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Yang C, Gong J, Xue M, Huang W, Yuan Y, Chen C, He Y, Yang C, Sun H, Liu Y, Gong Y, Wu Y, Lai X, Zhong D, Diao X, Lu H, Zheng Y. Effects of the Thiol Methyltransferase Inhibitor (±)-2,3-Dichloro- α-Methylbenzylamine (DCMB) on the Pharmacokinetics and Metabolism of Vicagrel in Rats. Drug Metab Dispos 2024; 52:988-996. [PMID: 38997155 DOI: 10.1124/dmd.124.001739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Revised: 06/18/2024] [Accepted: 07/08/2024] [Indexed: 07/14/2024] Open
Abstract
P2Y12 receptor inhibitors are commonly used in clinical antiplatelet therapy, typically alongside other medications. Vicagrel, a promising P2Y12 receptor inhibitor, has submitted a new drug marketing application to the United States Food and Drug Administration. Its primary metabolites and some metabolic pathways are identical to those of clopidogrel. The aim of this study was to investigate the effects of the thiol methyltransferase inhibitor (±)-2,3-dichloro-α-methylbenzylamine (DCMB) on the metabolism and pharmacokinetics of vicagrel. In vitro incubation with human and rat liver microsomes revealed that DCMB significantly inhibited the methylation of vicagrel's thiol metabolite M15-1. Rats were orally administered 6 mg/kg [14C]vicagrel (100 μCi/kg) 1 hour after peritoneal injection with or without DCMB (80 mg/kg). Compared with the control group, the plasma of DCMB-pretreated rats exhibited maximum plasma concentration (C max) decrease and time to reach C max (T max) delay for all vicagrel-related substances, the methylation product of the thiol metabolite (M9-2), and the derivatization product of the active thiol metabolite (MP-M15-2). However, no significant changes in area under the curve (AUC) or half-life (t 1/2) were observed. DCMB had negligible effect on the total radiological recovery of vicagrel within 72 hours, although the rate of vicagrel excretion slowed down within 48 hours. DCMB had a negligible impact on the metabolic pathway of vicagrel. Overall, the present study found that DCMB did not significantly affect the total exposure, metabolic pathways, metabolite profiles, or total excretion rates of vicagrel-related metabolites in rats, but led to C max decrease, T max delay, and slower excretion rate within 48 hours. SIGNIFICANCE STATEMENT: This study used liquid chromatography-tandem mass spectrometry combined with radiolabeling technology to investigate the effects of the thiol methyltransferase inhibitor (±)-2,3-dichloro-α-methylbenzylamine on the absorption, metabolism, and excretion of vicagrel in rats. This work helps to better understand the in vivo metabolism of active thiol metabolites of P2Y12 inhibitors such as clopidogrel, vicagrel, etc.
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Affiliation(s)
- Cheng Yang
- Shanghai Center for Drug Metabolism and Pharmacokinetics Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, China (M.X., W.H., Y.Y., C.C., Y.H., Chen Y., D.Z., X.D., Y.Z.); School of Chinese Materia Medica, Nanjing University of Chinese Medicine, Nanjing, China (Cheng Y., Y.Y., C.C., X.D.); Department of Pharmacy, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai, China (J.G., H.L.); Jiangsu Key Laboratory for Functional Substances of Chinese Medicine, Nanjing University of Chinese Medicine, Nanjing, China (M.X.); State Key Laboratory of Natural Medicines and Center of Drug Discovery, College of Pharmacy, China Pharmaceutical University, Nanjing, China (H.S.); and Jiangsu Vcare PharmaTech Co. Ltd., Nanjing, China (Y.L., Y.G., Y.W., X.L.)
| | - Jingru Gong
- Shanghai Center for Drug Metabolism and Pharmacokinetics Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, China (M.X., W.H., Y.Y., C.C., Y.H., Chen Y., D.Z., X.D., Y.Z.); School of Chinese Materia Medica, Nanjing University of Chinese Medicine, Nanjing, China (Cheng Y., Y.Y., C.C., X.D.); Department of Pharmacy, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai, China (J.G., H.L.); Jiangsu Key Laboratory for Functional Substances of Chinese Medicine, Nanjing University of Chinese Medicine, Nanjing, China (M.X.); State Key Laboratory of Natural Medicines and Center of Drug Discovery, College of Pharmacy, China Pharmaceutical University, Nanjing, China (H.S.); and Jiangsu Vcare PharmaTech Co. Ltd., Nanjing, China (Y.L., Y.G., Y.W., X.L.)
| | - Mingzhen Xue
- Shanghai Center for Drug Metabolism and Pharmacokinetics Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, China (M.X., W.H., Y.Y., C.C., Y.H., Chen Y., D.Z., X.D., Y.Z.); School of Chinese Materia Medica, Nanjing University of Chinese Medicine, Nanjing, China (Cheng Y., Y.Y., C.C., X.D.); Department of Pharmacy, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai, China (J.G., H.L.); Jiangsu Key Laboratory for Functional Substances of Chinese Medicine, Nanjing University of Chinese Medicine, Nanjing, China (M.X.); State Key Laboratory of Natural Medicines and Center of Drug Discovery, College of Pharmacy, China Pharmaceutical University, Nanjing, China (H.S.); and Jiangsu Vcare PharmaTech Co. Ltd., Nanjing, China (Y.L., Y.G., Y.W., X.L.)
| | - Wensi Huang
- Shanghai Center for Drug Metabolism and Pharmacokinetics Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, China (M.X., W.H., Y.Y., C.C., Y.H., Chen Y., D.Z., X.D., Y.Z.); School of Chinese Materia Medica, Nanjing University of Chinese Medicine, Nanjing, China (Cheng Y., Y.Y., C.C., X.D.); Department of Pharmacy, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai, China (J.G., H.L.); Jiangsu Key Laboratory for Functional Substances of Chinese Medicine, Nanjing University of Chinese Medicine, Nanjing, China (M.X.); State Key Laboratory of Natural Medicines and Center of Drug Discovery, College of Pharmacy, China Pharmaceutical University, Nanjing, China (H.S.); and Jiangsu Vcare PharmaTech Co. Ltd., Nanjing, China (Y.L., Y.G., Y.W., X.L.)
| | - Yali Yuan
- Shanghai Center for Drug Metabolism and Pharmacokinetics Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, China (M.X., W.H., Y.Y., C.C., Y.H., Chen Y., D.Z., X.D., Y.Z.); School of Chinese Materia Medica, Nanjing University of Chinese Medicine, Nanjing, China (Cheng Y., Y.Y., C.C., X.D.); Department of Pharmacy, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai, China (J.G., H.L.); Jiangsu Key Laboratory for Functional Substances of Chinese Medicine, Nanjing University of Chinese Medicine, Nanjing, China (M.X.); State Key Laboratory of Natural Medicines and Center of Drug Discovery, College of Pharmacy, China Pharmaceutical University, Nanjing, China (H.S.); and Jiangsu Vcare PharmaTech Co. Ltd., Nanjing, China (Y.L., Y.G., Y.W., X.L.)
| | - Chong Chen
- Shanghai Center for Drug Metabolism and Pharmacokinetics Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, China (M.X., W.H., Y.Y., C.C., Y.H., Chen Y., D.Z., X.D., Y.Z.); School of Chinese Materia Medica, Nanjing University of Chinese Medicine, Nanjing, China (Cheng Y., Y.Y., C.C., X.D.); Department of Pharmacy, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai, China (J.G., H.L.); Jiangsu Key Laboratory for Functional Substances of Chinese Medicine, Nanjing University of Chinese Medicine, Nanjing, China (M.X.); State Key Laboratory of Natural Medicines and Center of Drug Discovery, College of Pharmacy, China Pharmaceutical University, Nanjing, China (H.S.); and Jiangsu Vcare PharmaTech Co. Ltd., Nanjing, China (Y.L., Y.G., Y.W., X.L.)
| | - Yifei He
- Shanghai Center for Drug Metabolism and Pharmacokinetics Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, China (M.X., W.H., Y.Y., C.C., Y.H., Chen Y., D.Z., X.D., Y.Z.); School of Chinese Materia Medica, Nanjing University of Chinese Medicine, Nanjing, China (Cheng Y., Y.Y., C.C., X.D.); Department of Pharmacy, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai, China (J.G., H.L.); Jiangsu Key Laboratory for Functional Substances of Chinese Medicine, Nanjing University of Chinese Medicine, Nanjing, China (M.X.); State Key Laboratory of Natural Medicines and Center of Drug Discovery, College of Pharmacy, China Pharmaceutical University, Nanjing, China (H.S.); and Jiangsu Vcare PharmaTech Co. Ltd., Nanjing, China (Y.L., Y.G., Y.W., X.L.)
| | - Chen Yang
- Shanghai Center for Drug Metabolism and Pharmacokinetics Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, China (M.X., W.H., Y.Y., C.C., Y.H., Chen Y., D.Z., X.D., Y.Z.); School of Chinese Materia Medica, Nanjing University of Chinese Medicine, Nanjing, China (Cheng Y., Y.Y., C.C., X.D.); Department of Pharmacy, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai, China (J.G., H.L.); Jiangsu Key Laboratory for Functional Substances of Chinese Medicine, Nanjing University of Chinese Medicine, Nanjing, China (M.X.); State Key Laboratory of Natural Medicines and Center of Drug Discovery, College of Pharmacy, China Pharmaceutical University, Nanjing, China (H.S.); and Jiangsu Vcare PharmaTech Co. Ltd., Nanjing, China (Y.L., Y.G., Y.W., X.L.)
| | - Hongbin Sun
- Shanghai Center for Drug Metabolism and Pharmacokinetics Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, China (M.X., W.H., Y.Y., C.C., Y.H., Chen Y., D.Z., X.D., Y.Z.); School of Chinese Materia Medica, Nanjing University of Chinese Medicine, Nanjing, China (Cheng Y., Y.Y., C.C., X.D.); Department of Pharmacy, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai, China (J.G., H.L.); Jiangsu Key Laboratory for Functional Substances of Chinese Medicine, Nanjing University of Chinese Medicine, Nanjing, China (M.X.); State Key Laboratory of Natural Medicines and Center of Drug Discovery, College of Pharmacy, China Pharmaceutical University, Nanjing, China (H.S.); and Jiangsu Vcare PharmaTech Co. Ltd., Nanjing, China (Y.L., Y.G., Y.W., X.L.)
| | - Yongqiang Liu
- Shanghai Center for Drug Metabolism and Pharmacokinetics Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, China (M.X., W.H., Y.Y., C.C., Y.H., Chen Y., D.Z., X.D., Y.Z.); School of Chinese Materia Medica, Nanjing University of Chinese Medicine, Nanjing, China (Cheng Y., Y.Y., C.C., X.D.); Department of Pharmacy, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai, China (J.G., H.L.); Jiangsu Key Laboratory for Functional Substances of Chinese Medicine, Nanjing University of Chinese Medicine, Nanjing, China (M.X.); State Key Laboratory of Natural Medicines and Center of Drug Discovery, College of Pharmacy, China Pharmaceutical University, Nanjing, China (H.S.); and Jiangsu Vcare PharmaTech Co. Ltd., Nanjing, China (Y.L., Y.G., Y.W., X.L.)
| | - Yanchun Gong
- Shanghai Center for Drug Metabolism and Pharmacokinetics Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, China (M.X., W.H., Y.Y., C.C., Y.H., Chen Y., D.Z., X.D., Y.Z.); School of Chinese Materia Medica, Nanjing University of Chinese Medicine, Nanjing, China (Cheng Y., Y.Y., C.C., X.D.); Department of Pharmacy, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai, China (J.G., H.L.); Jiangsu Key Laboratory for Functional Substances of Chinese Medicine, Nanjing University of Chinese Medicine, Nanjing, China (M.X.); State Key Laboratory of Natural Medicines and Center of Drug Discovery, College of Pharmacy, China Pharmaceutical University, Nanjing, China (H.S.); and Jiangsu Vcare PharmaTech Co. Ltd., Nanjing, China (Y.L., Y.G., Y.W., X.L.)
| | - Yong Wu
- Shanghai Center for Drug Metabolism and Pharmacokinetics Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, China (M.X., W.H., Y.Y., C.C., Y.H., Chen Y., D.Z., X.D., Y.Z.); School of Chinese Materia Medica, Nanjing University of Chinese Medicine, Nanjing, China (Cheng Y., Y.Y., C.C., X.D.); Department of Pharmacy, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai, China (J.G., H.L.); Jiangsu Key Laboratory for Functional Substances of Chinese Medicine, Nanjing University of Chinese Medicine, Nanjing, China (M.X.); State Key Laboratory of Natural Medicines and Center of Drug Discovery, College of Pharmacy, China Pharmaceutical University, Nanjing, China (H.S.); and Jiangsu Vcare PharmaTech Co. Ltd., Nanjing, China (Y.L., Y.G., Y.W., X.L.)
| | - Xiaojuan Lai
- Shanghai Center for Drug Metabolism and Pharmacokinetics Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, China (M.X., W.H., Y.Y., C.C., Y.H., Chen Y., D.Z., X.D., Y.Z.); School of Chinese Materia Medica, Nanjing University of Chinese Medicine, Nanjing, China (Cheng Y., Y.Y., C.C., X.D.); Department of Pharmacy, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai, China (J.G., H.L.); Jiangsu Key Laboratory for Functional Substances of Chinese Medicine, Nanjing University of Chinese Medicine, Nanjing, China (M.X.); State Key Laboratory of Natural Medicines and Center of Drug Discovery, College of Pharmacy, China Pharmaceutical University, Nanjing, China (H.S.); and Jiangsu Vcare PharmaTech Co. Ltd., Nanjing, China (Y.L., Y.G., Y.W., X.L.)
| | - Dafang Zhong
- Shanghai Center for Drug Metabolism and Pharmacokinetics Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, China (M.X., W.H., Y.Y., C.C., Y.H., Chen Y., D.Z., X.D., Y.Z.); School of Chinese Materia Medica, Nanjing University of Chinese Medicine, Nanjing, China (Cheng Y., Y.Y., C.C., X.D.); Department of Pharmacy, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai, China (J.G., H.L.); Jiangsu Key Laboratory for Functional Substances of Chinese Medicine, Nanjing University of Chinese Medicine, Nanjing, China (M.X.); State Key Laboratory of Natural Medicines and Center of Drug Discovery, College of Pharmacy, China Pharmaceutical University, Nanjing, China (H.S.); and Jiangsu Vcare PharmaTech Co. Ltd., Nanjing, China (Y.L., Y.G., Y.W., X.L.)
| | - Xingxing Diao
- Shanghai Center for Drug Metabolism and Pharmacokinetics Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, China (M.X., W.H., Y.Y., C.C., Y.H., Chen Y., D.Z., X.D., Y.Z.); School of Chinese Materia Medica, Nanjing University of Chinese Medicine, Nanjing, China (Cheng Y., Y.Y., C.C., X.D.); Department of Pharmacy, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai, China (J.G., H.L.); Jiangsu Key Laboratory for Functional Substances of Chinese Medicine, Nanjing University of Chinese Medicine, Nanjing, China (M.X.); State Key Laboratory of Natural Medicines and Center of Drug Discovery, College of Pharmacy, China Pharmaceutical University, Nanjing, China (H.S.); and Jiangsu Vcare PharmaTech Co. Ltd., Nanjing, China (Y.L., Y.G., Y.W., X.L.)
| | - Huiping Lu
- Shanghai Center for Drug Metabolism and Pharmacokinetics Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, China (M.X., W.H., Y.Y., C.C., Y.H., Chen Y., D.Z., X.D., Y.Z.); School of Chinese Materia Medica, Nanjing University of Chinese Medicine, Nanjing, China (Cheng Y., Y.Y., C.C., X.D.); Department of Pharmacy, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai, China (J.G., H.L.); Jiangsu Key Laboratory for Functional Substances of Chinese Medicine, Nanjing University of Chinese Medicine, Nanjing, China (M.X.); State Key Laboratory of Natural Medicines and Center of Drug Discovery, College of Pharmacy, China Pharmaceutical University, Nanjing, China (H.S.); and Jiangsu Vcare PharmaTech Co. Ltd., Nanjing, China (Y.L., Y.G., Y.W., X.L.)
| | - Yuandong Zheng
- Shanghai Center for Drug Metabolism and Pharmacokinetics Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, China (M.X., W.H., Y.Y., C.C., Y.H., Chen Y., D.Z., X.D., Y.Z.); School of Chinese Materia Medica, Nanjing University of Chinese Medicine, Nanjing, China (Cheng Y., Y.Y., C.C., X.D.); Department of Pharmacy, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai, China (J.G., H.L.); Jiangsu Key Laboratory for Functional Substances of Chinese Medicine, Nanjing University of Chinese Medicine, Nanjing, China (M.X.); State Key Laboratory of Natural Medicines and Center of Drug Discovery, College of Pharmacy, China Pharmaceutical University, Nanjing, China (H.S.); and Jiangsu Vcare PharmaTech Co. Ltd., Nanjing, China (Y.L., Y.G., Y.W., X.L.)
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2
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Ju G, Huang Z, Zhao Y. Trialkoxysilane-Induced Iridium-Catalyzed para-Selective C-H Bond Borylation of Arenes. Nat Commun 2024; 15:2847. [PMID: 38565860 PMCID: PMC10987550 DOI: 10.1038/s41467-024-47205-8] [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: 09/15/2023] [Accepted: 03/22/2024] [Indexed: 04/04/2024] Open
Abstract
An ideal approach for the construction of aryl boron compounds is to selectively replace a C-H bond in arenes with a C-B bond, and controlling regioselectivity is one of the most challenging aspects of these transformations. Herein, we report an iridium-catalyzed trialkoxysilane protecting group-assisted regioselective C-H borylation of arenes, including derivatives of benzaldehydes, acetophenones, benzoic acids, benzyl alcohols, phenols, aryl silanes, benzyl silanes, and multi-functionalized aromatic rings are all well tolerated and gave the para -selective C-H borylation products in a short time without the requirement of inert gases atmosphere. The site-selective C-H borylation can be adjustable by installing the developed trialkoxysilane protecting group on different functional groups on one aromatic ring. Importantly, the preparation process of the trialkoxychlorosilane is efficient and scalable. Mechanistic and computational studies reveal that the steric hindrance of the trialkoxysilane protecting group plays a key role in dictating the para-selectivity.
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Affiliation(s)
- Guodong Ju
- Key Laboratory of Organic Synthesis of Jiangsu Province, College of Chemistry, Chemical Engineering and Materials Science, Soochow University, Suzhou, 215123, China
| | - Zhibin Huang
- Key Laboratory of Organic Synthesis of Jiangsu Province, College of Chemistry, Chemical Engineering and Materials Science, Soochow University, Suzhou, 215123, China
| | - Yingsheng Zhao
- Key Laboratory of Organic Synthesis of Jiangsu Province, College of Chemistry, Chemical Engineering and Materials Science, Soochow University, Suzhou, 215123, China.
- School of Chemistry and Chemical Engineering, Henan Normal University, Xinxiang, 453000, China.
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3
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Ren P, Li H, Nie T, Jian X, Yu C, Li J, Su H, Zhang X, Li S, Yang X, Peng C, Yin Y, Zhang L, Xu Y, Liu H, Bai F. Discovery and Mechanism Study of SARS-CoV-2 3C-like Protease Inhibitors with a New Reactive Group. J Med Chem 2023; 66:12266-12283. [PMID: 37594952 DOI: 10.1021/acs.jmedchem.3c00818] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/20/2023]
Abstract
3CLpro is an attractive target for the treatment of COVID-19. Using the scaffold hopping strategy, we identified a potent inhibitor of 3CLpro (3a) that contains a thiocyanate moiety as a novel warhead that can form a covalent bond with Cys145 of the protein. Tandem mass spectrometry (MS/MS) and X-ray crystallography confirmed the mechanism of covalent formation between 3a and the protein in its catalytic pocket. Moreover, several analogues of compound 3a were designed and synthesized. Among them, compound 3h shows the best inhibition of 3CLpro with an IC50 of 0.322 μM and a kinact/Ki value of 1669.34 M-1 s-1, and it exhibits good target selectivity for 3CLpro against host proteases. Compound 3c inhibits SARS-CoV-2 in Vero E6 cells (EC50 = 2.499 μM) with low cytotoxicity (CC50 > 200 μM). These studies provide ideas and insights to explore and develop new 3CLpro inhibitors in the future.
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Affiliation(s)
- Pengxuan Ren
- School of Life Science and Technology, and Shanghai Institute for Advanced Immunochemical Studies, ShanghaiTech University, Shanghai 201210, China
| | - Hui Li
- School of Chinese Materia Medica, Nanjing University of Chinese Medicine, Nanjing 210023, China
- State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai 201203, China
| | - Tianqing Nie
- State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai 201203, China
| | - Xiaoqin Jian
- State Key Laboratory of Virology, Wuhan Institute of Virology, Center for Biosafety Mega-Science, Chinese Academy of Sciences, Wuhan 430071, China
| | - Changyue Yu
- State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai 201203, China
| | - Jian Li
- State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai 201203, China
| | - Haixia Su
- State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai 201203, China
| | - Xianglei Zhang
- School of Life Science and Technology, and Shanghai Institute for Advanced Immunochemical Studies, ShanghaiTech University, Shanghai 201210, China
| | - Shiwei Li
- School of Life Science and Technology, and Shanghai Institute for Advanced Immunochemical Studies, ShanghaiTech University, Shanghai 201210, China
| | - Xin Yang
- School of Life Science and Technology, and Shanghai Institute for Advanced Immunochemical Studies, ShanghaiTech University, Shanghai 201210, China
| | - Chao Peng
- National Facility for Protein Science in Shanghai, Shanghai Advanced Research Institute, Chinese Academy of Science, Shanghai 201210, China
| | - Yue Yin
- National Facility for Protein Science in Shanghai, Shanghai Advanced Research Institute, Chinese Academy of Science, Shanghai 201210, China
| | - Leike Zhang
- State Key Laboratory of Virology, Wuhan Institute of Virology, Center for Biosafety Mega-Science, Chinese Academy of Sciences, Wuhan 430071, China
| | - Yechun Xu
- State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai 201203, China
- School of Pharmaceutical Science and Technology, Hangzhou Institute for Advanced Study, University of Chinese Academy of Sciences, Hangzhou 310024, China
| | - Hong Liu
- School of Chinese Materia Medica, Nanjing University of Chinese Medicine, Nanjing 210023, China
- State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai 201203, China
- School of Pharmaceutical Science and Technology, Hangzhou Institute for Advanced Study, University of Chinese Academy of Sciences, Hangzhou 310024, China
| | - Fang Bai
- School of Life Science and Technology, and Shanghai Institute for Advanced Immunochemical Studies, ShanghaiTech University, Shanghai 201210, China
- School of Information Science and Technology, ShanghaiTech University, Shanghai 201210, China
- Shanghai Clinical Research and Trial Center, Shanghai 201210, China
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4
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Tubek S, Niewinski P, Langner-Hetmanczuk A, Jura M, Kuliczkowski W, Reczuch K, Ponikowski P. The effects of P2Y 12 adenosine receptors' inhibitors on central and peripheral chemoreflexes. Front Physiol 2023; 14:1214893. [PMID: 37538377 PMCID: PMC10394699 DOI: 10.3389/fphys.2023.1214893] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Accepted: 06/30/2023] [Indexed: 08/05/2023] Open
Abstract
Introduction: The most common side effect of ticagrelor is dyspnea, which leads to premature withdrawal of this life-saving medication in 6.5% of patients. Increased chemoreceptors' sensitivity was suggested as a possible pathophysiological explanation of this phenomenon; however, the link between oversensitization of peripheral and/or central chemosensory areas and ticagrelor intake has not been conclusively proved. Methods: We measured peripheral chemoreceptors' sensitivity using hypoxic ventilatory response (HVR), central chemoreceptors' sensitivity using hypercapnic hyperoxic ventilatory response (HCVR), and dyspnea severity before and 4 ± 1 weeks following ticagrelor initiation in 11 subjects with chronic coronary syndrome undergoing percutaneous coronary intervention (PCI). The same tests were performed in 11 age-, sex-, and BMI-matched patients treated with clopidogrel. The study is registered at ClinicalTrials.com at NCT05080478. Results: Ticagrelor significantly increased both HVR (0.52 ± 0.46 vs. 0.84 ± 0.69 L min-1 %-1; p < 0.01) and HCVR (1.05 ± 0.64 vs. 1.75 ± 1.04 L min-1 mmHg-1; p < 0.01). The absolute change in HVR correlated with the change in HCVR. Clopidogrel administration did not significantly influence HVR (0.63 ± 0.32 vs. 0.58 ± 0.33 L min-1%-1; p = 0.53) and HCVR (1.22 ± 0.67 vs. 1.2 ± 0.64 L min-1 mmHg-1; p = 0.79). Drug-related dyspnea was reported by three subjects in the ticagrelor group and by none in the clopidogrel group. These patients were characterized by either high baseline HVR and HCVR or excessive increase in HVR following ticagrelor initiation. Discussion: Ticagrelor, contrary to clopidogrel, sensitizes both peripheral and central facets of chemodetection. Two potential mechanisms of ticagrelor-induced dyspnea have been identified: 1) high baseline HVR and HCVR or 2) excessive increase in HVR or HVR and HCVR. Whether other patterns of changes in chemosensitivities play a role in the pathogenesis of this phenomenon needs to be further investigated.
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Affiliation(s)
- Stanislaw Tubek
- Institute of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland
- Institute of Heart Diseases, University Hospital, Wroclaw, Poland
| | - Piotr Niewinski
- Institute of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland
- Institute of Heart Diseases, University Hospital, Wroclaw, Poland
| | - Anna Langner-Hetmanczuk
- Institute of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland
- Institute of Heart Diseases, University Hospital, Wroclaw, Poland
| | - Maksym Jura
- Institute of Heart Diseases, University Hospital, Wroclaw, Poland
- Department of Physiology, Wroclaw Medical University, Wroclaw, Poland
| | - Wiktor Kuliczkowski
- Institute of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland
- Institute of Heart Diseases, University Hospital, Wroclaw, Poland
| | - Krzysztof Reczuch
- Institute of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland
- Institute of Heart Diseases, University Hospital, Wroclaw, Poland
| | - Piotr Ponikowski
- Institute of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland
- Institute of Heart Diseases, University Hospital, Wroclaw, Poland
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5
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Jakob B, Schneider N, Gengenbach L, Manolikakes G. Palladium-catalyzed enantioselective three-component synthesis of α-arylglycine derivatives from glyoxylic acid, sulfonamides and aryltrifluoroborates. Beilstein J Org Chem 2023; 19:719-726. [PMID: 37284589 PMCID: PMC10241097 DOI: 10.3762/bjoc.19.52] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 05/17/2023] [Indexed: 06/08/2023] Open
Abstract
A palladium-catalyzed enantioselective three-component reaction of glyoxylic acid, sulfonamides and aryltrifluoroborates is described. This process provides modular access to the important α-arylglycine motif in moderate to good yields and enantioselectivies. The formed α-arylglycine products constitute useful building blocks for the synthesis of peptides or arylglycine-containing natural products.
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Affiliation(s)
- Bastian Jakob
- Department of Chemistry, RPTU Kaiserslautern-Landau, Erwin-Schrödinger-Str. Geb. 54, D-67663 Kaiserslautern, Germany
| | - Nico Schneider
- Department of Chemistry, RPTU Kaiserslautern-Landau, Erwin-Schrödinger-Str. Geb. 54, D-67663 Kaiserslautern, Germany
| | - Luca Gengenbach
- Department of Chemistry, RPTU Kaiserslautern-Landau, Erwin-Schrödinger-Str. Geb. 54, D-67663 Kaiserslautern, Germany
| | - Georg Manolikakes
- Department of Chemistry, RPTU Kaiserslautern-Landau, Erwin-Schrödinger-Str. Geb. 54, D-67663 Kaiserslautern, Germany
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6
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Jakob B, Diehl AM, Horst K, Kelm H, Manolikakes G. Palladium-catalyzed asymmetric three-component reaction between glyoxylic acid, sulfonamides and arylboronic acids for the synthesis of α-arylglycine derivatives. Front Chem 2023; 11:1165618. [PMID: 36993813 PMCID: PMC10040839 DOI: 10.3389/fchem.2023.1165618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 02/24/2023] [Indexed: 03/16/2023] Open
Abstract
A palladium-catalyzed asymmetric three-component synthesis of α-arylglycine derivatives starting from glyoxylic acid, sulfonamides and arylboronic acids is reported. This novel, operationally simple method offers access to the α-arylglycine scaffold in good yields and enantioselectivities. The utilization of α tailored catalyst system enables the enantioselective synthesis of the desired α-arylglycines despite a fast racemic background reaction. The obtained products can be directly employed as building blocks in peptide synthesis.
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7
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Maxfield DG, Bernasek TL, Engel CC, Gill MK. Is it Safe to Continue Clopidogrel in Elective Hip and Knee Arthroplasty? J Arthroplasty 2022; 37:1726-1730. [PMID: 35405265 DOI: 10.1016/j.arth.2022.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 03/15/2022] [Accepted: 04/05/2022] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND No evidence-based guidelines exist for the perioperative use of clopidogrel in elective hip and knee arthroplasty patients. This study compares the preoperative, intraoperative, and postoperative outcomes of total hip and knee arthroplasty in patients maintained on clopidogrel and with patients whose clopidogrel was held before surgery. METHODS We retrospectively identified 158 patients taking clopidogrel before undergoing elective total hip or knee arthroplasty. Patients were stratified for having clopidogrel held or continued, based on the interval between latest dose and date of surgery. The primary end points were receipt of transfusion and readmission within 90 days of surgery. Secondary end points were the incidence of complications such as bleeding, infection, re-operation, and major cardiac or neurologic events such as myocardial infarction or stroke during the 90-day postoperative period. RESULTS The two cohorts had similar demographics. Patients who continued clopidogrel were more likely to receive a blood transfusion postoperatively (9.1% vs 0%, P = .005), but there was no difference in wound drainage (P = .65), wound infection (P = .24), readmission (P = .74), major complications (P = .64), length of stay (P = .70), or mortality (P = .42). Patients who continued clopidogrel before surgery were more likely to have received general anesthesia (P < .001) per anesthesia protocol, however, three such patients did receive spinal anesthesia without any complications. With cementless implants, blood loss was not different between clopidogrel groups. CONCLUSION Patients undergoing elective total hip and knee arthroplasty may be safely maintained on clopidogrel without an increased risk of wound complications, infections, length of stay, readmission, reoperation, major medical complications, or mortality. Further prospective research is warranted to confirm the effects of continuing clopidogrel in patients undergoing elective hip and knee arthroplasty.
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Affiliation(s)
| | - Thomas L Bernasek
- Florida Orthopaedic Institute, Adult Reconstruction, Tampa, FL; Department of Orthopaedics, University of South Florida College of Medicine, Tampa, FL
| | - Corey C Engel
- Department of Orthopaedics, University of South Florida College of Medicine, Tampa, FL; Foundation for Orthopaedic Research and Education, Tampa, FL
| | - Meera K Gill
- Department of Orthopaedics, University of South Florida College of Medicine, Tampa, FL; Foundation for Orthopaedic Research and Education, Tampa, FL
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8
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Ali ZO, Bader L, Mohammed S, Arafa S, Arabi A, Cavallari L, Langaee T, Mraiche F, Rizk N, Awaisu A, Shahin MH, Elewa H. Effect of CYP2C19 genetic variants on bleeding and major adverse cardiovascular events in a cohort of Arab patients undergoing percutaneous coronary intervention and stent implantation. Pharmacogenet Genomics 2022; 32:183-191. [PMID: 35389962 DOI: 10.1097/fpc.0000000000000469] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
INTRODUCTION One-third of patients have clopidogrel resistance that may lead to major adverse cardiac events (MACEs). By contrast, it was found that some clopidogrel-treated patients have hyperresponsive platelets that are associated with higher bleeding risk. Several studies have shown that polymorphisms in the gene encoding the CYP2C19 contribute to the variability in response to clopidogrel. Data on genetic and nongenetic factors affecting clopidogrel response in the Arab population are scarce. In this prospective cohort study, we sought to assess the association between the increased function allele (CYP2C19*17) and bleeding events, and validate the effect of the CYP2C19 genetic variants and nongenetic factors on the incidence of MACEs. METHODS Blood samples were collected from patients that were undergoing percutaneous coronary intervention and receiving clopidogrel at the Heart Hospital, a specialist tertiary hospital in Doha, Qatar. Patients were followed for 12 months. Genotyping was performed for CYP2C19*2, *3, and *17 using TaqMan assays. RESULTS In 254 patients, the minor allele frequencies were 0.13, 0.004, and 0.21 for *2, *3, and *17, respectively. Over a 12-month follow-up period, there were 21 bleeding events (8.5 events/100 patient-year). CYP2C19*17 carriers were found to be associated with increased risk of bleeding (OR, 21.6; 95% CI, 4.8-96.8; P < 0.0001). CYP2C19*2 or *3 carriers were found to be associated with increased risk of baseline and incident MACE combined (OR, 8.4; 95% CI, 3.2-23.9; P < 0.0001). CONCLUSION This study showed a significant association between CYP2C19*17 allele and the increased risk of bleeding, and CYP2C19*2 or *3 with MACE outcomes.
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Affiliation(s)
- Zainab Omer Ali
- Pharmacy Department, Heart Hospital, Hamad Medical Corporation
| | - Loulia Bader
- College of Pharmacy, QU Health, Qatar University
| | - Shaaban Mohammed
- Pharmacy Department, Women Wellness and Research Center, Hamad Medical Corporation
| | - Salaheddin Arafa
- Department of Cardiology, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Abdulrahman Arabi
- Department of Cardiology, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Larisa Cavallari
- Department of Pharmacotherapy and Translational Research and Center for Pharmacogenomics and Precision Medicine, University of Florida, Gainesville, Florida, USA
| | - Taimour Langaee
- Department of Pharmacotherapy and Translational Research and Center for Pharmacogenomics and Precision Medicine, University of Florida, Gainesville, Florida, USA
| | - Fatima Mraiche
- College of Pharmacy, QU Health, Qatar University
- Biomedical and Pharmaceutical Research Unit, QU Health, Qatar University
| | - Nasser Rizk
- Biomedical and Pharmaceutical Research Unit, QU Health, Qatar University
- Pfizer Global Research, Groton, Connecticut, USA
| | - Ahmed Awaisu
- College of Pharmacy, QU Health, Qatar University
| | | | - Hazem Elewa
- College of Pharmacy, QU Health, Qatar University
- Biomedical and Pharmaceutical Research Unit, QU Health, Qatar University
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9
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Al-Najjar BO, Saqallah FG, Abbas MA, Al-Hijazeen SZ, Sibai OA. P2Y 12 antagonists: Approved drugs, potential naturally isolated and synthesised compounds, and related in-silico studies. Eur J Med Chem 2022; 227:113924. [PMID: 34731765 DOI: 10.1016/j.ejmech.2021.113924] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 09/27/2021] [Accepted: 10/13/2021] [Indexed: 12/12/2022]
Abstract
P2Y12 is a platelet surface protein which is responsible for the amplification of P2Y1 response. It plays a crucial role in platelet aggregation and thrombus formation through an ADP-induced platelet activation mechanism. Despite that P2Y12 platelets' receptor is an excellent target for developing antiplatelet agents, only five approved medications are currently in clinical use which are classified into thienopyridines and nucleoside-nucleotide derivatives. In the past years, many attempts for developing new candidates as P2Y12 inhibitors have been made. This review highlights the importance and the role of P2Y12 receptor as part of the coagulation cascade, its reported congenital defects, and the type of assays which are used to verify and measure its activity. Furthermore, an overview is given of the clinically approved medications, the potential naturally isolated inhibitors, and the synthesised candidates which were tested either in-vitro, in-vivo and/or clinically. Finally, we outline the in-silico attempts which were carried out using virtual screening, molecular docking and dynamics simulations in efforts of designing novel P2Y12 antagonists. Various phytochemical classes might be considered as a corner stone for the discovery of novel P2Y12 inhibitors, whereas a wide range of ring systems can be deliberated as leading scaffolds in that area synthetically and theoretically.
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Affiliation(s)
- Belal O Al-Najjar
- Department of Pharmaceutical Sciences, Faculty of Pharmacy, Al-Ahliyya Amman University, 19328, Amman, Jordan; Pharmacological and Diagnostic Research Lab, Al-Ahliyya Amman University, 19328, Amman, Jordan.
| | - Fadi G Saqallah
- Pharmaceutical Design and Simulation (PhDS) Laboratory, School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800, Penang, Malaysia
| | - Manal A Abbas
- Pharmacological and Diagnostic Research Lab, Al-Ahliyya Amman University, 19328, Amman, Jordan; Department of Medical Laboratory Sciences, Faculty of Allied Medical Sciences, Al-Ahliyya Amman University, 19328, Amman, Jordan
| | | | - Obada A Sibai
- Faculty of Pharmacy, Al-Ahliyya Amman University, 19328, Amman, Jordan
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10
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Zarkesh K, Entezar-Almahdi E, Ghasemiyeh P, Akbarian M, Bahmani M, Roudaki S, Fazlinejad R, Mohammadi-Samani S, Firouzabadi N, Hosseini M, Farjadian F. Drug-based therapeutic strategies for COVID-19-infected patients and their challenges. Future Microbiol 2021; 16:1415-1451. [PMID: 34812049 PMCID: PMC8610072 DOI: 10.2217/fmb-2021-0116] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 10/12/2021] [Indexed: 12/15/2022] Open
Abstract
Emerging epidemic-prone diseases have introduced numerous health and economic challenges in recent years. Given current knowledge of COVID-19, herd immunity through vaccines alone is unlikely. In addition, vaccination of the global population is an ongoing challenge. Besides, the questions regarding the prevalence and the timing of immunization are still under investigation. Therefore, medical treatment remains essential in the management of COVID-19. Herein, recent advances from beginning observations of COVID-19 outbreak to an understanding of the essential factors contributing to the spread and transmission of COVID-19 and its treatment are reviewed. Furthermore, an in-depth discussion on the epidemiological aspects, clinical symptoms and most efficient medical treatment strategies to mitigate the mortality and spread rates of COVID-19 is presented.
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Affiliation(s)
- Khatereh Zarkesh
- Pharmaceutical Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Pharmaceutics, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Elaheh Entezar-Almahdi
- Pharmaceutical Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Pharmaceutics, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Parisa Ghasemiyeh
- Pharmaceutical Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Clinical Pharmacy, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohsen Akbarian
- Pharmaceutical Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Marzieh Bahmani
- Pharmaceutical Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Shahrzad Roudaki
- Pharmaceutical Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Rahil Fazlinejad
- Department of Pharmacology & Toxicology, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Soliman Mohammadi-Samani
- Pharmaceutical Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Pharmaceutics, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Negar Firouzabadi
- Department of Pharmacology & Toxicology, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Majid Hosseini
- Department of Manufacturing & Industrial Engineering, The University of Texas Rio Grande Valley, Edinburg, TX 78539, USA
| | - Fatemeh Farjadian
- Pharmaceutical Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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11
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Edaravone Combined with Clopidogrel Is Beneficial to Improve Efficacy, Neurological Impairment, and Life Function in Acute Cerebral Infarction Patients. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:8030521. [PMID: 34691225 PMCID: PMC8531786 DOI: 10.1155/2021/8030521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 09/29/2021] [Indexed: 11/26/2022]
Abstract
Objective This research aimed at investigating the efficacy of edaravone combined with clopidogrel on acute cerebral infarction (ACI) and its influence on the neurological deficit and life function. Methods Totally, 154 ACI cases were included and then divided into the control group (CG) (n = 71) and research group (RG) (n = 83) according to the treatment methods. Patients in the CG were treated with clopidogrel alone, and those in the RG were under edaravone-clopidogrel combination therapy. The efficacy, adverse reactions, NIHSS score, cerebral hemodynamic indexes, and Fugl-Meyer scale (FMA) and Barthel index (BI) of activities of daily living (ADL) scores were observed. Results Compared with before treatment, the symptoms of both groups were improved after treatment: the NIHSS scores decreased, FMA and ADL scores increased, and cerebral hemodynamic indexes were improved. Compared with the CG, the efficacy and cerebral hemodynamic indexes of the RG were better, the adverse reactions were equivalent, the NIHSS score was lower, and the ADL and FMA scores were higher. Conclusion Edaravone combined with clopidogrel can effectively treat ACI and improve the neurological deficit and life function of patients.
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12
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He J, Liu W, Zhang Y, Zhang Z, Tian Y. Development and validation of a LC-MS/MS method for the enantioseparation and determination of clopidogrel bisulfate in beagle plasma and its application to a stereoselective pharmacokinetic study. J Pharm Biomed Anal 2021; 196:113901. [PMID: 33493742 DOI: 10.1016/j.jpba.2021.113901] [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: 11/19/2020] [Revised: 01/11/2021] [Accepted: 01/12/2021] [Indexed: 11/16/2022]
Abstract
A rapid and sensitive chiral liquid chromatography-tandem mass spectrometry (LC-MS/MS) method for the enantioseparation and determination of clopidogrel bisulfate enantiomers in beagle plasma was established and successfully applied to a stereoselective pharmacokinetic study. The chromatographic separation was achieved on an Ultron ES-OVM column (150 × 2.0 mm, 5 μm) with acetonitrile-ammonium acetate (10 mM, pH 4.5) (22:78, v/v) at a flow rate of 0.3 mL/min. The mass detection was conducted using multiple reaction monitoring mode with the transition of the m/z 322.00→212.00 for clopidogrel and m/z 285.00→193.00 for diazepam (IS), respectively. The calibration curve was linear at the range of 1-800 ng/mL (r2>0.997) for each enantiomer. The intra- and inter-day precision (CV%) was within 10.9 % and the accuracy was at the range of 88.5 %-101.3 % for both enantiomers. The extraction recovery was >90.2 % and no obvious matrix effect was observed. The pharmacokinetic results showed that the R-CB have higher Cmax and AUC than that of S-CB. It is first time to find the chiral inversion between S-CB and R-CB in beagle.
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Affiliation(s)
- Jian He
- Key Laboratory of Drug Quality Control and Pharmacovigilance (China Pharmaceutical University), Ministry of Education, Nanjing, 210009, China; Key Laboratory of Drug Consistency Evaluation, China Pharmaceutical University, Nanjing, 210009, China
| | - Wenxia Liu
- Key Laboratory of Drug Quality Control and Pharmacovigilance (China Pharmaceutical University), Ministry of Education, Nanjing, 210009, China; Key Laboratory of Drug Consistency Evaluation, China Pharmaceutical University, Nanjing, 210009, China
| | - Yu Zhang
- Key Laboratory of Drug Quality Control and Pharmacovigilance (China Pharmaceutical University), Ministry of Education, Nanjing, 210009, China; Key Laboratory of Drug Consistency Evaluation, China Pharmaceutical University, Nanjing, 210009, China
| | - Zunjian Zhang
- Key Laboratory of Drug Quality Control and Pharmacovigilance (China Pharmaceutical University), Ministry of Education, Nanjing, 210009, China; Key Laboratory of Drug Consistency Evaluation, China Pharmaceutical University, Nanjing, 210009, China; State Key Laboratory of Natural Medicine, China Pharmaceutical University, Nanjing, 210009, China.
| | - Yuan Tian
- Key Laboratory of Drug Quality Control and Pharmacovigilance (China Pharmaceutical University), Ministry of Education, Nanjing, 210009, China; Key Laboratory of Drug Consistency Evaluation, China Pharmaceutical University, Nanjing, 210009, China.
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13
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Song TJ, Kim J, Han SW, Kim YD, Lee JY, Ahn SH, Lee HS, Jung YH, Lee KY. Clopidogrel preventive effect based on cytochrome P450 2C19 genotype in ischaemic stroke: protocol for multicentre observational study. BMJ Open 2020; 10:e038031. [PMID: 32759249 PMCID: PMC7409960 DOI: 10.1136/bmjopen-2020-038031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 05/19/2020] [Accepted: 07/08/2020] [Indexed: 12/21/2022] Open
Abstract
INTRODUCTION Clopidogrel is an antiplatelet agent that is widely used for the secondary prevention of cardiovascular and cerebrovascular events. The genotype of cytochrome P450 2C19 (CYP2C19) differentially affects the liver's metabolism of clopidogrel, which may influence the drug's response and efficacy for cardiovascular event prevention. In contrast to prior studies of patients with coronary artery diseases, little is known about whether the CYP2C19 genotype influences the preventive efficacy of clopidogrel in patients who had a stroke. We hypothesise that, among patients who had an acute ischaemic stroke who are prescribed clopidogrel, the patients with a loss-of-function CYP2C19 genotype (poor and intermediate metabolisers) may be at a higher risk of composite cardiovascular events than those who are non-carriers (extensive metabolisers). METHODS AND ANALYSIS This prospective observational multicentre study was designed to determine whether composite cardiovascular events would differ among patients who had an ischaemic stroke prescribed clopidogrel according to CYP2C19 genotype (poor or intermediate vs extensive metabolisers). Inclusion criteria were patients who had an acute ischaemic stroke who underwent CYP2C19 genotype evaluation and received clopidogrel within 72 hours of stroke onset. The primary outcome is composite cardiovascular events (stroke, myocardial infarction, or cardiovascular death) within 6 months after acute ischaemic stroke between patients categorised as poor or intermediate metabolisers and those categorised as extensive metabolisers according to their CYP2C19 genotype. ETHICS AND DISSEMINATION The Institutional Review Board of Severance Hospital, Yonsei University College of Medicine approved this study (3-2019-0195). We received study approval from the institutional review board of each participating hospital. We plan to disseminate our findings at relevant conferences and meetings and through peer-reviewed journals. TRIAL REGISTRATION NUMBER NCT04072705.
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Affiliation(s)
- Tae-Jin Song
- Department of Neurology, Seoul Hospital, College of Medicine, Ewha Womans University, Seoul, South Korea
| | - Jinkwon Kim
- Department of Neurology, Yongin Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Sang Won Han
- Department of Neurology, Inje University Sanggye Paik Hospital, Seoul, South Korea
| | - Young Dae Kim
- Department of Neurology, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Jong Yun Lee
- Department of Neurology, National Medical Center, Seoul, South Korea
| | - Seong Hwan Ahn
- Department of Neurology, Chosun University Hospital, Gwangju, South Korea
| | - Hye Sun Lee
- Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, South Korea
| | - Yo Han Jung
- Department of Neurology, Gangnam Severance Hospital, Yonsei University Collegel of Medicine, Seoul, South Korea
| | - Kyung-Yul Lee
- Department of Neurology, Gangnam Severance Hospital, Yonsei University Collegel of Medicine, Seoul, South Korea
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14
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Zhu XY, Xia B, Ye T, Dai MZ, Yang H, Li CQ, Li P. Ponatinib-induced ischemic stroke in larval zebrafish for drug screening. Eur J Pharmacol 2020; 889:173292. [PMID: 32668288 DOI: 10.1016/j.ejphar.2020.173292] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 05/16/2020] [Accepted: 06/17/2020] [Indexed: 02/07/2023]
Abstract
Conventional mammalian ischemic stroke models for drug screening are technically challenging, laborious and time-consuming. In this study, using Ponatinib as an inducer, we developed and characterized a zebrafish ischemic stroke model. This zebrafish ischemic stroke had the cerebral vascular endothelial injury, thrombosis, reduced blood flow, inflammation and apoptosis as well as the reduced motility. The zebrafish ischemic stroke model was validated with 6 known human therapeutic drugs of ischemic stroke (Aspirin, Clopidogrel, Naoxintong capsules, Edaravone, Xingnaojing injection, Shuxuening injection). The mRNA levels of the neovascularization-related gene (vegfaa) and vascular endothelial growth factor receptor gene (VEGFR), neurodevelopment related genes (mbp and α1-tubulin), brain-derived neurotrophic factor (BDNF) and glial cell derived neurotrophic factor (GDNF) were significantly downregulated; whereas apoptosis-related genes (caspase-3, caspase-7, caspase-9 and bax/bcl-2), and inflammatory factor genes (IL-1β, IL-6, IL-10, TNF-α and NF-κB) were remarkably upregulated in the model. These results suggest that the pathophysiology of Ponatinib-induced zebrafish ischemic stroke is similar to that of human ischemic stroke patients and this whole animal model could be used to study the complex cellular and molecular pathogenesis of ischemic stroke and to rapidly identify therapeutic agents.
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Affiliation(s)
- Xiao-Yu Zhu
- State Key Laboratory of Natural Medicines, China Pharmaceutical University, Nanjing, Jiangsu Province, 210009, PR China; Hunter Biotechnology, Inc, F1A, Building 5, No. 88 Jiangling Road, Binjiang Zone, Hangzhou City, Zhejiang Province, 310051, PR China
| | - Bo Xia
- Hunter Biotechnology, Inc, F1A, Building 5, No. 88 Jiangling Road, Binjiang Zone, Hangzhou City, Zhejiang Province, 310051, PR China
| | - Ting Ye
- Hunter Biotechnology, Inc, F1A, Building 5, No. 88 Jiangling Road, Binjiang Zone, Hangzhou City, Zhejiang Province, 310051, PR China
| | - Ming-Zhu Dai
- Hunter Biotechnology, Inc, F1A, Building 5, No. 88 Jiangling Road, Binjiang Zone, Hangzhou City, Zhejiang Province, 310051, PR China
| | - Hua Yang
- State Key Laboratory of Natural Medicines, China Pharmaceutical University, Nanjing, Jiangsu Province, 210009, PR China
| | - Chun-Qi Li
- Hunter Biotechnology, Inc, F1A, Building 5, No. 88 Jiangling Road, Binjiang Zone, Hangzhou City, Zhejiang Province, 310051, PR China.
| | - Ping Li
- State Key Laboratory of Natural Medicines, China Pharmaceutical University, Nanjing, Jiangsu Province, 210009, PR China.
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15
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Diehl AM, Manolikakes G. Palladium‐Catalyzed Decarboxylative Three‐Component Synthesis of α‐Arylglycines: Replacing Boronic with Carboxylic Acids in the Petasis Reaction. ChemCatChem 2020. [DOI: 10.1002/cctc.202000652] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Andreas M. Diehl
- Department of ChemistryTechnische Universität Kaiserslautern Erwin-Schrödinger-Str. Geb. 54 D-67663 Kaiserslautern Germany
| | - Georg Manolikakes
- Department of ChemistryTechnische Universität Kaiserslautern Erwin-Schrödinger-Str. Geb. 54 D-67663 Kaiserslautern Germany
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16
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Pulavendran S, Rudd JM, Maram P, Thomas PG, Akhilesh R, Malayer JR, Chow VTK, Teluguakula N. Combination Therapy Targeting Platelet Activation and Virus Replication Protects Mice against Lethal Influenza Pneumonia. Am J Respir Cell Mol Biol 2020; 61:689-701. [PMID: 31070937 DOI: 10.1165/rcmb.2018-0196oc] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Excessive neutrophils recruited during influenza pneumonia contribute to severe lung pathology through induction of neutrophil extracellular traps (NETs) and release of extracellular histones. We have recently shown that activation of platelets during influenza enhances pulmonary microvascular thrombosis, leading to vascular injury and hemorrhage. Emerging evidence indicates that activated platelets also interact with neutrophils, forming neutrophil-platelet aggregates (NPAs) that contribute to tissue injury. Here, we examined neutrophil-platelet interactions and evaluated the formation of NPAs during influenza pneumonia. We also evaluated the efficacy of clopidogrel (CLP), an antagonist of the ADP-P2Y12 platelet receptor, alone or in combination with an antiviral agent (oseltamivir) against influenza infection in mice. Our studies demonstrated increased platelet activation and induction of NPAs in influenza-infected lungs, and that these NPAs led to NET release both in vitro and in vivo. Furthermore, neutrophil integrin Mac-1 (macrophage-1 antigen)-mediated platelet binding was critical for NPA formation and NET release. Administration of CLP reduced platelet activation and NPA formation but did not protect the mice against lethal influenza challenge. However, administration of CLP together with oseltamivir improved survival rates in mice compared with oseltamivir alone. The combination treatment reduced lung pathology, neutrophil influx, NPAs, NET release, and inflammatory cytokine release in infected lungs. Taken together, these results provide the first evidence that NPAs formed during influenza contribute to acute lung injury. Targeting both platelet activation and virus replication could represent an effective therapeutic option for severe influenza pneumonia.
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Affiliation(s)
- Sivasami Pulavendran
- Center for Veterinary Health Sciences and.,Oklahoma Center for Respiratory and Infectious Diseases, Oklahoma State University, Stillwater, Oklahoma
| | - Jennifer M Rudd
- Center for Veterinary Health Sciences and.,Oklahoma Center for Respiratory and Infectious Diseases, Oklahoma State University, Stillwater, Oklahoma
| | - Prasanthi Maram
- Center for Veterinary Health Sciences and.,Oklahoma Center for Respiratory and Infectious Diseases, Oklahoma State University, Stillwater, Oklahoma
| | - Paul G Thomas
- Department of Immunology, St. Jude Children's Research Hospital, Memphis, Tennessee; and
| | | | | | - Vincent T K Chow
- Department of Microbiology and Immunology, School of Medicine, National University Health System, National University of Singapore, Kent Ridge, Singapore
| | - Narasaraju Teluguakula
- Center for Veterinary Health Sciences and.,Oklahoma Center for Respiratory and Infectious Diseases, Oklahoma State University, Stillwater, Oklahoma
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17
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Jiang XW, Liu Y, Huang TS, Zhu XY. MGB Block ARMS Real-Time PCR for Diagnosis of CYP2C19 Mutation in a Chinese Population. Curr Bioinform 2019. [DOI: 10.2174/1574893614666190109154252] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background:
CYP2C19 is an important genetic factor modulating clopidogrel dose
requirement.
Objective:
Therefore, a simple and economic genotyping method for predicting the clopidogrel
dose of patients would be useful in clinical applications.
Methods:
In this study, the MGB blocker ARMS real-time PCR contained two forward primers,
two MGB blockers and a common reverse primer have been used for CYP2C19*2, *3 and *17
substitutions.
Results:
Results showed that heterozygotes and homozygotes of CYP2C19*2, *3 and *17 could be
distinguished by the MGB blocker ARMS real-time PCR successfully. In the Chinese population,
patients with allele frequencies of CYP2C19*2, *3, and *17 are 18.43%, 3.03% and 0.76%,
respectively.
Conclusion:
This study indicates that the MGB blocker ARMS real-time PCR will be a simple,
economical method for the rapid detection of SNPs in CYP2C19.
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Affiliation(s)
- Xi-Wen Jiang
- DAAN Gene Co., Ltd. of Sun Yat-Sen University, 19 Xiangshan Road, Science Park, High & New Technology Development District, Guangzhou, Guangdong, China
| | - Yue Liu
- DAAN Gene Co., Ltd. of Sun Yat-Sen University, 19 Xiangshan Road, Science Park, High & New Technology Development District, Guangzhou, Guangdong, China
| | - Tao-Sheng Huang
- DAAN Gene Co., Ltd. of Sun Yat-Sen University, 19 Xiangshan Road, Science Park, High & New Technology Development District, Guangzhou, Guangdong, China
| | - Xiao-Ya Zhu
- DAAN Gene Co., Ltd. of Sun Yat-Sen University, 19 Xiangshan Road, Science Park, High & New Technology Development District, Guangzhou, Guangdong, China
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Máchal J, Hlinomaz O. Efficacy of P2Y12 Receptor Blockers After Myocardial Infarction and Genetic Variability of their Metabolic Pathways. Curr Vasc Pharmacol 2018; 17:35-40. [DOI: 10.2174/1570161116666180206110657] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Revised: 07/18/2017] [Accepted: 11/07/2017] [Indexed: 01/15/2023]
Abstract
Background: Various antiplatelet drugs are used following Acute Coronary Syndromes
(ACS). Of them, adenosine diphosphate receptor P2Y12 inhibitors clopidogrel, prasugrel and ticagrelor
are currently used for post-ACS long-term treatment. Although they act on the same receptor, they differ
in pharmacodynamics and pharmacokinetics. Several enzymes and transporters involved in the metabolism
of P2Y12 inhibitors show genetic variability with functional impact. This includes Pglycoprotein,
carboxylesterase 1 and, most notably, CYP2C19 that is important in clopidogrel activation.
Common gain-of-function or loss-of-function alleles of CYP2C19 gene are associated with lower
or higher platelet reactivity that may impact clinical outcomes of clopidogrel treatment. Prasugrel is
considered to be less dependent on CYP2C19 variability as it is also metabolized by other CYP450 isoforms.
Some studies, however, showed the relevance of CYP2C19 variants for platelet reactivity during
prasugrel treatment as well. Ticagrelor is metabolized mainly by CYP3A4, which does not show functionally
relevant genetic variability. Its concentrations may be modified by the variants of Pglycoprotein
gene ABCB1. While no substantial difference between the clinical efficacy of prasugrel
and ticagrelor has been documented, both of them have been shown to be superior to clopidogrel in
post-ACS treatment. This can be partially explained by lower variability at each step of their metabolism.
It is probable that factors influencing the pharmacokinetics of both drugs, including genetic factors,
may predict the clinical efficacy of antiplatelet treatment in personalized medicine.
</P><P>
Conclusion: We summarize the pharmacokinetics and pharmacogenetics of P2Y12 inhibitors with respect
to their clinical effects in post-myocardial infarction treatment.
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Affiliation(s)
- Jan Máchal
- International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czech Republic
| | - Ota Hlinomaz
- International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czech Republic
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19
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Li X, Liu C, Zhu X, Wei H, Zhang H, Chen H, Chen G, Yang D, Sun H, Shen Z, Zhang Y, Li W, Yang J, Liu Y, Lai X, Gong Y, Liu X, Li Y, Zhong D, Niu J, Liu B, Ding Y. Evaluation of Tolerability, Pharmacokinetics and Pharmacodynamics of Vicagrel, a Novel P2Y12 Antagonist, in Healthy Chinese Volunteers. Front Pharmacol 2018; 9:643. [PMID: 29973877 PMCID: PMC6019484 DOI: 10.3389/fphar.2018.00643] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Accepted: 05/29/2018] [Indexed: 01/26/2023] Open
Abstract
Background: Vicagrel is a novel anti-platelet drug and hydrolyzed to the same intermediate as clopidogrel via esterase, instead of CYP2C19. Here we report the first clinical trial on the tolerability, pharmacokinetics and pharmacodynamics of different doses of vicagrel, and comparison with clopidogrel in healthy Chinese volunteers. Methods: This study was conducted in two parts. Study I was a dose-escalating (5-15 mg) study. For each dose, 15 participants were randomized into three groups (total n = 45); nine participants were given vicagrel, three were given clopidogrel, and three were given a placebo. Study II was conducted to assess interactions between vicagrel and aspirin in 15 healthy participants. The plasma concentrations of the metabolites of vicagrel and clopidogrel were determined using a LC-MS/MS method. Platelet aggregation was assessed using the VerifyNow-P2Y12 assay. Results: Vicagrel (5-15 mg per day) dosing for 10 days or addition of aspirin was well tolerated in healthy volunteers. The exposure of the active metabolite increased proportionally across the dose range and was higher (~10-fold) than clopidogrel. The levels of IPA dosing 75 mg clopidogrel were between the responses of 5 mg and 10 mg vicagrel. After a single loading dose of vicagrel (30 mg) and a once-daily maintenance dose (7.5 mg) for 8 days, the maximum inhibition of platelet aggregation was similar to that seen with the combined use of vicagrel and aspirin (100 mg/day). Conclusion: Oral vicagrel demonstrated a favorable safety profile and excellent anti-platelet activity, which could be a promising P2Y12 antagonist as anti-platelet drug and can be further developed in phase II/III studies, and marketing for the unmet medical needs of cardiovascular diseases. The study was registered at http://www.chictr.org.cn (ChiCTR-IIR-16009260).
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Affiliation(s)
- Xiaojiao Li
- Phase I Clinical Trial Unit, First Hospital, Jilin University, Jilin, China
| | - Cai Liu
- State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, China
| | - Xiaoxue Zhu
- Phase I Clinical Trial Unit, First Hospital, Jilin University, Jilin, China
| | - Haijing Wei
- Phase I Clinical Trial Unit, First Hospital, Jilin University, Jilin, China
| | - Hong Zhang
- Phase I Clinical Trial Unit, First Hospital, Jilin University, Jilin, China
| | - Hong Chen
- Phase I Clinical Trial Unit, First Hospital, Jilin University, Jilin, China
| | - Guiling Chen
- Phase I Clinical Trial Unit, First Hospital, Jilin University, Jilin, China
| | - Deming Yang
- Phase I Clinical Trial Unit, First Hospital, Jilin University, Jilin, China
| | - Hongbin Sun
- State Key Laboratory of Natural Medicines and Center of Drug Discovery, College of Pharmacy, China Pharmaceutical University, Nanjing, China
| | - Zhenwei Shen
- First Hospital and Institute of Immunology, First Hospital, Jilin University, Jilin, China
| | - Yifan Zhang
- State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, China
| | - Wei Li
- State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, China
| | - Jin Yang
- Center of Drug Metabolism and Pharmacokinetics, China Pharmaceutical University, Nanjing, China
| | | | - Xiaojuan Lai
- Jiangsu Vcare PharmaTech Co. Ltd., Nanjing, China
| | - Yanchun Gong
- Jiangsu Vcare PharmaTech Co. Ltd., Nanjing, China
| | - Xuefang Liu
- Jiangsu Vcare PharmaTech Co. Ltd., Nanjing, China
| | | | - Dafang Zhong
- State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, China
| | - Junqi Niu
- Department of Hepatology, First Hospital, Jilin University, Jilin, China
| | - Bin Liu
- Department of Hand Surgery, First Hospital, Jilin University, Jilin, China
| | - Yanhua Ding
- Phase I Clinical Trial Unit, First Hospital, Jilin University, Jilin, China
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20
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Ferretti R, Zanitti L, Cirilli R. Development of a high-performance liquid chromatography method for the simultaneous determination of chiral impurities and assay of (S
)-clopidogrel using a cellulose-based chiral stationary phase in methanol/water mode. J Sep Sci 2018; 41:1208-1215. [DOI: 10.1002/jssc.201701191] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Revised: 11/16/2017] [Accepted: 11/17/2017] [Indexed: 11/08/2022]
Affiliation(s)
- Rosella Ferretti
- Centro nazionale per il controllo e la valutazione dei farmaci; Istituto Superiore di Sanità; Rome Italy
| | - Leo Zanitti
- Centro nazionale per il controllo e la valutazione dei farmaci; Istituto Superiore di Sanità; Rome Italy
| | - Roberto Cirilli
- Centro nazionale per il controllo e la valutazione dei farmaci; Istituto Superiore di Sanità; Rome Italy
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21
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Mohamed SH, Magdy AI, Ahmed AA. Exploring the nature of the clopidogrel–bromocresol green interactionviaspectrophotometric measurements and quantum chemical calculations. RSC Adv 2018; 8:29104-29114. [PMID: 35547975 PMCID: PMC9084451 DOI: 10.1039/c8ra05187a] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2018] [Accepted: 08/08/2018] [Indexed: 11/23/2022] Open
Abstract
Clopidogrel is an oral, thienopyridine class antiplatelet agent used to inhibit blood clots in coronary arteries, peripheral vascular and cerebrovascular diseases. A spectrophotometric method was developed for clopidogrel bisulfate (CLOP·H2SO4) determination using bromocresol green (BCG) as an ion-pairing agent. To explore the binding nature of CLOP·H2SO4 with BCG at a molecular level, quantum chemical calculations have been performed. DFT based full geometry optimization has been carried out for BCG and clopidogrel in basic (CLOP) and protonated (CLOP+) forms as well as for BCG ion-pairs with CLOP and CLOP·H2SO4. The DFT calculations referred to the stability of the BCG–CLOP+ ion-pair and its spontaneous formation reaction from BCG and CLOP·H2SO4 compared to the BCG–CLOP-ion-pair. Furthermore, the UV-visible spectra and their corresponding excited states and electronic transitions for BCG, BCG–CLOP+ ion-pair, and BCG–CLOP ion-pair have been investigated. These spectra provided a molecular level understanding of the nature of the different intra-molecular and intermolecular electronic transitions in the BCG ion-pairs with CLOP+. Moreover, the quantitative analysis based on extracting a yellow-formed ion-pair into chloroform from aqueous medium was carried out. The ion-pair exhibits an absorption maximum at 413 nm. The optimum conditions of the reactions were studied experimentally and optimized. The calibration graph shows that CLOP·H2SO4 can be determined up to 100.0 μg mL−1 with detection limit (LOD) of 0.57 μg mL−1 and quantification limit (LOQ) of 1.86 μg mL−1. The low relative standard deviation values, 0.16–1.16, indicate good precision. The results were compared to other published data and were treated statistically using F and t-tests. The nature of the different electronic transitions of clopidogrel bisulfate; antiplatelet agent, in BCG ion-pair and quantitative analysis based on extracting a yellow-formed ion-pair into chloroform from aqueous medium is obtained.![]()
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Affiliation(s)
| | - Alyaa I. Magdy
- Chemistry Department
- Faculty of Engineering
- Madina High Institute for Engineering and Technology
- Giza
- Egypt
| | - Ashour A. Ahmed
- Institute of Physics
- University of Rostock
- D-18059 Rostock
- Germany
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22
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Zhu XY, Liu HC, Guo SY, Xia B, Song RS, Lao QC, Xuan YX, Li CQ. A Zebrafish Thrombosis Model for Assessing Antithrombotic Drugs. Zebrafish 2016; 13:335-44. [DOI: 10.1089/zeb.2016.1263] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Affiliation(s)
- Xiao-Yu Zhu
- Zhejiang Provincial Key Lab for Technology and Application of Model Organisms, Wenzhou Medical University, Wenzhou, People's Republic of China
- Hunter Biotechnology, Inc., Hangzhou City, People's Republic of China
- Innovation Team of Drug Safety Evaluation, Collaborative Innovation Center of Yangtze River Delta Region Green Pharmaceuticals, Hangzhou, People's Republic of China
| | - Hong-Cui Liu
- Hunter Biotechnology, Inc., Hangzhou City, People's Republic of China
| | - Sheng-Ya Guo
- Hunter Biotechnology, Inc., Hangzhou City, People's Republic of China
| | - Bo Xia
- Hunter Biotechnology, Inc., Hangzhou City, People's Republic of China
| | - Ru-Shun Song
- Hunter Biotechnology, Inc., Hangzhou City, People's Republic of China
| | - Qiao-Cong Lao
- Hunter Biotechnology, Inc., Hangzhou City, People's Republic of China
| | - Yao-Xian Xuan
- Innovation Team of Drug Safety Evaluation, Collaborative Innovation Center of Yangtze River Delta Region Green Pharmaceuticals, Hangzhou, People's Republic of China
- Center of Safety Evaluation, Zhejiang Academy of Medical Sciences, Hangzhou, People's Republic of China
| | - Chun-Qi Li
- Zhejiang Provincial Key Lab for Technology and Application of Model Organisms, Wenzhou Medical University, Wenzhou, People's Republic of China
- Hunter Biotechnology, Inc., Hangzhou City, People's Republic of China
- Innovation Team of Drug Safety Evaluation, Collaborative Innovation Center of Yangtze River Delta Region Green Pharmaceuticals, Hangzhou, People's Republic of China
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23
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Strategies for managing clopidogrel hypersensitivity should take patient-specific factors into account. DRUGS & THERAPY PERSPECTIVES 2016. [DOI: 10.1007/s40267-015-0261-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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24
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Oliphant CS, Trevarrow BJ, Dobesh PP. Clopidogrel Response Variability: Review of the Literature and Practical Considerations. J Pharm Pract 2015; 29:26-34. [PMID: 26589471 DOI: 10.1177/0897190015615900] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Dual antiplatelet therapy with aspirin and a P2Y12 inhibitor is standard therapy following acute coronary syndrome and percutaneous coronary intervention. Despite the use of potent antiplatelet agents, vascular events continue to occur. Lack of response to clopidogrel therapy has been widely investigated using various methods of platelet function testing. These studies have consistently found an association between poor clopidogrel response and an increased risk of vascular events. Strategies to overcome this problem include higher clopidogrel doses or the use of an alternative P2Y12 agent. To date, the majority of studies investigating tailored antiplatelet therapy have failed to show any reduction in clinical events likely due to the low-risk population studied. Despite this lack of benefit from altering therapy, platelet function testing may be done in certain patient populations. Patients at high risk of deleterious outcomes from stent thrombosis may be an appropriate patient population for platelet function testing to ensure adequate response to therapy. In addition, emerging data suggests a potential role for platelet function testing to assess for bleeding risk. The purpose of this article is to review the key studies demonstrating response variability to clopidogrel therapy, strategies to overcome variability, and practical considerations for the clinician.
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Affiliation(s)
- Carrie S Oliphant
- Methodist Healthcare, University Hospital, Memphis, TN, USA Department of Clinical Pharmacy, University of Tennessee College of Pharmacy, Memphis, TN, USA
| | - Brian J Trevarrow
- Department of Pharmaceutical and Nutrition Care-Nebraska Medicine, Omaha, NE, USA College of Pharmacy, University of Nebraska Medical Center, Omaha, NE, USA
| | - Paul P Dobesh
- College of Pharmacy, University of Nebraska Medical Center, Omaha, NE, USA
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25
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Chen F, Yang Y, Fang C, Zhao J, Han M, Zhu Q, Bai X, Liu M, Yang G. Effect of fluvoxamine on the pharmacokinetics and pharmacodynamics of clopidogrel in rats. Xenobiotica 2015; 45:1122-8. [DOI: 10.3109/00498254.2015.1045570] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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26
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Khanam H, Shamsuzzaman. Bioactive Benzofuran derivatives: A review. Eur J Med Chem 2015; 97:483-504. [DOI: 10.1016/j.ejmech.2014.11.039] [Citation(s) in RCA: 277] [Impact Index Per Article: 30.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Revised: 11/19/2014] [Accepted: 11/21/2014] [Indexed: 12/13/2022]
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Abstract
Ticagrelor (Brilique™, Brilinta®), a cyclopentyl-triazolopyrimidine, is an orally active, reversible, and selective adenosine diphosphate (ADP) receptor antagonist indicated for use in patients with acute coronary syndromes (ACS). Ticagrelor has a faster onset of action and provides greater inhibition of platelet aggregation than clopidogrel. In the large well-designed, PLATO study in adult patients with ACS, 12 months' treatment with ticagrelor was more effective than clopidogrel in reducing the incidence of the primary composite endpoint of myocardial infarction, stroke, or cardiovascular (CV) death. Ticagrelor also reduced all-cause mortality relative to clopidogrel, although statistical significance of this was not confirmed in hierarchical testing. Benefit with ticagrelor was seen both in invasively and noninvasively managed patients. Ticagrelor was generally well tolerated and was not associated with an increased risk of major bleeding relative to clopidogrel. However, the incidences of non-coronary artery bypass grafting (CABG)-related bleeding, and major or minor bleeding, as well as some non-hemorrhagic adverse events, including dyspnea (usually of mild or moderate severity) and ventricular pauses (largely asymptomatic) were higher with ticagrelor. In addition, the ATLANTIC study showed that although pre-hospital administration of ticagrelor did not improve pre-percutaneous coronary intervention (PCI) coronary reperfusion in ACS patients relative to in-hospital administration, ticagrelor was safe in both instances, with no significant between-group differences in non-CABG-related major and minor bleeding events. Although further comparative studies with other antiplatelet agents, including prasugrel, are required to position it more definitively, current evidence indicates that ticagrelor is a useful option for the prevention of thrombotic CV events in ACS patients managed invasively or noninvasively.
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28
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Li P, Bu SH, Lu XT, Li LX, Xu AJ, Tang YN, Zhang J. Relationships between PON1 Q192R polymorphism and clinical outcome of antiplatelet treatment after percutaneous coronary intervention: a meta-analysis. Mol Biol Rep 2014; 41:6263-73. [PMID: 24981930 DOI: 10.1007/s11033-014-3509-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2014] [Accepted: 06/19/2014] [Indexed: 01/11/2023]
Abstract
This meta-analysis was performed to assess the relationships between the PON1 Q192R (rs662 T>C) polymorphism and the clinical outcome of antiplatelet treatment after percutaneous coronary intervention (PCI). A range of electronic databases were searched: Web of Science (1945-2013), the Cochrane Library Database (Issue 12, 2013), PubMed (1966-2013), EMBASE (1980-2013), CINAHL (1982-2013) and the Chinese Biomedical Database (CBM) (1982-2013) without language restrictions. Meta-analysis was conducted using the STATA 12.0 software. The crude odds ratio (OR) with their 95 % confidence interval (CI) were calculated. Six clinical cohort studies with a total number of 5,189 patients undergoing PCI for coronary heart disease were included. Our meta-analysis revealed that the PON1 Q192R polymorphism was correlated with an increased risk of major adverse cardiovascular events (MACE) in patients receiving antiplatelet treatment after PCI (C allele vs. T allele: OR = 1.22, 95 % CI 1.04-1.43, P = 0.014; CT+CC vs. TT: OR = 1.38, 95 % CI 1.03-1.86, P = 0.029; CC vs. TT: OR = 1.45, 95 % CI 1.05-1.99, P = 0.024; respectively), especially among Asians. Furthermore, we found significantly positive correlations between the PON1 Q192R polymorphism and the incidence of stent thrombosis in patients receiving antiplatelet treatment after PCI (C allele vs. T allele: OR = 1.42, 95 % CI 1.08-1.87, P = 0.011; CT+CC vs. TT: OR = 1.93, 95 % CI 1.01-3.67, P = 0.046; CC vs. TT: OR = 2.18, 95 % CI 1.09-4.35, P = 0.027; respectively). Our meta-analysis of clinical cohort studies provides evidence that the PON1 Q192R polymorphism may increase the risk of MACE and stent thrombosis in patients receiving antiplatelet treatment after PCI.
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Affiliation(s)
- Ping Li
- Department of Pharmacy, The Affiliated Xinhua Hospital of Shanghai Jiaotong University, Kongjiang Road No. 1665, Yangpu District, Shanghai, 200082, People's Republic China
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Manaqibwala MI, Butler KA, Sagebien CA. Complications of hip fracture surgery on patients receiving clopidogrel therapy. Arch Orthop Trauma Surg 2014; 134:747-53. [PMID: 24682494 DOI: 10.1007/s00402-014-1981-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2013] [Indexed: 12/21/2022]
Abstract
INTRODUCTION Clopidogrel (Plavix(®)) may influence patient safety during fracture surgery. Our study examines the incidence of complications for patients undergoing hemiarthroplasty on clopidogrel therapy. MATERIALS AND METHODS All patients, who underwent hemiarthroplasty between 2005 and 2011 were retrospectively reviewed. Patients were placed in two comparative groups based on the use of clopidogrel antiplatelet therapy. Records were reviewed for patient demographics, ASA score, pre and postoperative hemoglobin, time to surgery, length of stay, bleeding events, transfusions and complications. Comparative statistical analysis was performed using Fisher's exact test and Student's t test, using P < 0.05 to identify statistical significance. RESULTS A total of 203 charts were reviewed, of which 162 patients met inclusion/exclusion criteria. One hundred and twelve females and 50 males with mean age of 84 years were identified. The clopidogrel group consisted of 15 (9.3 %) patients and the nonclopidogrel group 147 (90.7 %). The clopidogrel group had more comorbidities resulting in a significantly higher ASA score (3.9 vs. 2.9), and lower preoperative hemoglobin (11.3 vs. 12.0). There was no significant difference identified in time to surgery, intraoperative blood loss, hemoglobin on days 1-3, or number of transfusions received between groups. Patients on clopidogrel were seen to have significantly longer hospital stays (10.6 vs. 7.4 days). However, a similar rate of wound and bleeding related complications (6.7 vs. 6.1 %) was seen. CONCLUSIONS The optimal treatment for hip fracture patients on antiplatelet therapy is unclear. However, in this study there appears to be no significant difference with regards to bleeding and bleeding related wound complications, suggesting it is safe to proceed with hemiarthroplasty for patients receiving clopidogrel.
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Affiliation(s)
- Moiz I Manaqibwala
- Robert Wood Johnson Medical School, 1 Robert Wood Johnson Place, New Brunswick, NJ, 08901, USA,
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30
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Schneider AE, Beisel T, Shemet A, Manolikakes G. Bi(OTf)3-catalyzed three-component synthesis of α-amino acid derivatives. Org Biomol Chem 2014; 12:2356-9. [PMID: 24599384 DOI: 10.1039/c4ob00265b] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
A highly efficient Bi(OTf)3-catalyzed multicomponent synthesis of arylglycines from readily available starting materials is described. The reaction proceeds under mild conditions and provides a general route to various N-protected arylglycines.
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Affiliation(s)
- Angelika E Schneider
- Department of Organic Chemistry and Chemical Biology, Goethe University Frankfurt, Frankfurt am Main, Germany.
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31
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So SS, Mattson AE. Stereoselective NH Insertion-Arylation Reactions of Nitrodiazoesters. ASIAN J ORG CHEM 2014. [DOI: 10.1002/ajoc.201300285] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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32
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Reversal of thienopyridine-induced platelet dysfunction following desmopressin administration. J Med Toxicol 2013; 9:139-43. [PMID: 23161280 DOI: 10.1007/s13181-012-0275-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
Adenosine diphosphate (ADP)-receptor antagonists are widely used for thrombus prevention, although reversing their platelet dysfunction is difficult. This study evaluated the ability of desmopressin to reverse clopidogrel-induced platelet dysfunction. Sprague-Dawley rats received either clopidogrel (30 mg/kg) or placebo, followed 4 h later by saline or desmopressin (0.15, 0.3, or 0.6 μg/kg). Bleeding times and platelet aggregation studies were subsequently performed. A bleeding time >25 min was considered "prolonged." The median bleeding time for clopidogrel-exposed rats was 21 min, vs. 6 min for controls (p < 0.01). Progressively higher doses of 1-deamino-8-D-arginine vasopressin (DDAVP) were associated with a reduced number of rats with prolonged bleeding time (p = 0.001). Higher doses of DDAVP were also associated with a reduction in the median (IQR) bleeding time; 29 (13.5-30) min in rats receiving clopidogrel without DDAVP vs. 19 (12-28) min in rats receiving clopidogrel and 0.6 μg/kg DDAVP. The step-wise dosing of DDAVP resulted in a 54 % reduction in meeting the endpoint of prolonged bleeding time (OR 0.46; p = 0.025; 95 % CI 0.23-0.91). Platelet aggregation was observed in all control rats, but only some of those clopidogrel-treated rats who received 0.6 μg/kg DDAVP. In this model of an ADP-receptor antagonist, DDAVP results in partial reversal of clopidogrel-induced platelet dysfunction.
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33
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Halli J, Manolikakes G. Iron-Catalyzed Three-Component Synthesis of α-Amino Acid Derivatives. European J Org Chem 2013. [DOI: 10.1002/ejoc.201301349] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Pi Z, Sutton J, Lloyd J, Hua J, Price L, Wu Q, Chang M, Zheng J, Rehfuss R, Huang CS, Wexler RR, Lam PY. 2-Aminothiazole based P2Y1 antagonists as novel antiplatelet agents. Bioorg Med Chem Lett 2013; 23:4206-9. [DOI: 10.1016/j.bmcl.2013.05.025] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2013] [Revised: 05/01/2013] [Accepted: 05/07/2013] [Indexed: 11/30/2022]
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Abstract
BACKGROUND Patients medicated with clopidogrel who require orthopaedic surgery present a particular challenge. Whether in an emergency or elective situation the orthopaedic surgeon must balance the risks of ceasing clopidogrel versus the risk of increased bleeding that dual antiplatelet therapy generates. METHOD This paper reviews the current published evidence regarding the risks of continuing clopidogrel, the risks of discontinuing clopidogrel and associated considerations such as venous thromboprophylaxis. RESULTS Little good quality evidence exists in regard to perioperative clopidogrel for orthopaedic surgery. Available evidence across non-cardiac and cardiac surgery were assessed and presented in regards to current practices, blood loss for orthopaedic operations, risks when continuing clopidogrel, risks of stopping clopidogrel and also the consideration of venous thromboembolism. CONCLUSIONS The patients at greatest risk, when discontinuing clopidogrel therapy, are those with drug eluting stents who may be at risk of stent thrombosis. Where possible, efforts should be made to continue clopidogrel therapy through the perioperative period, taking precautions to minimize bleeding. If the risk of bleeding is too high, antiplatelet therapy must be reinstated as soon as considered reasonable after surgery. In addition, patients on clopidogrel who sustain a fall or other general trauma need to be carefully assessed because of the possibility of occult bleeding, such as into the retroperitoneal space. Until more definitive evidence becomes available, this review aims to provide a guide for the orthopaedic surgeon in dealing with the difficult dilemma of the patient on clopidogrel therapy, recommending that orthopaedic surgeons take a team approach to assess the individual risks for all patients and consider continuation of clopidogrel therapy perioperatively where possible.
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Affiliation(s)
- Mitchell J Steele
- Wollongong Hospital, 4 Mansion Pt Road, Grays Point, Sydney, NSW 2232, Australia.
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Cheng JWM. Ticagrelor: oral reversible P2Y(12) receptor antagonist for the management of acute coronary syndromes. Clin Ther 2012; 34:1209-20. [PMID: 22521881 DOI: 10.1016/j.clinthera.2012.04.005] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2012] [Revised: 03/15/2012] [Accepted: 04/06/2012] [Indexed: 11/25/2022]
Abstract
BACKGROUND The clinical benefits of dual antiplatelet treatment (aspirin + clopidogrel) in the management of acute coronary syndromes (ACS) are well established. However, clopidogrel is a prodrug that requires hepatic activation. Concerns regarding its delayed onset of action, variability in antiplatelet effects, and prolonged recovery of platelet function after discontinuation have prompted the development of P2Y(12) receptor antagonists. Ticagrelor is the most recently developed P2Y(12) receptor antagonist available in the United States. Ticagrelor is a nonthienopyridine antiplatelet agent and is the first reversible oral antagonist of the P2Y(12) receptors. OBJECTIVE This article reviews the pharmacology, clinical efficacy, and tolerability of ticagrelor use in management of ACS. METHODS Peer-reviewed clinical trials, review articles, and relevant treatment guidelines published from 1966 to March 15, 2012, were identified from the MEDLINE and Current Content databases using the search terms ticagrelor, ACS, pharmacokinetics, pharmacodynamics, pharmacoeconomics, and cost-effectiveness. Citations from available articles were also reviewed for additional references. RESULTS Nine pharmacokinetics/pharmacodynamics studies in humans and 1 clinical study were identified. In addition, the findings from 6 subanalyses based on the clinical study were included. Compared with clopidogrel, ticagrelor was associated with a significantly reduced composite rate of death from cardiovascular causes, myocardial infarction, or stroke (ticagrelor, 9.8%; clopidogrel, 11.7%; hazard ratio [HR] = 0.84; 95% CI, 0.77-0.92; P < 0.001). The difference in the rates of major bleeding was not significant (ticagrelor, 11.6%; clopidogrel, 11.2%). Ticagrelor was associated with a higher rate of non-coronary artery bypass graft surgery related major bleeding (4.5% vs 3.8%; P = 0.03), including fatal intracranial bleeding (0.1% vs 0.01%; P = 0.02), and fewer cases of other types of fatal bleeding (0.1% vs 0.3%; P = 0.03). Other adverse events reported with ticagrelor use included dyspnea (13.8%), headache (6.5%), and bradyarrhythmia (5.8%). The effects of ticagrelor have not been compared to those of other antiplatelet agents, including prasugrel. CONCLUSIONS Based on the findings from the present review, ticagrelor provides reversible inhibition of adenosine diphosphate-induced platelet aggregation, with a faster onset of action than clopidogrel, and is effective in the treatment of patients with ACS. More data are required to definitively position ticagrelor with respect to other antiplatelet agents, including prasugrel.
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Affiliation(s)
- Judy W M Cheng
- Massachusetts College of Pharmacy and Health Sciences, Brigham and Women's Hospital, Boston, MA 02115-5896, USA.
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Bracey AW, Reyes MA, Chen AJ, Bayat M, Allison PM. How do we manage patients treated with antithrombotic therapy in the perioperative interval. Transfusion 2011; 51:2066-77. [PMID: 21517891 DOI: 10.1111/j.1537-2995.2011.03146.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Arthur W Bracey
- Department of Pathology, Texas Heart Institute at St Luke's Episcopal Hospital, Houston, Texas, USA.
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Is prasugrel more effective than clopidogrel at preventing future cardiac events? JAAPA 2011; 24:52, 55. [PMID: 21387971 DOI: 10.1097/01720610-201102000-00010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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De Rango P, Parlani G, Romano L, Verzini F, Giordano G, Cieri E, Barbante M, Cao P. Second-generation Thienopyridine use is not Associated with Better Early Perioperative Outcome During Carotid Stenting. Eur J Vasc Endovasc Surg 2011; 41:214-21. [DOI: 10.1016/j.ejvs.2010.10.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2010] [Accepted: 10/15/2010] [Indexed: 11/29/2022]
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Thalji RK, Aiyar N, Davenport EA, Erhardt JA, Kallal LA, Morrow DM, Senadhi S, Burns-Kurtis CL, Marino JP. Benzofuran-substituted urea derivatives as novel P2Y1 receptor antagonists. Bioorg Med Chem Lett 2010; 20:4104-7. [DOI: 10.1016/j.bmcl.2010.05.072] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2010] [Revised: 05/14/2010] [Accepted: 05/18/2010] [Indexed: 11/27/2022]
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Palmerini T, Barozzi C, Tomasi L, Sangiorgi D, Marzocchi A, De Servi S, Ortolani P, Reggiani LB, Alessi L, Lauria G, Bassi M, Branzi A. A randomised study comparing the antiplatelet and antinflammatory effect of clopidogrel 150mg/day versus 75mg/day in patients with ST-segment elevation acute myocardial infarction and poor responsiveness to clopidogrel: Results from the DOUBLE study. Thromb Res 2010; 125:309-14. [PMID: 19604542 DOI: 10.1016/j.thromres.2009.06.016] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2009] [Revised: 06/17/2009] [Accepted: 06/19/2009] [Indexed: 11/19/2022]
Affiliation(s)
- Tullio Palmerini
- Istituto di Cardiologia, Policlinico S. Orsola, Università di Bologna, Italy.
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Capillary zone electrophoresis method for determination of (+)-S clopidogrel carboxylic acid metabolite in human plasma and urine designed for biopharmaceutic studies. J Chromatogr B Analyt Technol Biomed Life Sci 2010; 878:1013-8. [PMID: 20346740 DOI: 10.1016/j.jchromb.2010.02.033] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2009] [Revised: 02/05/2010] [Accepted: 02/25/2010] [Indexed: 11/23/2022]
Abstract
Fast and reproducible Capillary Zone Electrophoresis (CZE) method for the quantification of (+)-S clopidogrel carboxylic acid metabolite in human fluids was elaborated for the first time. Optimal buffer and CZE conditions were established to obtain the complete separation of clopidogrel, its metabolite and piroxicam (internal standard), during one analytical run. Finally, resolution of the analytes was obtained in an uncoated silica capillary filled with a phosphate buffer of pH 2.5. The analytes were isolated from plasma and urine samples using solid phase extraction (SPE). Validation of the CZE method was carried out. The calibration curve of clopidogrel was linear in the range of 0.5-10.0mg/L in plasma and urine, whereas for (+)-S carboxylic acid metabolite linearity was confirmed in the range of 0.25-20.0mg/L in plasma and 0.25-10.0mg/L in urine. Intra- and inter-day precision and accuracy were repeatable. LOD and LOQ were also estimated. SPE recovery of the analytes from plasma and urine was comparable and greater than 80%. The validated method was successfully applied in pharmacokinetic investigations of (+)-S carboxylic acid metabolite of clopidogrel following the oral administration of clopidogrel to patients prior to percutaneous coronary intervention.
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Gresham C, Levine M, Ruha AM. Case files of the Medical Toxicology Fellowship at Banner Good Samaritan Medical Center in Phoenix, AZ: a non-warfarin anticoagulant overdose. J Med Toxicol 2010; 5:242-9. [PMID: 19876861 DOI: 10.1007/bf03178275] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
A 50-year-old man presented to the emergency department (ED) following an overdose of his "blood thinners." The patient had become increasingly depressed over financial concerns, prompting a suicide attempt. He declined to provide any details regarding his current medications or his past medical history. A review of the computerized medical record, however, revealed he had a Factor V Leiden mutation with multiple venothromboembolic events. He previously had an inferior vena cava filter placed, and had received tissue plasminogen activator (tPA) for a cerebrovascular accident. A toxicology consult was obtained in the ED.
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Affiliation(s)
- Chip Gresham
- Department of Medical Toxicology, Banner Good Samaritan Medical Center, Banner Poison Control Center, Phoenix, AZ 85006, USA
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Ellis KJ, Stouffer GA, McLeod HL, Lee CR. Clopidogrel pharmacogenomics and risk of inadequate platelet inhibition: US FDA recommendations. Pharmacogenomics 2010; 10:1799-817. [PMID: 19891556 DOI: 10.2217/pgs.09.143] [Citation(s) in RCA: 73] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Antiplatelet therapy with clopidogrel is the current standard of care for coronary artery disease patients undergoing a percutaneous coronary intervention. However, approximately 25% of patients experience a subtherapeutic antiplatelet response. Clopidogrel is a prodrug that undergoes hepatic biotransformation by CYP2C19 into its active metabolite. Several studies have reported that, compared with wild-type individuals, CYP2C19 variant allele carriers exhibit a significantly lower capacity to metabolize clopidogrel into its active metabolite and inhibit platelet activation, and are therefore at significantly higher risk of adverse cardiovascular events. Consequently, the US FDA has recently changed clopidogrel's prescribing information to highlight the impact of CYP2C19 genotype on clopidogrel pharmacokinetics, pharmacodynamics and clinical response. Future studies remain necessary to develop effective personalized therapeutic strategies for CYP2C19 variant allele carriers and other individuals at risk for clopidogrel nonresponsiveness.
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Affiliation(s)
- Kyle J Ellis
- Division of Pharmacotherapy and Experimental Therapeutics, UNC Eshelman School of Pharmacy, CB# 7569, Kerr Hall, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-27569, USA
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Uchiyama S, Goto S, Matsumoto M, Nagai R, Origasa H, Yamazaki T, Shigematsu H, Shimada K, Yamada N, Bhatt DL, Steg PG, Ikeda Y. Cardiovascular event rates in patients with cerebrovascular disease and atherothrombosis at other vascular locations: results from 1-year outcomes in the Japanese REACH Registry. J Neurol Sci 2009; 287:45-51. [PMID: 19815240 DOI: 10.1016/j.jns.2009.09.011] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2009] [Revised: 08/13/2009] [Accepted: 09/10/2009] [Indexed: 11/18/2022]
Abstract
The REduction of Atherothrombosis for Continued Health (REACH) Registry is a large, international, prospective cohort of patients with atherothrombosis or multiple (>or=3) risk factors (MRFs) for atherothrombosis. Japanese patients (n=5193) were enrolled into the REACH registry between August and December 2004. One-year event rate in patients with cerebrovascular disease (CVD) was compared with that of patients with symptomatic atherothrombosis at other locations. After one year (n=5021), patients with CVD (n=1962) experienced a higher rate of non-fatal strokes than patients with coronary artery disease (CAD), peripheral artery disease (PAD) or MRFs alone (2.77% vs. 1.28%, 2.07% and 1.56%, respectively), but a lower rate of non-fatal myocardial infarction (0.45% vs. 1.31%, 0.77% and 0.66%, respectively). Patients with CVD plus disease in >or=1 other vascular bed had higher rates of cardiovascular events than patients with CVD alone. Overall, event rates including non-fatal stroke, non-fatal myocardial infarction and cardiovascular death were higher for patients with CVD and PAD than for patients with CVD and CAD. Asymptomatic carotid stenosis >or=70% and ankle-brachial index <0.9 were significant predisposing factors for stroke. Patients with CVD and co-existing atherothrombotic diseases had a high risk of recurrent events, including events arising in other vascular beds than originally diagnosed.
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Affiliation(s)
- Shinichiro Uchiyama
- Department of Neurology, Tokyo Women's Medical University School of Medicine, Tokyo, Japan.
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Latour-Perez J, de-Miguel-Balsa E. Cost effectiveness of fondaparinux in non-ST-elevation acute coronary syndrome. PHARMACOECONOMICS 2009; 27:585-595. [PMID: 19663529 DOI: 10.2165/11310120-000000000-00000] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
BACKGROUND Fondaparinux has been shown to reduce the risk of major bleeding and 30-day mortality compared with enoxaparin, in patients with non-ST-elevation acute coronary syndrome (NSTE-ACS). However, its cost effectiveness is not well known. OBJECTIVE To evaluate the effectiveness and economic attractiveness of fondaparinux relative to enoxaparin in patients with NSTE-ACS treated with triple antiplatelet therapy and early (non-urgent) invasive strategy. METHODS The decision model compares two alternative strategies: subcutaneous (SC) enoxaparin (1 mg/kg 12 hourly) versus SC fondaparinux (2.5 mg/day) in NSTE-ACS patients pre-treated with triple antiplatelet therapy and early revascularization. Cost-effectiveness and cost-utility analyses were performed from a healthcare perspective, based on a Markov model with a time horizon of the patient lifespan. Univariate sensitivity analysis and probabilistic (Monte Carlo) microsimulation analysis were performed. RESULTS In the base-case analysis (65 years, Thrombolysis In Myocardial Infarction [TIMI] score 4), the use of fondaparinux was associated with a significant reduction in major bleeding, a slight reduction in adverse cardiac events, and minor improvements in survival and QALYs, together with a small reduction in costs. The dominance of fondaparinux over enoxaparin remained unchanged in the univariate sensitivity analyses. According to Monte Carlo simulation, fondaparinux was cost saving in 99.9% of cases. CONCLUSION Compared with enoxaparin, the use of fondaparinux in patients with NSTE-ACS managed with an early invasive strategy appears to be cost effective, even in patients with a low risk of bleeding.
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Affiliation(s)
- Jaime Latour-Perez
- Intensive Care and Coronary Unit, Hospital General Universitario de Elche, Elche, Spain.
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Ostini R, Hegney D, Mackson JM, Williamson M, Tett SE. Why is the use of clopidogrel increasing rapidly in Australia? An exploration of geographical location, age, sex and cardiac stenting rates as possible influences on clopidogrel use. Pharmacoepidemiol Drug Saf 2008; 17:1077-90. [PMID: 18698666 DOI: 10.1002/pds.1638] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To explore clopidogrel use within Australia, investigating geography, age, sex and cardiac stenting rates. METHODS Data for clopidogrel supply (Pharmaceutical Benefits Scheme (PBS) and Repatriation Pharmaceutical Benefits Scheme (RPBS)) and cardiac stenting procedures (State Health Departments) were obtained for four different geographic regions (very remote/remote and major city in two Australian states). General linear modelling and correlation analyses were used to test for associations and chi2 analyses for proportions. RESULTS Clopidogrel supply increased rapidly in Australia since introduction, from 1.2 to 9.0 Defined Daily Doses (DDD)/1000 population/day. Among concessional and veteran populations use was much higher. Analysis of geographical area data confirmed an association between clopidogrel supply rates and cardiac stenting rates (r = 0.8-0.9 Spearman's rho, p < 0.01). Sex, age and geographical location were associated with both rates when considered together and when considered independently. Further modelling indicated that between 30 and 73% of clopidogrel supply could be accounted for by people receiving cardiac stents. CONCLUSIONS The supply of clopidogrel increases with age, male sex and living in a major city. These same demographic variables were important for cardiac stenting, an indication which is currently not approved for subsidy by the Australian government, but which modelling indicated could account for between one-third and three quarters of clopidogrel use. A review may be required to ensure subsidised indications reflect current evidence and cost-effective use.
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Affiliation(s)
- R Ostini
- School of Pharmacy, University of Queensland, Brisbane, Australia
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Coller BS, Shattil SJ. The GPIIb/IIIa (integrin alphaIIbbeta3) odyssey: a technology-driven saga of a receptor with twists, turns, and even a bend. Blood 2008; 112:3011-25. [PMID: 18840725 PMCID: PMC2569161 DOI: 10.1182/blood-2008-06-077891] [Citation(s) in RCA: 255] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2008] [Accepted: 07/21/2008] [Indexed: 01/24/2023] Open
Abstract
Starting 90 years ago with a clinical description by Glanzmann of a bleeding disorder associated with a defect in platelet function, technologic advances helped investigators identify the defect as a mutation(s) in the integrin family receptor, alphaIIbbeta3, which has the capacity to bind fibrinogen (and other ligands) and support platelet-platelet interactions (aggregation). The receptor's activation state was found to be under exquisite control, with activators, inhibitors, and elaborate inside-out signaling mechanisms controlling its conformation. Structural biology has produced high-resolution images defining the ligand binding site at the atomic level. Research on alphaIIbbeta3 has been bidirectional, with basic insights resulting in improved Glanzmann thrombasthenia carrier detection and prenatal diagnosis, assays to identify single nucleotide polymorphisms responsible for alloimmune neonatal thrombocytopenia, and the development of alphaIIbbeta3 antagonists, the first rationally designed antiplatelet agents, to prevent and treat thrombotic cardiovascular disease. The future looks equally bright, with the potential for improved drugs and the application of gene therapy and stem cell biology to address the genetic abnormalities. The alphaIIbbeta3 saga serves as a paradigm of rigorous science growing out of careful clinical observations of a rare disorder yielding both important new scientific information and improved diagnosis, therapy, and prevention of other disorders.
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Affiliation(s)
- Barry S Coller
- Laboratory of Blood and Vascular Biology, The Rockefeller University, New York, NY, USA.
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