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Patyk-Kaźmierczak E, Izquierdo-Ruiz F, Lobato A, Kaźmierczak M, Moszczyńska I, Olejniczak A, Recio JM. The curious case of proton migration under pressure in the malonic acid and 4,4'-bipyridine cocrystal. IUCRJ 2024; 11:168-181. [PMID: 38275161 PMCID: PMC10916288 DOI: 10.1107/s2052252524000344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 01/09/2024] [Indexed: 01/27/2024]
Abstract
In the search for new active pharmaceutical ingredients, the precise control of the chemistry of cocrystals becomes essential. One crucial step within this chemistry is proton migration between cocrystal coformers to form a salt, usually anticipated by the empirical ΔpKa rule. Due to the effective role it plays in modifying intermolecular distances and interactions, pressure adds a new dimension to the ΔpKa rule. Still, this variable has been scarcely applied to induce proton-transfer reactions within these systems. In our study, high-pressure X-ray diffraction and Raman spectroscopy experiments, supported by DFT calculations, reveal modifications to the protonation states of the 4,4'-bipyridine (BIPY) and malonic acid (MA) cocrystal (BIPYMA) that allow the conversion of the cocrystal phase into ionic salt polymorphs. On compression, neutral BIPYMA and monoprotonated (BIPYH+MA-) species coexist up to 3.1 GPa, where a phase transition to a structure of P21/c symmetry occurs, induced by a double proton-transfer reaction forming BIPYH22+MA2-. The low-pressure C2/c phase is recovered at 2.4 GPa on decompression, leading to a 0.7 GPa hysteresis pressure range. This is one of a few studies on proton transfer in multicomponent crystals that shows how susceptible the interconversion between differently charged species is to even slight pressure changes, and how the proton transfer can be a triggering factor leading to changes in the crystal symmetry. These new data, coupled with information from previous reports on proton-transfer reactions between coformers, extend the applicability of the ΔpKa rule incorporating the pressure required to induce salt formation.
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Affiliation(s)
- Ewa Patyk-Kaźmierczak
- Facuty of Chemistry, Adam Mickiewicz University in Poznań, Uniwersytetu Poznańskiego 8, Poznań 61-614, Poland
| | - Fernando Izquierdo-Ruiz
- MALTA-Consolider Team and Departamento de Química Física, University Complutense of Madrid, Avda. de Séneca, 2 Ciudad Universitaria, Madrid 28040, Spain
| | - Alvaro Lobato
- MALTA-Consolider Team and Departamento de Química Física, University Complutense of Madrid, Avda. de Séneca, 2 Ciudad Universitaria, Madrid 28040, Spain
| | - Michał Kaźmierczak
- Facuty of Chemistry, Adam Mickiewicz University in Poznań, Uniwersytetu Poznańskiego 8, Poznań 61-614, Poland
| | - Ida Moszczyńska
- Facuty of Chemistry, Adam Mickiewicz University in Poznań, Uniwersytetu Poznańskiego 8, Poznań 61-614, Poland
| | - Anna Olejniczak
- Facuty of Chemistry, Adam Mickiewicz University in Poznań, Uniwersytetu Poznańskiego 8, Poznań 61-614, Poland
| | - J. Manuel Recio
- MALTA-Consolider Team and Departamento de Química Física y Analítica, University of Oviedo, Julián Clavería n° 8, Oviedo 33006, Spain
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Phetruen T, van Dam B, Chanarat S. Andrographolide Induces ROS-Mediated Cytotoxicity, Lipid Peroxidation, and Compromised Cell Integrity in Saccharomyces cerevisiae. Antioxidants (Basel) 2023; 12:1765. [PMID: 37760068 PMCID: PMC10525756 DOI: 10.3390/antiox12091765] [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: 08/28/2023] [Revised: 09/08/2023] [Accepted: 09/11/2023] [Indexed: 09/29/2023] Open
Abstract
Andrographolide, a bioactive compound found in Andrographis paniculata, has gained significant attention for its potential therapeutic properties. Despite its promising benefits, the understanding of its side effects and underlying mechanisms remains limited. Here, we investigated the impact of andrographolide in Saccharomyces cerevisiae and observed that andrographolide induced cytotoxicity, particularly when oxidative phosphorylation was active. Furthermore, andrographolide affected various cellular processes, including vacuole fragmentation, endoplasmic reticulum stress, lipid droplet accumulation, reactive oxygen species levels, and compromised cell integrity. Moreover, we unexpectedly observed that andrographolide induced the precipitation of biomolecules secreted from yeast cells, adding an additional source of stress. Overall, this study provides insights into the cellular effects and potential mechanisms of andrographolide in yeast, shedding light on its side effects and underlying cytotoxicity pathways.
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Affiliation(s)
| | | | - Sittinan Chanarat
- Laboratory of Molecular Cell Biology, Department of Biochemistry, Center for Excellence in Protein and Enzyme Technology, Faculty of Science, Mahidol University, Bangkok 10400, Thailand
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3
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Ratiani L, Pachkoria E, Mamageishvili N, Shengelia R, Hovhannisyan A, Panossian A. Efficacy of Kan Jang ® in Patients with Mild COVID-19: A Randomized, Quadruple-Blind, Placebo-Controlled Trial. Pharmaceuticals (Basel) 2023; 16:1196. [PMID: 37765004 PMCID: PMC10535596 DOI: 10.3390/ph16091196] [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: 07/29/2023] [Revised: 08/14/2023] [Accepted: 08/16/2023] [Indexed: 09/29/2023] Open
Abstract
Background and aim. This study aimed to assess the efficacy of the treatment of Kan Jang®, a fixed combination of Andrographis paniculata (Burm. F.) Wall. ex. Nees and Eleutherococcus senticosus (Rupr. & Maxim.) Maxim extracts in patients with mild symptoms of COVID-19. Methods. One hundred and forty patients received six capsules of Kan Jang® (n = 68, daily dose of andrographolides-90 mg) or placebo (n = 72) and supportive treatment (paracetamol) for 14 consecutive days in a randomized, quadruple-blinded, placebo-controlled, two-parallel-group design. The efficacy outcomes were the rate of cases turning to severe, the detection rate of coronavirus SARS-CoV-2 over the time of treatment, the duration, and the severity of symptoms (sore throat, runny nose, cough, headache, fatigue, loss of smell, taste, pain in muscles) in the acute phase of the disease. Other efficacy measures included improving cognitive and physical performance, quality of life, and the levels of inflammatory blood markers-interleukin 6 (IL-6), C-reactive protein, and D-dimer. Results. Kan Jang® significantly (p < 0.05) reduced the rate of cases turning to severe (5.36%) compared to the placebo (17.86%) and decreased the detection rate of SARS-CoV-2 virus over the time of the treatment. The statistical difference in the rates of patients with clinical deterioration in the Kan Jang treatment and placebo control groups was significant (p = 0.0176) both in the 112 patients in the included-per-protocol (IPP) analysis and in the 140 patients in the intended-to-treat (ITT) analysis (p = 0.0236); the absolute risk reduction in cases thanks to the Kan Jang treatment was 12.5%, and the number we needed to treat with Kan Jang was 8. The patient's recovery time (number of sick days at the home/clinic) was shorter in the Kan Jang group compared with the placebo group. The rate of attenuation of inflammatory symptoms in the Kan Jang® group was significantly higher, decreasing the severity of cough, sore throat/pain, runny nose, and muscle soreness compared with the placebo group. Kan Jang® significantly decreased the Wisconsin Upper Respiratory Symptoms scores compared to the placebo in the sample size of 140 patients. However, the relief of fatigue and headache and the decrease in IL-6 in the blood were observed only in a subset of 86 patients infected during the second three waves of the pandemic. Kan Jang® significantly increased physical activity and workout; however, it did not affect cognitive functions (attention and memory), quality of life score, inflammatory marker D-dimer, and C-reactive protein compared with the placebo group. Conclusions. Overall, the results of this study suggest that Kan Jang® is effective in treating mild and moderate COVID-19 irrespective of the SARS-CoV-2 variant of infection.
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Affiliation(s)
- Levan Ratiani
- Department of Infectious Diseases, The First University Clinic, Tbilisi State Medical University, Gudamakari St., Tbilisi 0141, Georgia; (L.R.); (E.P.)
| | - Elene Pachkoria
- Department of Infectious Diseases, The First University Clinic, Tbilisi State Medical University, Gudamakari St., Tbilisi 0141, Georgia; (L.R.); (E.P.)
| | - Nato Mamageishvili
- Department for History of Medicine and Bioethics, Faculty of Medicine, Tbilisi State Medical University, Vazha-Pshavela Ave. 33, Tbilisi 0162, Georgia; (N.M.); (R.S.)
| | - Ramaz Shengelia
- Department for History of Medicine and Bioethics, Faculty of Medicine, Tbilisi State Medical University, Vazha-Pshavela Ave. 33, Tbilisi 0162, Georgia; (N.M.); (R.S.)
| | - Areg Hovhannisyan
- Institute of Fine Organic Chemistry of the National Academy of Science, Azatutian Ave. 26, Yerevan 375014, Armenia;
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Bosco F, Ruga S, Citraro R, Leo A, Guarnieri L, Maiuolo J, Oppedisano F, Macrì R, Scarano F, Nucera S, Bava I, Palma E, Muscoli C, Hancke J, De Sarro G, Mollace V. The Effects of Andrographis paniculata (Burm.F.) Wall. Ex Nees and Andrographolide on Neuroinflammation in the Treatment of Neurodegenerative Diseases. Nutrients 2023; 15:3428. [PMID: 37571363 PMCID: PMC10421033 DOI: 10.3390/nu15153428] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 07/29/2023] [Accepted: 07/31/2023] [Indexed: 08/13/2023] Open
Abstract
Neurodegenerative diseases (NDs) affect millions of people worldwide, and to date, Alzheimer's and Parkinson's diseases are the most common NDs. Of the many risk factors for neurodegeneration, the aging process has the most significant impact, to the extent that it is tempting to consider neurodegenerative disease as a manifestation of accelerated aging. However, genetic and environmental factors determine the course of neurodegenerative disease progression. It has been proposed that environmental stimuli influence neuroplasticity. Some clinical studies have shown that healthy lifestyles and the administration of nutraceuticals containing bioactive molecules possessing antioxidant and anti-inflammatory properties have a preventive impact or mitigate symptoms in previously diagnosed patients. Despite ongoing research efforts, the therapies currently used for the treatment of NDs provide only marginal therapeutic benefits; therefore, the focus is now directly on the search for natural products that could be valuable tools in combating these diseases, including the natural compound Andrographis paniculata (Ap) and its main constituent, andrographolide (Andro). Preclinical studies have shown that the aqueous extract of Ap can modulate neuroinflammatory and neurodegenerative responses, reducing inflammatory markers and oxidative stress in various NDs. Therefore, in this review, we will focus on the molecular mechanisms by which Ap and Andro can modulate the processes of neurodegeneration and neuroinflammation, which are significant causes of neuronal death and cognitive decline.
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Affiliation(s)
- Francesca Bosco
- Department of Health Sciences, Institute of Research for Food, Safety, and Health (IRC-FSH), University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy; (S.R.); (F.O.); (R.M.); (F.S.); (S.N.); (I.B.); (E.P.); (C.M.); (V.M.)
- Section of Pharmacology, Science of Health Department, School of Medicine, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy; (R.C.); (A.L.); (G.D.S.)
| | - Stefano Ruga
- Department of Health Sciences, Institute of Research for Food, Safety, and Health (IRC-FSH), University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy; (S.R.); (F.O.); (R.M.); (F.S.); (S.N.); (I.B.); (E.P.); (C.M.); (V.M.)
| | - Rita Citraro
- Section of Pharmacology, Science of Health Department, School of Medicine, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy; (R.C.); (A.L.); (G.D.S.)
- Research Center FAS@UMG, Science of Health Department, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy
| | - Antonio Leo
- Section of Pharmacology, Science of Health Department, School of Medicine, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy; (R.C.); (A.L.); (G.D.S.)
- Research Center FAS@UMG, Science of Health Department, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy
| | - Lorenza Guarnieri
- Section of Pharmacology, Science of Health Department, School of Medicine, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy; (R.C.); (A.L.); (G.D.S.)
| | - Jessica Maiuolo
- Laboratory of Pharmaceutical Biology, IRC-FSH Center, Department of Health Sciences, School of Pharmacy and Nutraceutical, Faculty of Pharmacy, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy;
| | - Francesca Oppedisano
- Department of Health Sciences, Institute of Research for Food, Safety, and Health (IRC-FSH), University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy; (S.R.); (F.O.); (R.M.); (F.S.); (S.N.); (I.B.); (E.P.); (C.M.); (V.M.)
| | - Roberta Macrì
- Department of Health Sciences, Institute of Research for Food, Safety, and Health (IRC-FSH), University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy; (S.R.); (F.O.); (R.M.); (F.S.); (S.N.); (I.B.); (E.P.); (C.M.); (V.M.)
| | - Federica Scarano
- Department of Health Sciences, Institute of Research for Food, Safety, and Health (IRC-FSH), University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy; (S.R.); (F.O.); (R.M.); (F.S.); (S.N.); (I.B.); (E.P.); (C.M.); (V.M.)
| | - Saverio Nucera
- Department of Health Sciences, Institute of Research for Food, Safety, and Health (IRC-FSH), University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy; (S.R.); (F.O.); (R.M.); (F.S.); (S.N.); (I.B.); (E.P.); (C.M.); (V.M.)
| | - Irene Bava
- Department of Health Sciences, Institute of Research for Food, Safety, and Health (IRC-FSH), University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy; (S.R.); (F.O.); (R.M.); (F.S.); (S.N.); (I.B.); (E.P.); (C.M.); (V.M.)
| | - Ernesto Palma
- Department of Health Sciences, Institute of Research for Food, Safety, and Health (IRC-FSH), University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy; (S.R.); (F.O.); (R.M.); (F.S.); (S.N.); (I.B.); (E.P.); (C.M.); (V.M.)
| | - Carolina Muscoli
- Department of Health Sciences, Institute of Research for Food, Safety, and Health (IRC-FSH), University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy; (S.R.); (F.O.); (R.M.); (F.S.); (S.N.); (I.B.); (E.P.); (C.M.); (V.M.)
| | | | - Giovambattista De Sarro
- Section of Pharmacology, Science of Health Department, School of Medicine, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy; (R.C.); (A.L.); (G.D.S.)
- Research Center FAS@UMG, Science of Health Department, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy
| | - Vincenzo Mollace
- Department of Health Sciences, Institute of Research for Food, Safety, and Health (IRC-FSH), University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy; (S.R.); (F.O.); (R.M.); (F.S.); (S.N.); (I.B.); (E.P.); (C.M.); (V.M.)
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Gan J, Guo L, Zhang X, Yu Q, Yang Q, Zhang Y, Zeng W, Jiang X, Guo M. Anti-inflammatory therapy of atherosclerosis: focusing on IKKβ. J Inflamm (Lond) 2023; 20:8. [PMID: 36823573 PMCID: PMC9951513 DOI: 10.1186/s12950-023-00330-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 01/24/2023] [Indexed: 02/25/2023] Open
Abstract
Chronic low-grade inflammation has been identified as a major contributor in the development of atherosclerosis. Nuclear Factor-κappa B (NF-κB) is a critical transcription factors family of the inflammatory pathway. As a major catalytic subunit of the IKK complex, IκB kinase β (IKKβ) drives canonical activation of NF-κB and is implicated in the link between inflammation and atherosclerosis, making it a promising therapeutic target. Various natural product derivatives, extracts, and synthetic, show anti-atherogenic potential by inhibiting IKKβ-mediated inflammation. This review focuses on the latest knowledge and current research landscape surrounding anti-atherosclerotic drugs that inhibit IKKβ. There will be more opportunities to fully understand the complex functions of IKKβ in atherogenesis and develop new effective therapies in the future.
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Affiliation(s)
- Jiali Gan
- grid.410648.f0000 0001 1816 6218School of Integrative Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Lin Guo
- grid.410648.f0000 0001 1816 6218School of Integrative Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Xiaolu Zhang
- grid.410648.f0000 0001 1816 6218School of Integrative Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Qun Yu
- grid.410648.f0000 0001 1816 6218School of Integrative Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Qiuyue Yang
- grid.410648.f0000 0001 1816 6218School of Integrative Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Yilin Zhang
- grid.410648.f0000 0001 1816 6218School of Integrative Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Wenyun Zeng
- grid.459559.10000 0004 9344 2915Oncology department, Ganzhou People’s Hospital, Ganzhou, Jiangxi China
| | - Xijuan Jiang
- School of Integrative Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China.
| | - Maojuan Guo
- School of Integrative Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China.
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Hasan A, Devi Ms S, Sharma G, Narayanan V, Sathiyarajeswaran P, Vinayak S, Sunil S. Vathasura Kudineer, an Andrographis based polyherbal formulation exhibits immunomodulation and inhibits chikungunya virus (CHIKV) under invitro conditions. JOURNAL OF ETHNOPHARMACOLOGY 2023; 302:115762. [PMID: 36181982 DOI: 10.1016/j.jep.2022.115762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 09/23/2022] [Accepted: 09/24/2022] [Indexed: 06/16/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Chikungunya disease (CHIKD) is caused by the alphavirus, chikungunya virus (CHIKV) and is characterized by acute fever and joint inflammation; the inflammation continues even after clearance of the virus from the system, persisting for several months to years. Currently, there are no modern medicines/vaccines available for its treatment and use of over-the-counter anti-inflammatory generic medicines to relieve symptoms is generally practiced. In India, Indian traditional medicines hold a lot of promise to treat this infection and are routinely used during outbreaks. AIM OF THE STUDY In the present study, we characterized the phytochemical and physicochemical properties of aqueous and ethanol extracts of the Vathasura Kudineer (VSK), a Andrographis based Siddha polyherbal formulation. Additionally, we evaluated its immunomodulatory and antiviral potential using an in vitro system. MATERIALS AND METHODS Aqueous and ethanolic extracts of VSK were prepared and their physico and phytochemical properties were obtained by biochemical and biophysical assays, HPTLC and FTIR. The aqueous extracts of VSK and several of its ingredients were evaluated for their cytotoxicity in Vero cells and using the maximum non-toxic concentration (MNTC), were processed further for evaluating their ability to inhibit CHIKV infection in Vero cells. We performed the co-treatment assay with ethanol extract of VSK and several of its ingredients to assess the antiviral activity against chikungunya virus on Vero cells and through pre-treatment assay (anti-adhesive effect), co-incubation assay (virucidal effect) and post-treatment assay (post-entry effect) were evaluated. Further, we tested the aqueous extract of VSK along with some of its ingredients for their immunomodulatory properties. We performed antioxidant and anti-inflammatory assays using LPS-simulated RAW 264.7 cells. For antioxidant capacity of extracts, we performed extra-cellular ABTS radical scavenging activity and intra-cellular effects on ROS generation and SOD activity. We assessed the effect on most important inflammatory mediators like Nitric oxide (NO) and Prostaglandin E2 (PGE2) and pro-inflammatory cytokines like interleukin-1 beta (IL-1β) and tumor necrosis factor alpha (TNFα). RESULTS We provided the fingerprint of the phytochemicals of both ethanol and aqueous extracts of VSK that can be used for identification. We observed that ethanol extract was able to inhibit CHIKV infection at MNTC with 48 h of treatment on Vero cells. Its ingredient VSKI-As (Anethum sowa) found to be most effective to show virucidal effect while VSKI-Cs (Clerodendrum serratum) and VSKI-Pn (Pipper nigrum) found to be effective in post-entry effect. VSK was able to show ABTS radical scavenging activity, reduce ROS generation, inhibit the inflammatory mediators (NO and PGE2) and pro-inflammatory cytokines (IL-1β and TNFα) production in LPS-stimulated RAW 264.7 cells. CONCLUSIONS We provided the evidence that VSK has both immunomodulatory as well as antiviral potential. It shows virucidal as well as post-entry effects on chikungunya virus. VSK can inhibit pro-inflammatory cytokines, IL-1β and TNFα production by suppressing the inflammatory mediators, NO and PGE2.
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Affiliation(s)
- Abdul Hasan
- Vector Borne Disease Group, International Center for Genetic Engineering and Biotechnology, New Delhi, India
| | - Shree Devi Ms
- Siddha Central Research Institute, Chennai, Tamil Nadu, India
| | - Geetika Sharma
- Vector Borne Disease Group, International Center for Genetic Engineering and Biotechnology, New Delhi, India
| | - Vimal Narayanan
- Vector Borne Disease Group, International Center for Genetic Engineering and Biotechnology, New Delhi, India
| | | | - S Vinayak
- Siddha Central Research Institute, Chennai, Tamil Nadu, India
| | - Sujatha Sunil
- Vector Borne Disease Group, International Center for Genetic Engineering and Biotechnology, New Delhi, India.
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Liu W, Zhang T, Zhang Q, Li L, Xu C. A systematic review and meta-analysis of neoadjuvant chemoimmunotherapy in stage III non-small cell lung cancer. BMC Pulm Med 2022; 22:490. [PMID: 36582007 PMCID: PMC9798701 DOI: 10.1186/s12890-022-02292-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Accepted: 12/20/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Stage III non-small cell lung cancer (NSCLC) is a heterogeneous disease with different subtypes, multidisciplinary teams-led management, and a poor prognosis. Currently, the clinical benefits of stage III NSCLC in the neoadjuvant setting are still unclear. We performed a meta-analysis of published data on neoadjuvant chemoimmunotherapy in stage III NSCLC to systematically evaluate its efficacy and safety. METHODS We searched the databases to identify eligible studies of neoadjuvant chemoimmunotherapy for stage III NSCLC. The primary outcomes mainly included pathological and radiological response outcomes, the feasibility of surgery, and the safety of the regimen. The pathological and radiological response included the rate of major pathologic response (MPR), complete pathologic response (pCR), radiological response outcomes, and R0 resection; The feasibility included the rate of surgical resection, conversion to thoracotomy, surgical complications, pathological downstaging of clinical disease stage. The safety included the incidence of treatment-related adverse events (TRAEs) and severe adverse events (SAEs). R 4.1.3 software was conducted for data analysis, and p < 0.05 was considered statistically significant. RESULTS Nine trials containing a total of 382 populations were eligible for the meta-analysis, with the pooled surgical resection rate of 90%. Owing to the large heterogeneity of the single-rate meta-analysis, the random effect model was adopted. The estimated pooled prevalence of MPR was 56% (95%CI 0.39-0.72) and of pCR was 39% (95%CI 0.28-0.51). The pooled rate of TRAEs was 65% (95%CI 0.17-0.99) and SAEs was 24% (95%CI 0.05-0.49). CONCLUSION Compared to neoadjuvant chemotherapy or immunotherapy, neoadjuvant chemoimmunotherapy achieved more pathological and radiological relief, and has a high surgical resection rate and low risk of conversion to thoracotomy and surgical complications, with poor tolerance of toxicity but rarely developing life-threatening adverse events. In conclusion, neoadjuvant chemoimmunotherapy is suggested to be beneficial for stage III NSCLC.
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Affiliation(s)
- Wei Liu
- grid.89957.3a0000 0000 9255 8984Department of Respiratory Medicine, The Affiliated Nanjing Brain Hospital of Nanjing Medical University, 215 Guangzhou Road, Nanjing, 210029 Jiangsu Province China ,Clinical Center of Nanjing Respiratory Diseases and Imaging, Nanjing, 210029 Jiangsu China
| | - Tiantian Zhang
- grid.89957.3a0000 0000 9255 8984Department of Respiratory Medicine, The Affiliated Nanjing Brain Hospital of Nanjing Medical University, 215 Guangzhou Road, Nanjing, 210029 Jiangsu Province China ,Clinical Center of Nanjing Respiratory Diseases and Imaging, Nanjing, 210029 Jiangsu China
| | - Qian Zhang
- grid.89957.3a0000 0000 9255 8984Department of Respiratory Medicine, The Affiliated Nanjing Brain Hospital of Nanjing Medical University, 215 Guangzhou Road, Nanjing, 210029 Jiangsu Province China ,Clinical Center of Nanjing Respiratory Diseases and Imaging, Nanjing, 210029 Jiangsu China
| | - Li Li
- grid.89957.3a0000 0000 9255 8984Department of Respiratory Medicine, The Affiliated Nanjing Brain Hospital of Nanjing Medical University, 215 Guangzhou Road, Nanjing, 210029 Jiangsu Province China ,Clinical Center of Nanjing Respiratory Diseases and Imaging, Nanjing, 210029 Jiangsu China
| | - Chunhua Xu
- grid.89957.3a0000 0000 9255 8984Department of Respiratory Medicine, The Affiliated Nanjing Brain Hospital of Nanjing Medical University, 215 Guangzhou Road, Nanjing, 210029 Jiangsu Province China ,Clinical Center of Nanjing Respiratory Diseases and Imaging, Nanjing, 210029 Jiangsu China
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8
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Efficacy of Kan Jang® in Patients with Mild COVID-19: Interim Analysis of a Randomized, Quadruple-Blind, Placebo-Controlled Trial. Pharmaceuticals (Basel) 2022; 15:ph15081013. [PMID: 36015163 PMCID: PMC9415141 DOI: 10.3390/ph15081013] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 08/07/2022] [Accepted: 08/10/2022] [Indexed: 12/13/2022] Open
Abstract
Kan Jang®, the fixed combination of Andrographis paniculata (Burm. F.) Wall. ex. Nees and Eleutherococcus senticosus (Rupr. & Maxim.) Maxim extracts, is a herbal medicinal product for relieving symptoms of upper respiratory tract infections. This study aimed to assess the efficacy of Kan Jang®/Nergecov® on duration and the relief of inflammatory symptoms in adults with mild COVID-19. 86 patients with laboratory-confirmed COVID-19 and mild symptoms for one to three days received supportive treatment (paracetamol) and six Kan Jang® (daily dose of andrographolides—90 mg) or placebo capsules a day for 14 consecutive days in this randomized, quadruple-blinded, placebo-controlled, two-parallel-group study. The primary efficacy outcomes were the decrease in the acute-phase duration and the severity of symptoms score (sore throat, runny nose, cough, headache, fatigue, loss of smell, taste, pain in muscles), an increase in cognitive functions, physical performance, quality of life, and decrease in IL-6, c-reactive protein, and D-dimer in blood. Kan Jang®/Nergecov® was effective in reducing the risk of progression to severe COVID-19, decreasing the disease progression rate by almost 2.5-fold compared to placebo. Absolute risk reduction by Kan Jang treatment is 14%, the relative risk reduction is 243.9%, and the number Needed to Treat is 7.14. Kan Jang®/Nergecov® reduces the duration of disease, virus clearance, and days of hospitalization and accelerates recovery of patients, relief of sore throat, muscle pain, runny nose, and normalization of body temperature. Kan Jang®/Nergecov® significantly relieves the severity of inflammatory symptoms such as sore throat, runny nose, and muscle pain, decreases pro-inflammatory cytokine IL-6 level in the blood, and increases patients’ physical performance (workout) compared to placebo. In this study, for the first time we demonstrate that Kan Jang®/Nergecov® is effective in treating mild COVID-19.
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