingly, they are more sensitive to TOP2 inhibitors (e.g. etoposide and teniposide). DFF40 deficient cells exposed to cytarabine present lower phosphatidylserine translocation levels to the outer cell membrane layer. Etoposide exposure in DFF40 deficient cells induces higher mortality levels and downregulation of Bcl-xL cells compared to DFF40 expressing T cells. The abolition of DFF40 expression in Jurkat cells significantly impairs histone H2AX phosphorylation following etoposide and cytarabine treatments. Our findings suggest that DFF40 is a novel key target in cancer cell resistance that potentially regulates genomic stability.
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Ayed WB, Drira C, Soussi MA, Ouesleti H, Hamdene B, Khrouf M, Safta F, Fradi I. Physical and chemical stability of cytarabine in polypropylene syringes. J Oncol Pharm Pract 2020; 27:827-833. [PMID: 32605496 DOI: 10.1177/1078155220937405] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND Cytarabine is widely used to treat leukemia and lymphoma. Currently, Cyrabol®, powder for injection, is one of the specialties marketed in Tunisia. However, no stability data when diluted with 0.9% NaCl are available. The aim of this study is to evaluate the physical and chemical stability of cytarabine (Cyrabol®) solution after dilution in 0.9% NaCl (1 mg/mL, 5 mg/mL and 10 mg/mL) in polypropylene syringes under different storage conditions. METHODS Cytarabine solutions (1 mg/mL, 5 mg/mL and 10 mg/mL) in 0.9% NaCl were prepared in polypropylene syringes and stored for 28 days under different conditions. Cytarabine preparations in glass containers were prepared as a control to detect any adsorption. Chemical stability was assessed by a stability-indicating high-performance liquid chromatography method. The stability-indicating capacity of the method was proved by forced degradation tests. Linearity, precision and limit of detection and quantification were performed according to the International Conference on Harmonisation recommendations. Physical stability was checked by visual inspection. RESULTS The method was proven to be a validated stability-indicating assay. At 2-8°C, all tested solutions were chemically stable for 28 days. However, at 25°C, the main degradation product gradually increased during the study and the chemical stability of 1 mg/mL, 5 mg/mL and 10 mg/mL solutions was 14 days, 8 days and 5 days, respectively. Similar results were observed in the glass containers. CONCLUSION The highest physical and chemical stability of cytarabine diluted in 0.9% NaCl in polypropylene syringes was observed at 2-8°C. At 25°C, better stability was found in the 1 mg/mL solution compared with those at higher concentrations (5 mg/mL and 10 mg/mL).
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Affiliation(s)
- Wiem Ben Ayed
- National Center for Bone Marrow Transplantation, Tunis, Tunisia
| | - Chema Drira
- National Center for Bone Marrow Transplantation, Tunis, Tunisia.,Faculty of Pharmacy of Monastir, University of Monastir, Monastir, Tunisia
| | - Mohamed Ali Soussi
- National Center for Bone Marrow Transplantation, Tunis, Tunisia.,Faculty of Pharmacy of Monastir, University of Monastir, Monastir, Tunisia
| | - Hanen Ouesleti
- Faculty of Pharmacy of Monastir, University of Monastir, Monastir, Tunisia
| | - Besma Hamdene
- National Center for Bone Marrow Transplantation, Tunis, Tunisia
| | - Myriam Khrouf
- Faculty of Pharmacy of Monastir, University of Monastir, Monastir, Tunisia
| | - Fathi Safta
- Faculty of Pharmacy of Monastir, University of Monastir, Monastir, Tunisia
| | - Ines Fradi
- National Center for Bone Marrow Transplantation, Tunis, Tunisia.,Faculty of Pharmacy of Monastir, University of Monastir, Monastir, Tunisia
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Obligation de dépistage du déficit en DPD avant prescription de fluoropyrimidines. Bull Cancer 2018; 105:331-332. [DOI: 10.1016/j.bulcan.2018.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Goszczyński T, Nevozhay D, Wietrzyk J, Omar MS, Boratyński J. The antileukemic activity of modified fibrinogen–methotrexate conjugate. Biochim Biophys Acta Gen Subj 2013; 1830:2526-30. [DOI: 10.1016/j.bbagen.2012.11.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2012] [Revised: 11/07/2012] [Accepted: 11/10/2012] [Indexed: 01/29/2023]
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