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Sourkatti H, Pajula J, Keski-Kuha T, Koivisto J, Hilvo M, Lähteenmäki J. Predictive modeling for identification of older adults with high utilization of health and social services. Scand J Prim Health Care 2024:1-8. [PMID: 38958358 DOI: 10.1080/02813432.2024.2372297] [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: 02/06/2024] [Accepted: 06/19/2024] [Indexed: 07/04/2024] Open
Abstract
AIM Machine learning techniques have demonstrated success in predictive modeling across various clinical cases. However, few studies have considered predicting the use of multisectoral health and social services among older adults. This research aims to utilize machine learning models to detect high-risk groups of excessive health and social services utilization at early stage, facilitating the implementation of preventive interventions. METHODS We used pseudonymized data covering a four-year period and including information on a total of 33,374 senior citizens from Southern Finland. The endpoint was defined based on the occurrence of unplanned healthcare visits and the total number of different services used. Input features included individual's basic demographics, health status and past usage of healthcare resources. Logistic regression and eXtreme Gradient Boosting (XGBoost) methods were used for binary classification, with the dataset split into 70% training and 30% testing sets. RESULTS Subgroup-based results mirrored trends observed in the full cohort, with age and certain health issues, e.g. mental health, emerging as positive predictors for high service utilization. Conversely, hospital stay and urban residence were associated with decreased risk. The models achieved a classification performance (AUC) of 0.61 for the full cohort and varying in the range of 0.55-0.62 for the subgroups. CONCLUSIONS Predictive models offer potential for predicting future high service utilization in the older adult population. Achieving high classification performance remains challenging due to diverse contributing factors. We anticipate that classification performance could be increased by including features based on additional data categories such as socio-economic data.
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Affiliation(s)
- Heba Sourkatti
- VTT Technical Research Centre of Finland Ltd, Espoo, Finland
| | - Juha Pajula
- VTT Technical Research Centre of Finland Ltd, Espoo, Finland
| | - Teemu Keski-Kuha
- Finnish Institute of Health and Welfare (THL), Helsinki, Finland
| | - Juha Koivisto
- Finnish Institute of Health and Welfare (THL), Helsinki, Finland
| | - Mika Hilvo
- VTT Technical Research Centre of Finland Ltd, Espoo, Finland
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Park TJ, Hong H, Kim MS, Park JS, Chi WJ, Kim SY. Prunetin 4'- O-Phosphate, a Novel Compound, in RAW 264.7 Macrophages Exerts Anti-Inflammatory Activity via Suppression of MAP Kinases and the NFκB Pathway. Molecules 2021; 26:molecules26226841. [PMID: 34833933 PMCID: PMC8622051 DOI: 10.3390/molecules26226841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 11/03/2021] [Accepted: 11/09/2021] [Indexed: 11/30/2022] Open
Abstract
Biorenovation, a microbial enzyme-assisted degradation process of precursor compounds, is an effective approach to unraveling the potential bioactive properties of the derived compounds. In this study, we obtained a new compound, prunetin 4′-O-phosphate (P4P), through the biorenovation of prunetin (PRN), and investigated its anti-inflammatory effects in lipopolysaccharide (LPS)-treated RAW 264.7 macrophage cells. The anti-inflammatory effect of P4P was evaluated by measuring the production of prostaglandin-E2 (PGE2), nitric oxide (NO), which is an inflammation-inducing factor, and related cytokines such as tumor necrosis factor-α (TNFα), interleukin-1β (IL1β), and interleukin-6 (IL6). The findings demonstrated that P4P was non-toxic to cells, and its inhibition of the secretion of NO—as well as pro-inflammatory cytokines—was concentration-dependent. A simultaneous reduction in the protein expression level of pro-inflammatory proteins such as cyclooxygenase-2 (COX-2) and inducible nitric oxide synthase (iNOS) was observed. Moreover, the phosphorylation of mitogen-activated protein kinases (MAPKs) such as extracellular signal-regulated kinases (ERKs), c-Jun N-terminal kinase (JNK), p38 MAPK (p38), and nuclear factor kappa B (NFκB) was downregulated. To conclude, we report that biorenovation-based phosphorylation of PRN improved its anti-inflammatory activity. Cell-based in vitro assays further confirmed that P4P could be applied in the development of anti-inflammatory therapeutics.
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Affiliation(s)
- Tae-Jin Park
- Department of Pharmaceutical Engineering & Biotechnology, Sunmoon University, Asan 31460, Korea; (T.-J.P.); (H.H.)
| | - Hyehyun Hong
- Department of Pharmaceutical Engineering & Biotechnology, Sunmoon University, Asan 31460, Korea; (T.-J.P.); (H.H.)
| | - Min-Seon Kim
- Natural Product Informatics Research Center, Korea Institute of Science and Technology, Gangneung 25451, Korea; (M.-S.K.); (J.-S.P.)
| | - Jin-Soo Park
- Natural Product Informatics Research Center, Korea Institute of Science and Technology, Gangneung 25451, Korea; (M.-S.K.); (J.-S.P.)
| | - Won-Jae Chi
- Genetic Resources Assessment Division, National Institute of Biological Resources, Incheon 22689, Korea;
| | - Seung-Young Kim
- Department of Pharmaceutical Engineering & Biotechnology, Sunmoon University, Asan 31460, Korea; (T.-J.P.); (H.H.)
- Correspondence: ; Tel.: +82-41-530-2390
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3
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Bustos-Salgado P, Andrade-Carrera B, Domínguez-Villegas V, Díaz-Garrido N, Rodríguez-Lagunas MJ, Badía J, Baldomà L, Mallandrich M, Calpena-Campmany A, Garduño-Ramírez ML. Screening Anti-Inflammatory Effects of Flavanones Solutions. Int J Mol Sci 2021; 22:ijms22168878. [PMID: 34445584 PMCID: PMC8396196 DOI: 10.3390/ijms22168878] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 08/15/2021] [Accepted: 08/16/2021] [Indexed: 12/14/2022] Open
Abstract
There are a large number of remedies in traditional medicine focused on relieving pain and inflammation. Flavanones have been a potential source in the search for leading compounds and biologically active components, and they have been the focus of much research and development in recent years. Eysenhardtia platycarpa is used in traditional medicine for the treatment of kidney diseases, bladder infections, and diabetes mellitus. Many compounds have been isolated from this plant, such as flavones, flavanones, phenolic compounds, triterpenoid acids, chalcones, sugars, and fatty acids, among others. In this paper, natural flavanone 1 (extracted from Eysenhardtia platycarpa) as lead compound and flavanones 1a–1d as its structural analogues were screened for anti-inflammatory activity using Molinspiration® and PASS Online in a computational study. The hydro alcoholic solutions (FS) of flavanones 1, 1a–1d (FS1, FS1a–FS1d) were also assayed to investigate their in vivo anti-inflammatory cutaneous effect using two experimental models, a rat ear edema induced by arachidonic acid (AA) and a mouse ear edema induced by 12-O-tetradecanoylphorbol acetate (TPA). Histological studies and analysis of pro-inflammatory cytokines TNF-α, IL-1β, and IL-6 were also assessed in AA-inflamed rat ear tissue. The results showed that the flavanone hydro alcoholic solutions (FS) caused edema inhibition in both evaluated models. This study suggests that the evaluated flavanones will be effective when used in the future in skin pathologies with inflammation, with the results showing 1b and 1d to be the best.
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Affiliation(s)
- Paola Bustos-Salgado
- Department of Pharmacy and Pharmaceutical Technology and Physical Chemistry, Faculty of Pharmacy and Food Science, University of Barcelona, Av. Joan XXIII 29-31, 08028 Barcelona, Spain; (P.B.-S.); (M.M.)
| | - Berenice Andrade-Carrera
- Faculty of Chemical Sciences and Engineering, Autonomous University of the State of Morelos, Av. Universidad 1001, Cuernavaca 62209, Mexico; (B.A.-C.); (V.D.-V.)
| | - Valeri Domínguez-Villegas
- Faculty of Chemical Sciences and Engineering, Autonomous University of the State of Morelos, Av. Universidad 1001, Cuernavaca 62209, Mexico; (B.A.-C.); (V.D.-V.)
| | - Natalia Díaz-Garrido
- Department of Biochemistry and Physiology, Faculty of Pharmacy and Food Sciences, University of Barcelona, 08028 Barcelona, Spain; (N.D.-G.); (M.J.R.-L.); (J.B.); (L.B.)
- Institute of Biomedicine, University of Barcelona (IBUB), 08028 Barcelona, Spain
- Research Institute Sant Joan De Déu (IR-SJD), University of Barcelona (IBUB), 08028 Barcelona, Spain
| | - María J. Rodríguez-Lagunas
- Department of Biochemistry and Physiology, Faculty of Pharmacy and Food Sciences, University of Barcelona, 08028 Barcelona, Spain; (N.D.-G.); (M.J.R.-L.); (J.B.); (L.B.)
- Institute of Research in Food Nutrition and Safety, University of Barcelona (INSA-UB), 08921 Santa Coloma de Gramenet, Spain
| | - Josefa Badía
- Department of Biochemistry and Physiology, Faculty of Pharmacy and Food Sciences, University of Barcelona, 08028 Barcelona, Spain; (N.D.-G.); (M.J.R.-L.); (J.B.); (L.B.)
- Institute of Biomedicine, University of Barcelona (IBUB), 08028 Barcelona, Spain
- Research Institute Sant Joan De Déu (IR-SJD), University of Barcelona (IBUB), 08028 Barcelona, Spain
| | - Laura Baldomà
- Department of Biochemistry and Physiology, Faculty of Pharmacy and Food Sciences, University of Barcelona, 08028 Barcelona, Spain; (N.D.-G.); (M.J.R.-L.); (J.B.); (L.B.)
- Institute of Biomedicine, University of Barcelona (IBUB), 08028 Barcelona, Spain
- Research Institute Sant Joan De Déu (IR-SJD), University of Barcelona (IBUB), 08028 Barcelona, Spain
| | - Mireia Mallandrich
- Department of Pharmacy and Pharmaceutical Technology and Physical Chemistry, Faculty of Pharmacy and Food Science, University of Barcelona, Av. Joan XXIII 29-31, 08028 Barcelona, Spain; (P.B.-S.); (M.M.)
| | - Ana Calpena-Campmany
- Department of Pharmacy and Pharmaceutical Technology and Physical Chemistry, Faculty of Pharmacy and Food Science, University of Barcelona, Av. Joan XXIII 29-31, 08028 Barcelona, Spain; (P.B.-S.); (M.M.)
- Correspondence: (A.C.-C.); (M.L.G.-R.); Tel.: +34-93-402-4578 (A.C.-C.); +52-777-329-7997 (M.L.G.-R.)
| | - María Luisa Garduño-Ramírez
- Center for Chemical Research, Institute for Research Basic and Applied Sciences, Autonomous University of the State of Morelos, Av. Universidad 1001, Cuernavaca 62209, Mexico
- Correspondence: (A.C.-C.); (M.L.G.-R.); Tel.: +34-93-402-4578 (A.C.-C.); +52-777-329-7997 (M.L.G.-R.)
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Al-Qurain AA, Gebremichael LG, Khan MS, Williams DB, Mackenzie L, Phillips C, Russell P, Roberts MS, Wiese MD. Prevalence and Factors Associated with Analgesic Prescribing in Poly-Medicated Elderly Patients. Drugs Aging 2020; 37:291-300. [PMID: 32016823 DOI: 10.1007/s40266-019-00742-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Pain is common in older patients and management guidelines rarely consider the effect of multiple comorbidities and concurrent medications on analgesic selection. OBJECTIVES The objectives of this study were to identify the prevalence and pattern of analgesic prescribing and associated factors in older patients with polypharmacy. METHODS Older patients (aged ≥ 75 years) admitted to the Royal Adelaide Hospital between September 2015 and August 2016 and with polypharmacy were included and their comorbidities and medications prescribed at discharge were recorded. Drug Burden Index and Charlson Comorbidity Index were calculated. The number of medications that increased the risk of orthostatic hypotension were recorded. Logistic regression was used to compute the association between analgesic use and participant characteristics, and results were presented as odds ratios and 95% confidence intervals, adjusted for age, sex, Charlson Comorbidity Index, Drug Burden Index and orthostatic hypotension. RESULTS Over 15,000 admissions were identified, of which 1192 patients were included, 824 (69%) of whom were prescribed an analgesic medication. Paracetamol (used by 89% of analgesic users), opioids (34%) and adjuvants (17%) were used more frequently than non-steroidal anti-inflammatory drugs (8%). Analgesic users had a higher Drug Burden Index, were prescribed more medications and were less likely to be male compared with non-users. Charlson Comorbidity Index across the cohort was high (7.3 ± 1.9) but there was no difference between analgesic users and non-users, but analgesic users were more likely to have a documented diagnosis of osteoarthritis, osteoporosis and falls. Opioid use was associated with the Drug Burden Index, while adjuvant use was associated with orthostatic hypotension. Opioid use was associated with having a diagnosis of osteoporosis and falls. CONCLUSIONS In our cohort of poly-medicated elderly patients, prescription of analgesic medications was common, and these patients are likely to have an increased rate of adverse drug reactions and falls compared with those who were not prescribed analgesic medications.
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Affiliation(s)
- Aymen Ali Al-Qurain
- School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, Australia.,Basil Hetzel Institute for Translational Research, The Queen Elizabeth Hospital, Woodville, Australia.,Saudi Arabian Cultural Mission, Ministry of Education, Riyadh, Saudi Arabia
| | - Lemlem G Gebremichael
- School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, Australia.,Basil Hetzel Institute for Translational Research, The Queen Elizabeth Hospital, Woodville, Australia
| | - Muhammad Suleman Khan
- School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, Australia.,Basil Hetzel Institute for Translational Research, The Queen Elizabeth Hospital, Woodville, Australia
| | - Desmond B Williams
- School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, Australia
| | - Lorraine Mackenzie
- School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, Australia.,Basil Hetzel Institute for Translational Research, The Queen Elizabeth Hospital, Woodville, Australia
| | - Craig Phillips
- School of Nursing and Midwifery, University of South Australia, Adelaide, Australia
| | | | - Michael S Roberts
- School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, Australia.,Basil Hetzel Institute for Translational Research, The Queen Elizabeth Hospital, Woodville, Australia.,Therapeutics Research Centre, Diamantina Institute, Translational Research Institute, The University of Queensland, Brisbane, Australia
| | - Michael D Wiese
- School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, Australia.
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Asfandiyarova NS, Philippov EV. [The use of nonsteroidal anti - inflammatory drugs in polymorbid pathology]. TERAPEVT ARKH 2020; 92:82-88. [PMID: 32598668 DOI: 10.26442/00403660.2020.01.000480] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Indexed: 11/22/2022]
Abstract
The literature review presents the possibilities of using non - steroidal anti - inflammatory drugs (NSAIDs) for polymorbid pathology. The mechanism of NSAIDs action, risk factors for the development of undesirable effects on the cardiovascular, digestive, urinary and other systems are considered; prevention measures and drug selection options are discussed, NSAIDs prescribing algorithm is considered.
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Hwang KA, Hwang YJ, Kim HS, Hwang HJ, Song J, Kim YJ. Anti-inflammatory effect of aerial bulblets of Dioscorea japonica Thunb extract through inhibition of NF-κB and MAPK signalling pathway in RAW 264.7. J Chin Med Assoc 2019; 82:251-255. [PMID: 30946705 DOI: 10.1097/jcma.0000000000000051] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Yam (Dioscorea japonica Thunb) is a well-known health food in Korea and is widely distributed in the temperate and tropical regions. Although various medical effects of yam have been demonstrated, there is little current knowledge on the efficacy of Youngyeoja (YYJ; the aerial bulblets of the yam plant), their physiological effects, and their mechanism of action. METHODS To investigate the anti-inflammatory effects of YYJ, we examined the level of inflammatory mediators in lipopolysaccharide (LPS)-stimulated RAW 264.7 cells treated with YYJ extract. Nitric oxide (NO) and prostaglandin E2 (PGE2) levels were determined using enzyme-linked immunosorbent assays. Expression of inducible nitric oxide synthase (iNOS) and cyclooxygenase-2 (COX-2) were evaluated using real-time polymerase chain reaction and western blotting. In addition, activation of nuclear factor-kappaB (NF-κB) and mitogen-activated protein kinase (MAPK) was detected using western blotting. RESULTS Treatment of macrophages with LPS markedly induced the production of NO and PGE2. YYJ treatment inhibited the induction of inflammatory mediators and the expression of iNOS and COX-2. More importantly, LPS-induced phosphorylation of nuclear factor of kappa light polypeptide gene enhancer in B-cells inhibitor (IκB) was suppressed by treatment with YYJ, suggesting YYJ inhibited NF-κB activation. Furthermore, YYJ inhibited the LPS-induced phosphorylation of MAPKs. CONCLUSION YYJ was shown to have a potent anti-inflammatory effect in LPS-stimulated RAW 264.7 cells, which may be attributed to its inhibitory effect on NF-κB and MAPK activation, consequently blocking the production of inflammatory factors. Therefore, these results suggest that the YYJ extracts could be used as anti-inflammatory agents.
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Affiliation(s)
- Kyung-A Hwang
- Department of Agrofood Resources, National Institute of Agricultural Sciences, RDA, Wanju-gun, Jeollabuk-do, Korea
| | - Yu-Jin Hwang
- Department of Agrofood Resources, National Institute of Agricultural Sciences, RDA, Wanju-gun, Jeollabuk-do, Korea
| | - Hoi Seok Kim
- Department of Agrofood Resources, National Institute of Agricultural Sciences, RDA, Wanju-gun, Jeollabuk-do, Korea
| | - Hye Jeong Hwang
- Department of Agrofood Resources, National Institute of Agricultural Sciences, RDA, Wanju-gun, Jeollabuk-do, Korea
| | - Jin Song
- Department of Agrofood Resources, National Institute of Agricultural Sciences, RDA, Wanju-gun, Jeollabuk-do, Korea
| | - Young Jun Kim
- Department of Food and Biotechnology, Korea University, Sejong, Korea
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Intravenous Acetaminophen Before Pelvic Organ Prolapse Repair: A Randomized Controlled Trial. Obstet Gynecol 2019; 133:492-502. [PMID: 30741813 DOI: 10.1097/aog.0000000000003102] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To compare the effect of preoperative intravenous (IV) acetaminophen compared with placebo on pain scores after pelvic organ prolapse surgery. METHODS This double-blind placebo-controlled multicenter trial randomized women undergoing prolapse surgery to IV acetaminophen (1,000 mg) or preoperative saline stratified by surgical route (laparoscopic or vaginal). The primary outcome was the change from baseline in patient-reported visual analog scale pain scores at 24 hours after surgery. Secondary outcomes included narcotic use measured in morphine milligram equivalents, satisfaction and quality of life (QOL) using validated questionnaires on postoperative days 1 and 7, and overall side effects. RESULTS Between 2014 and 2017, 204 women were enrolled and primary-outcome data from 162 were analyzed. Women had a mean (±SD) age of 66±10 years, were predominantly Caucasian (96%) and postmenopausal (96%). Acetaminophen was administered to 52 of the 101 women undergoing vaginal surgery, and 50 of the 101 women undergoing laparoscopy. There were no overall or route of surgery differences in mean change from baseline pain scores at 24 hours between acetaminophen and placebo (overall 25±26 vs 21±24 mm; vaginal 29±28 vs 21±23 mm; laparoscopic 20±26 vs 21±25 mm). There were no differences in 24-hour morphine milligram equivalent narcotic use (overall 38±25 vs 40±25 mg; vaginal 32±24 vs 33±25 mg; laparoscopic 45±24 vs 47±24 mg). No differences were seen in patient satisfaction, QOL, or side effects, except for urinary retention. CONCLUSION In women undergoing prolapse repair, preoperative IV acetaminophen did not reduce pain scores or opioid use and had no effect on patient satisfaction or QOL. Routine use of preemptive IV acetaminophen alone is not supported by this study. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov, NCT02155738.
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Lucas GNC, Leitão ACC, Alencar RL, Xavier RMF, Daher EDF, Silva Junior GBD. Pathophysiological aspects of nephropathy caused by non-steroidal anti-inflammatory drugs. ACTA ACUST UNITED AC 2018; 41:124-130. [PMID: 30281062 PMCID: PMC6534025 DOI: 10.1590/2175-8239-jbn-2018-0107] [Citation(s) in RCA: 86] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Accepted: 08/05/2018] [Indexed: 12/29/2022]
Abstract
Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly used medications associated with nephrotoxicity, especially when used chronically. Factors such as advanced age and comorbidities, which in themselves already lead to a decrease in glomerular filtration rate, increase the risk of NSAID-related nephrotoxicity. The main mechanism of NSAID action is cyclooxygenase (COX) enzyme inhibition, interfering on arachidonic acid conversion into E2 prostaglandins E2, prostacyclins and thromboxanes. Within the kidneys, prostaglandins act as vasodilators, increasing renal perfusion. This vasodilatation is a counter regulation of mechanisms, such as the renin-angiotensin-aldosterone system works and that of the sympathetic nervous system, culminating with compensation to ensure adequate flow to the organ. NSAIDs inhibit this mechanism and can lead to acute kidney injury (AKI). High doses of NSAIDs have been implicated as causes of AKI, especially in the elderly. The main form of AKI by NSAIDs is hemodynamically mediated. The second form of NSAID-induced AKI is acute interstitial nephritis, which may manifest as nephrotic proteinuria. Long-term NSAID use can lead to chronic kidney disease (CKD). In patients without renal diseases, young and without comorbidities, NSAIDs are not greatly harmful. However, because of its dose-dependent effect, caution should be exercised in chronic use, since it increases the risk of developing nephrotoxicity.
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Affiliation(s)
| | - Ana Carla Carneiro Leitão
- Universidade de Fortaleza, Programa de Pós-Graduação em Saúde Coletiva, Centro de Ciências da Saúde, Fortaleza, CE, Brasil
| | - Renan Lima Alencar
- Universidade de Fortaleza, Programa de Pós-Graduação em Saúde Coletiva, Centro de Ciências da Saúde, Fortaleza, CE, Brasil
| | - Rosa Malena Fagundes Xavier
- Universidade de Fortaleza, Programa de Pós-Graduação em Saúde Coletiva, Centro de Ciências da Saúde, Fortaleza, CE, Brasil.,Universidade do Estado da Bahia, Curso de Farmácia, Salvador, BA, Brasil.,Universidade Federal da Bahia, Instituto de Saúde Coletiva, Salvador, BA, Brasil
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Synthesis, Characterization, and Biodistribution of Quantum Dot-Celecoxib Conjugate in Mouse Paw Edema Model. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2018; 2018:3090517. [PMID: 30046374 PMCID: PMC6038454 DOI: 10.1155/2018/3090517] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Accepted: 01/15/2018] [Indexed: 01/06/2023]
Abstract
Increased risk of cardiovascular side effects has been reported with many of the drugs in the market, including nonsteroidal anti-inflammatory drugs (NSAIDs). Hence, it is critical to thoroughly evaluate the biodistribution and pharmacokinetic properties of the drugs. Presently nanotechnology in combination with noninvasive imaging techniques such as magnetic resonance imaging (MRI), computed axial tomography (CAT), and positron emission tomography (PET) provides a better estimate of the spatio-temporal distribution of therapeutic molecules. Optical imaging using quantum dot- (QD-) tagged biological macromolecules is emerging as a fast, economical, sensitive, and safer alternative for theranostic purposes. In the present study, we report the nanoconjugates of mercaptopropionic acid- (MPA-) capped CdTe quantum dots (QDs) and Celecoxib for bio-imaging in carrageenan-induced mouse paw edema model of inflammation. QD-Celecoxib conjugates were characterized by fluorescence, FT-IR, NMR, and zeta-potential studies. In vivo imaging of QD-Celecoxib conjugates showed clear localization in the inflamed tissue of mouse paw within 3 h, with a gradual increase reaching a maximum and a later decline. This decrease of fluorescence in the paw region is followed by an increase in urinary bladder region, suggesting the possible excretion of QD-drug conjugates from mice within 24 h.
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10
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Syed M, Skonberg C, Hansen SH. Mitochondrial toxicity of selective COX-2 inhibitors via inhibition of oxidative phosphorylation (ATP synthesis) in rat liver mitochondria. Toxicol In Vitro 2015; 32:26-40. [PMID: 26689325 DOI: 10.1016/j.tiv.2015.12.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Revised: 10/14/2015] [Accepted: 12/08/2015] [Indexed: 10/22/2022]
Abstract
Cyclooxygenase-2 (COX-2) inhibitors (coxibs) are non-steroidal anti-inflammatory drugs (NSAIDs) designed to selectively inhibit COX-2. However, drugs of this therapeutic class are associated with drug induced liver injury (DILI) and mitochondrial injury is likely to play a role. The effects of selective COX-2 inhibitors on inhibition of oxidative phosphorylation (ATP synthesis) in rat liver mitochondria were investigated. The order of potency of inhibition of ATP synthesis was: lumiracoxib (IC50: 6.48 ± 2.74 μM)>celecoxib (IC50: 14.92 ± 6.40 μM)>valdecoxib (IC50: 161.4 ± 28.6 μM)>rofecoxib (IC50: 238.4 ± 79.2 μM)>etoricoxib (IC50: 405.1 ± 116.3 μM). Mechanism based inhibition of ATP synthesis (Kinact 0.078 min(-1) and KI 21.46 μM and Kinact/KI ratio 0.0036 min(-1)μM(-1)) was shown by lumiracoxib and data suggest that the opening of the MPT pore may not be the mechanism of toxicity. A positive correlation (with r(2)=0.921) was observed between the potency of inhibition of ATP synthesis and the log P values. The in vitro metabolism of coxibs in rat liver mitochondria yielded for each drug substance a major single metabolite and identified a hydroxy metabolite with each of the coxibs and these metabolites did not alter the inhibition profile of ATP synthesis of the parent compound. The results suggest that coxibs themselves could be involved in the hepatotoxic action through inhibition of ATP synthesis.
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Affiliation(s)
- Muzeeb Syed
- Section of Analytical Biosciences, Department of Pharmacy, School of Pharmaceutical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
| | - Christian Skonberg
- Discovery ADME Department, Diabetes Pharmacology and Bioanalysis, Novo Nordisk A/S, Måløv, Copenhagen, Denmark
| | - Steen Honoré Hansen
- Section of Analytical Biosciences, Department of Pharmacy, School of Pharmaceutical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Price SD, Holman CDJ, Sanfilippo FM, Emery JD. Impact of specific Beers Criteria medications on associations between drug exposure and unplanned hospitalisation in elderly patients taking high-risk drugs: a case-time-control study in Western Australia. Drugs Aging 2014; 31:311-25. [PMID: 24615204 DOI: 10.1007/s40266-014-0164-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Certain broad medication classes have previously been associated with high rates of hospitalisation due to related adverse events in elderly Western Australians, based on clinical coding recorded on inpatient summaries. Similarly, some medications from the Beers Criteria, considered potentially inappropriate in older people, have been linked with an increased risk of unplanned hospitalisation in this population. OBJECTIVE Our objective was to determine whether risk estimates of drug-related hospitalisations are altered in elderly patients taking 'high-risk drugs' (HRDs) when specific Beers potentially inappropriate medications (PIMS) are taken into consideration. METHODS Using the pharmaceutical claims of 251,305 Western Australians aged ≥65 years (1993-2005) linked with other health data, we applied a case-time-control design to estimate odds ratios (ORs) for unplanned hospitalisations associated with anticoagulants, antirheumatics, opioids, corticosteroids and four major cardiovascular drug groups, from which attributable fractions (AFs), number and proportion of drug-related admissions were derived. The analysis was repeated, taking into account exposure to eight specific PIMs, and results were compared. RESULTS A total of 1,899,699 index hospitalisations were involved. Of index subjects, 12-57 % were exposed to each HRD at the time of admission, although the proportions taking both an HRD and one of the selected PIMs were much lower (generally ≤2 %, but as high as 8 % for combinations involving temazepam and for most PIMs combined with hypertension drugs). Included PIMs (indomethacin, naproxen, temazepam, oxazepam, diazepam, digoxin, amiodarone and ferrous sulphate) all tended to increase ORs, AFs and drug-related hospitalisation estimates in HRD combinations, although this was less evident for opioids and corticosteroids. Indomethacin had the greatest overall impact on HRD ORs/AFs. Indomethacin (OR 1.40; 95 % confidence interval [CI] 1.27-1.54) and naproxen (OR 1.22; 1.14-1.31) were associated with higher risks of unplanned hospitalisation than other antirheumatics (overall OR 1.09; 1.06-1.12). Similarly, among cardiac rhythm regulators, amiodarone (OR 1.22; 1.13-1.32) was riskier than digoxin (OR 1.08; 1.04-1.13). For comparisons of drug-related hospitalisation estimates, temazepam yielded the greatest absolute increases, especially with hypertension drugs. CONCLUSIONS Indomethacin and temazepam should be prescribed cautiously in elderly patients, especially in drug combinations. Furthermore, it appears other antirheumatics should be favoured over indomethacin/naproxen and, in situations where both drugs may be appropriate, digoxin over amiodarone. Our methodology may help assess the safety of new medications in drug combinations in preliminary pharmacovigilance investigations.
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Affiliation(s)
- Sylvie D Price
- School of Population Health (M431), The University of Western Australia, 35 Stirling Highway, Crawley, WA, 6009, Australia,
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