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El-Fatatry BM, El-Haggar SM, Ibrahim OM, Shalaby KH. Repurposing fexofenadine as a promising candidate for diabetic kidney disease: randomized clinical trial. Int Urol Nephrol 2024; 56:1395-1402. [PMID: 37741921 PMCID: PMC10923951 DOI: 10.1007/s11255-023-03804-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 09/13/2023] [Indexed: 09/25/2023]
Abstract
PURPOSE Diabetic kidney disease (DKD) is a devastating complication of diabetes mellitus. Inflammation and histamine are potentially involved in the disease progression. This study aimed to evaluate the role of fexofenadine in patients with DKD. METHODS From January 2020 to February 2022, out of 123 patients screened for eligibility, 61 patients completed the study. Patients were randomized into two groups, the fexofenadine group (n = 30): received ramipril plus fexofenadine, and the control group (n = 31): received ramipril only for six months. Changes in urinary albumin to creatinine ratio (UACR) and estimated glomerular filtration rate (eGFR) were considered primary outcomes. Measurements of urinary cyclophilin A, monocyte chemoattractant protein-1 (MCP-1), 8-hydroxy-2' deoxyguanosine (8-OHdG), and podocalyxin (PCX) were considered secondary outcomes. The study was prospectively registered on clinicaltrial.gov on January 13, 2020, with identification code NCT04224428. RESULTS At the end of the study, fexofenadine reduced UACR by 16% (95% CI, - 23.4% to - 9.3%) versus a noticeable rise of 11% (95% CI, 4.1% to 17.8%) in UACR in the control group, (p < 0.001). No significant difference in eGFR was revealed between the two groups. However, the control group showed a significant decrease of - 3.5% (95% CI, - 6.6% to - 0.3%) in eGFR, compared to its baseline value. This reduction was not reported in the fexofenadine group. Fexofenadine use was associated with a significant decline in MCP-1, 8-OHdG, and PCX compared to baseline values. CONCLUSION Fexofenadine is a possible promising adjuvant therapy in patients with DKD. Further large-scale trials are needed to confirm our preliminary results.
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Affiliation(s)
- Basma Mahrous El-Fatatry
- Department of Clinical Pharmacy, Faculty of Pharmacy, Tanta University, Al-Guiesh Street, Tanta, 31527, Egypt.
| | - Sahar Mohamed El-Haggar
- Department of Clinical Pharmacy, Faculty of Pharmacy, Professor of Clinical Pharmacy, Tanta University, Al-Geish Street, Tanta, Egypt
| | - Osama Mohamed Ibrahim
- Department of Clinical Pharmacy, Faculty of Pharmacy, Professor of Clinical Pharmacy, Tanta University, Al-Geish Street, Tanta, Egypt
| | - Khaled Hamed Shalaby
- Department of Internal Medicine, Faculty of Medicine, Lecturer of Internal Medicine, Tanta University, Al-Geish Street, Tanta, Egypt
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Boscaro V, Rivoira M, Sgorbini B, Bordano V, Dadone F, Gallicchio M, Pons A, Benetti E, Rosa AC. Evidence-Based Anti-Diabetic Properties of Plant from the Occitan Valleys of the Piedmont Alps. Pharmaceutics 2022; 14:2371. [PMID: 36365189 PMCID: PMC9693256 DOI: 10.3390/pharmaceutics14112371] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 10/20/2022] [Accepted: 10/28/2022] [Indexed: 10/29/2023] Open
Abstract
Data on urban and rural diabetes prevalence ratios show a significantly lower presence of diabetes in rural areas. Several bioactive compounds of plant origin are known to exert anti-diabetic properties. Interestingly, most of them naturally occur in different plants present in mountainous areas and are linked to traditions of herbal use. This review will aim to evaluate the last 10 years of evidence-based data on the potential anti-diabetic properties of 9 plants used in the Piedmont Alps (North-Western Italy) and identified through an ethnobotanical approach, based on the Occitan language minority of the Cuneo province (Sambucus nigra L., Achillea millefolium L., Cornus mas L., Vaccinium myrtillus L., Fragaria vesca L., Rosa canina L., Rubus idaeus L., Rubus fruticosus/ulmifolius L., Urtica dioica L.), where there is a long history of herbal remedies. The mechanism underlying the anti-hyperglycemic effects and the clinical evidence available are discussed. Overall, this review points to the possible use of these plants as preventive or add-on therapy in treating diabetes. However, studies of a single variety grown in the geographical area, with strict standardization and titration of all the active ingredients, are warranted before applying the WHO strategy 2014-2023.
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Affiliation(s)
- Valentina Boscaro
- Dipartimento di Scienza e Tecnologia del Farmaco, University of Turin, Via Pietro Giuria 9, 10125 Turin, Italy
| | - Matteo Rivoira
- Dipartimento di Studi Umanistici, University of Turin, Via Sant’Ottavio 20, 10124 Turin, Italy
- Atlante Linguistico Italiano (ALI), Via Sant’Ottavio 20, 10124 Turin, Italy
| | - Barbara Sgorbini
- Dipartimento di Scienza e Tecnologia del Farmaco, University of Turin, Via Pietro Giuria 9, 10125 Turin, Italy
| | - Valentina Bordano
- Dipartimento di Scienza e Tecnologia del Farmaco, University of Turin, Via Pietro Giuria 9, 10125 Turin, Italy
| | - Francesca Dadone
- Dipartimento di Scienza e Tecnologia del Farmaco, University of Turin, Via Pietro Giuria 9, 10125 Turin, Italy
| | - Margherita Gallicchio
- Dipartimento di Scienza e Tecnologia del Farmaco, University of Turin, Via Pietro Giuria 9, 10125 Turin, Italy
| | - Aline Pons
- Dipartimento di Studi Umanistici, University of Turin, Via Sant’Ottavio 20, 10124 Turin, Italy
| | - Elisa Benetti
- Dipartimento di Scienza e Tecnologia del Farmaco, University of Turin, Via Pietro Giuria 9, 10125 Turin, Italy
| | - Arianna Carolina Rosa
- Dipartimento di Scienza e Tecnologia del Farmaco, University of Turin, Via Pietro Giuria 9, 10125 Turin, Italy
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In Silico Searching for Alternative Lead Compounds to Treat Type 2 Diabetes through a QSAR and Molecular Dynamics Study. Pharmaceutics 2022; 14:pharmaceutics14020232. [PMID: 35213965 PMCID: PMC8879932 DOI: 10.3390/pharmaceutics14020232] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 12/28/2021] [Accepted: 01/07/2022] [Indexed: 02/01/2023] Open
Abstract
Free fatty acid receptor 1 (FFA1) stimulates insulin secretion in pancreatic β-cells. An advantage of therapies that target FFA1 is their reduced risk of hypoglycemia relative to common type 2 diabetes treatments. In this work, quantitative structure–activity relationship (QSAR) approach was used to construct models to identify possible FFA1 agonists by applying four different machine-learning algorithms. The best model (M2) meets the Tropsha’s test requirements and has the statistics parameters R2 = 0.843, Q2CV = 0.785, and Q2ext = 0.855. Also, coverage of 100% of the test set based on the applicability domain analysis was obtained. Furthermore, a deep analysis based on the ADME predictions, molecular docking, and molecular dynamics simulations was performed. The lipophilicity and the residue interactions were used as relevant criteria for selecting a candidate from the screening of the DiaNat and DrugBank databases. Finally, the FDA-approved drugs bilastine, bromfenac, and fenofibric acid are suggested as potential and lead FFA1 agonists.
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Verta R, Gurrieri M, Borga S, Benetti E, Pollicino P, Cavalli R, Thurmond RL, Chazot PL, Pini A, Rosa AC, Grange C. The Interplay between Histamine H 4 Receptor and the Kidney Function: The Lesson from H 4 Receptor Knockout Mice. Biomolecules 2021; 11:biom11101517. [PMID: 34680152 PMCID: PMC8533779 DOI: 10.3390/biom11101517] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 09/30/2021] [Accepted: 10/13/2021] [Indexed: 01/15/2023] Open
Abstract
Previous studies implicated the histamine H4 receptor in renal pathophysiology. The aim here is to elucidate the role of this receptor on renal function using H4 receptor knockout mice (H4R-/-). Healthy and diabetic H4R-/- mice compared to their C57BL/6J wild-type counterpart for renal function and the expression of crucial tubular proteins. H4R-/- and wild-type mice, matched for ages, showed comparable weight gain curves reaching similar median weight at the end of the study. However, H4R-/- mice displayed a higher basal glycemia. H4R-/- mice showed a lower urine 24 h outflow, and albumin-to-creatinine ratio (ACR) compared to wild-type mice. Consistently, H4R-/- mice presented a higher expression of megalin and a lower basal expression of the sodium-hydrogen exchanger (NHE)3 and aquaporin (AQP)2. According to these basal differences, diabetic H4R-/- mice developed more severe hyperglycemia and a higher 24 h urine volume, but a lower increase in ACR and decrease in urine pH were observed. These events were paralleled by a reduced NHE3 over-expression and megalin loss in diabetic H4R-/- mice. The AQP1 and AQP7 patterns were also different between H4R-/- and wild-type diabetic mice. The collected results highlight the role of the histamine H4 receptor in the control of renal reabsorption processes, particularly albumin uptake.
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Affiliation(s)
- Roberta Verta
- Department of Biotechnology and Health Sciences, University of Turin, C.So Dogliotti 14, 10126 Turin, Italy;
| | - Maura Gurrieri
- Department of Scienza e Tecnologia del Farmaco, University of Turin, Via P. Giuria 9, 10125 Turin, Italy; (M.G.); (S.B.); (E.B.); (R.C.)
| | - Sara Borga
- Department of Scienza e Tecnologia del Farmaco, University of Turin, Via P. Giuria 9, 10125 Turin, Italy; (M.G.); (S.B.); (E.B.); (R.C.)
| | - Elisa Benetti
- Department of Scienza e Tecnologia del Farmaco, University of Turin, Via P. Giuria 9, 10125 Turin, Italy; (M.G.); (S.B.); (E.B.); (R.C.)
| | - Paolo Pollicino
- Direzione Ricerca e Terza Missione, University of Turin, Via Bogino 9 Torino, 10123 Turin, Italy;
| | - Roberta Cavalli
- Department of Scienza e Tecnologia del Farmaco, University of Turin, Via P. Giuria 9, 10125 Turin, Italy; (M.G.); (S.B.); (E.B.); (R.C.)
| | - Robin L. Thurmond
- Janssen Research & Development, LLC, 3210 Merryfield Row, San Diego, CA 92121, USA;
| | - Paul L. Chazot
- Department of Biosciences and Wolfson Research Institute, Durham University, South Road, Durham DH1 3LE, UK;
| | - Alessandro Pini
- Department of Clinical and Experimental Medicine, University of Florence, Viale Pieraccini 6, 50139 Florence, Italy;
| | - Arianna Carolina Rosa
- Department of Scienza e Tecnologia del Farmaco, University of Turin, Via P. Giuria 9, 10125 Turin, Italy; (M.G.); (S.B.); (E.B.); (R.C.)
- Correspondence: ; Tel.: +39-011-6707955
| | - Cristina Grange
- Department of Medical Sciences, University of Turin, C.So Dogliotti 14, 10126 Turin, Italy;
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Sudarikova AV, Fomin MV, Yankelevich IA, Ilatovskaya DV. The implications of histamine metabolism and signaling in renal function. Physiol Rep 2021; 9:e14845. [PMID: 33932106 PMCID: PMC8087988 DOI: 10.14814/phy2.14845] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 03/31/2021] [Accepted: 03/31/2021] [Indexed: 01/18/2023] Open
Abstract
Inflammation is an essential part of the immune response; it has been found to be central to the disruption of kidney function in acute kidney injury, diabetic nephropathy, hypertension, and other renal conditions. One of the well‐known mediators of the inflammatory response is histamine. Histamine receptors are expressed throughout different tissues, including the kidney, and their inhibition has proven to be a viable strategy for the treatment of many inflammation‐associated diseases. Here, we provide an overview of the current knowledge regarding the role of histamine and its metabolism in the kidney. Establishing the importance of histamine signaling for kidney function will enable new approaches for the treatment of kidney diseases associated with inflammation.
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Affiliation(s)
| | - Mikhail V Fomin
- Division of Nephrology, Department of Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Irina A Yankelevich
- St. Petersburg State Chemical Pharmaceutical University, St. Petersburg, Russia.,Institute of Experimental Medicine, St. Petersburg, Russia
| | - Daria V Ilatovskaya
- Division of Nephrology, Department of Medicine, Medical University of South Carolina, Charleston, SC, USA
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