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Li N, Gou ZP, Du SQ, Zhu XH, Lin H, Liang XF, Wang YS, Feng P. Effect of JAK inhibitors on high- and low-density lipoprotein in patients with rheumatoid arthritis: a systematic review and network meta-analysis. Clin Rheumatol 2022; 41:677-688. [PMID: 34993729 DOI: 10.1007/s10067-021-06003-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 11/22/2021] [Accepted: 11/23/2021] [Indexed: 02/08/2023]
Abstract
OBJECTIVES Janus kinase (JAK) inhibitors are a new class of medication for treatment of rheumatoid arthritis (RA), and such inhibitors alter levels of high-density lipoprotein (HDL) and low-density lipoprotein (LDL) in RA patients. However, the extent of such changes has not been systematically reviewed. METHOD A systematic review and network meta-analysis was performed on randomized trials in RA patients in response to JAKi identified from Pubmed, Medline, Embase, and Cochrane Controlled Trials Register. The primary outcome was mean change of HDL-C and LDL-C from baseline. Mean treatment differences and the rank of the effect of various JAKi on HDL-C and LDL-C were estimated. RESULTS Based on data from 18 unique studies involving five approved JAK inhibitors and 6697 RA patients (JAKi = 3341, placebo = 3356), such inhibitors led to a mean increase of 8.11 mg/dl (95% CI 6.65-9.58, I2 = 82%) in HDL levels from baseline, and a mean increase of 11.37 mg/dl (95% CI 7.84-14.91, I2 = 88%) in LDL levels from baseline. Cardiovascular disease risk did not differ significantly between patients who received JAK inhibitors or those who received placebo or active agents. CONCLUSIONS Our analysis suggests that, at their recommended doses, all five JAK inhibitors lead to an increase in HDL and LDL levels in RA patients. Further long-term research is required to extend these results and understand whether changes in lipid levels in RA patients can affect cardiovascular risk. Key Points • This is the first systematic review and NMA examining the effect of all five clinically approved JAK inhibitors on lipid levels in RA patients. • Recommended doses of JAK inhibitors used for the treatment of RA patients can induce a significant increase in HDL and LDL levels. • Indirect pairwise comparisons suggest that only upadacitinib and peficitinib have significantly different ability to induce LDL change in RA patients.
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Affiliation(s)
- Na Li
- National Medical Products Administration Key Laboratory for Clinical Research and Evaluation of Innovative Drugs, Institute of Clinical Trials, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Zhong-Ping Gou
- National Medical Products Administration Key Laboratory for Clinical Research and Evaluation of Innovative Drugs, Institute of Clinical Trials, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Shuang-Qing Du
- National Medical Products Administration Key Laboratory for Clinical Research and Evaluation of Innovative Drugs, Institute of Clinical Trials, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Xiao-Hong Zhu
- National Medical Products Administration Key Laboratory for Clinical Research and Evaluation of Innovative Drugs, Institute of Clinical Trials, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Hui Lin
- Department of Rheumatology, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Xiu-Fang Liang
- National Medical Products Administration Key Laboratory for Clinical Research and Evaluation of Innovative Drugs, Institute of Clinical Trials, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Yong-Sheng Wang
- National Medical Products Administration Key Laboratory for Clinical Research and Evaluation of Innovative Drugs, Institute of Clinical Trials, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Ping Feng
- National Medical Products Administration Key Laboratory for Clinical Research and Evaluation of Innovative Drugs, Institute of Clinical Trials, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.
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Gou ZP, Zhao YL, Zou LL, Wang Y, Shu SQ, Zhu XH, Zheng L, Shen Q, Luo Z, Miao J, Wang YS, Luo XD, Feng P. The safety and tolerability of alkaloids from Alstonia scholaris leaves in healthy Chinese volunteers: a single-centre, randomized, double-blind, placebo-controlled phase I clinical trial. Pharm Biol 2021; 59:484-493. [PMID: 33899689 PMCID: PMC8086589 DOI: 10.1080/13880209.2021.1893349] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 01/12/2021] [Accepted: 02/16/2021] [Indexed: 02/06/2023]
Abstract
CONTEXT Capsule of alkaloids from the leaf of Alstonia scholaris (L.) R.Br. (Apocynaceae) (CALAS) is a new investigational botanical drug (No. 2011L01436) for bronchitis, post-infectious cough and asthma. OBJECTIVE To observe the clinical safety and tolerability of CALAS. MATERIALS AND METHODS Subjects were assigned to eight cohorts, and each received randomly CALAS or placebo in one of single ascending dose (SAD) of 8, 40, 120, 240, 360, 480, or in one of multiple ascending dose (MAD) of 40 or 120 mg, three times daily for 7 days. Each cohort contained two placebo subjects. RESULTS Sixty-two enrolled volunteers completed the study and no serious adverse events and clinically significant changes in vital signs, electrocardiography, and upper abdominal Doppler ultrasonography were observed. The ratios of treatment-emergent adverse events (TEAEs) were reported in 11/46 (23.91%) of CALAS groups and 3/16 (18.75%) of the placebo group (p > 0.05), respectively, based on the results of SAD and MAD. All TEAEs were mild, transient, and disappeared without any intervention. The TEAEs possibly related to CALAS treatment were as followings: hiccups (4/46: 8%), dry mouth and nausea (3/46: 6%), increased sleep (2/46: 4%), abdominal distension (1/46: 2%), bilirubin elevated (1/46: 2%). DISCUSSION AND CONCLUSIONS CALAS is safe and well-tolerated with no unexpected or clinically relevant safety concerns up to a single dose of 360 mg and three times daily for 7 days up to 120 mg in healthy Chinese volunteers, supporting further Phase II studies.
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Affiliation(s)
- Zhong-Ping Gou
- Institute of Drug Clinical Trials, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
| | - Yun-Li Zhao
- State Key Laboratory of Phytochemistry and Plant Resources in West China, Kunming Institute of Botany, Chinese Academy of Sciences, Kunming, People’s Republic of China
- Key Laboratory of Medicinal Chemistry for Natural Resource, Ministry of Education; Yunnan Provincial Center for Research & Development of Natural Products; School of Chemical Science and Technology, Yunnan University, Kunming, People's Republic of China
| | - Lin-Ling Zou
- Institute of Drug Clinical Trials, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
| | - Ying Wang
- Institute of Drug Clinical Trials, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
| | - Shi-Qing Shu
- Institute of Drug Clinical Trials, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
| | - Xiao-Hong Zhu
- Institute of Drug Clinical Trials, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
| | - Li Zheng
- Institute of Drug Clinical Trials, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
| | - Qi Shen
- Institute of Drug Clinical Trials, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
| | - Zhu Luo
- Institute of Drug Clinical Trials, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
| | - Jia Miao
- Institute of Drug Clinical Trials, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
| | - Yong-Sheng Wang
- Institute of Drug Clinical Trials, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
| | - Xiao-Dong Luo
- State Key Laboratory of Phytochemistry and Plant Resources in West China, Kunming Institute of Botany, Chinese Academy of Sciences, Kunming, People’s Republic of China
- Key Laboratory of Medicinal Chemistry for Natural Resource, Ministry of Education; Yunnan Provincial Center for Research & Development of Natural Products; School of Chemical Science and Technology, Yunnan University, Kunming, People's Republic of China
| | - Ping Feng
- Institute of Drug Clinical Trials, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
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Zhao YL, Gou ZP, Shang JH, Li WY, Kuang Y, Li MY, Luo XD. Anti-microbial Effects In Vitro and In Vivo of Alstonia scholaris. Nat Prod Bioprospect 2021; 11:127-135. [PMID: 33389714 PMCID: PMC7778864 DOI: 10.1007/s13659-020-00294-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 12/15/2020] [Indexed: 02/05/2023]
Abstract
Alstonia scholaris could be used as a traditional medicinal plant in China for the treatment of acute respiratory, which might be caused by respiratory tract infections. The investigation tested the anti-infective effects of total alkaloids extract (TA) from leaves of A. scholaris, and as a result, TA inhibited herpes simplex virus type 1 (HSV-1), respiratory syncytial virus (RSV) and influenza A virus (H1N1) in vitro respectively. In addition, the survival days of mice were prolonged, and the lung weights and mortality of mice were decreased significantly, after oral administrated TA in H1N1 and beta-hemolytic streptococcus infectious models in vivo respectively. The finding supported partly the traditional usage of A. scholaris in the treatment of respiratory infections.
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Affiliation(s)
- Yun-Li Zhao
- State Key Laboratory of Phytochemistry and Plant Resources in West China, Kunming Institute of Botany, Chinese Academy of Sciences, Kunming, 650201, People's Republic of China
- Key Laboratory of Medicinal Chemistry for Natural Resource, Ministry of Education; Yunnan Provincial Center for Research & Development of Natural Products; School of Chemical Science and Technology, Yunnan University, Kunming, 650091, P. R. China
| | - Zhong-Ping Gou
- Institute of Drug Clinical Trials, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Jian-Hua Shang
- Key Laboratory of Medicinal Chemistry for Natural Resource, Ministry of Education; Yunnan Provincial Center for Research & Development of Natural Products; School of Chemical Science and Technology, Yunnan University, Kunming, 650091, P. R. China
| | - Wan-Yi Li
- West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, 610041, China
| | - Yu Kuang
- West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, 610041, China
| | - Ming-Yuan Li
- West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, 610041, China.
| | - Xiao-Dong Luo
- State Key Laboratory of Phytochemistry and Plant Resources in West China, Kunming Institute of Botany, Chinese Academy of Sciences, Kunming, 650201, People's Republic of China.
- Key Laboratory of Medicinal Chemistry for Natural Resource, Ministry of Education; Yunnan Provincial Center for Research & Development of Natural Products; School of Chemical Science and Technology, Yunnan University, Kunming, 650091, P. R. China.
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Gou ZP, Wang ZL, Liang XF, Zheng L, Wang Y, Feng P. Single-dose escalation study of yogliptin in healthy Chinese volunteers. Eur J Pharm Sci 2019; 136:104950. [PMID: 31173870 DOI: 10.1016/j.ejps.2019.06.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 05/12/2019] [Accepted: 06/03/2019] [Indexed: 02/05/2023]
Abstract
BACKGROUND Yogliptin is a novel xanthine dipeptidyl peptidase-4 (DPP-4) inhibitor targeting type 2 diabetes. After promising preclinical pharmacological studies, the first human trial of yogliptin was designed. METHODS A randomized, double-blind, parallel, placebo-controlled phase I single-dose escalation study was designed to evaluate the pharmacokinetics, pharmacodynamics, and tolerability after single oral doses of yogliptin in healthy Chinese subjects. Healthy subjects were assigned to nine cohorts, which received a single dose of yogliptin at 2.5, 5, 10, 25, 50, 100, 200, 400, or 600 mg. Two subjects in each cohort received placebo. Blood samples were collected before dosing and up to 192 h afterwards. Urine samples were collected until 120 h after dosing. Plasma and urine drug concentrations were determined using liquid chromatography coupled with tandem mass spectrometry, and DPP-4 activity was measured using a semi-quantitative, fluorescence-based kinetic assay. RESULTS A total of 104 subjects were enrolled, 103 of whom completed the study (mean age, 25.3 years; mean weight, 58.8 kg; mean BMI, 21.8 kg/m2). A total of 27 adverse events (AEs) occurred in 25 of 86 yogliptin subjects (29.1%), and 3 AEs occurred in 3 of 18 placebo subjects (16.7%). Yogliptin was absorbed with a median time of maximum observed concentration (Tmax) of 3.0 h and was eliminated slowly with a t1/2 of 25.45-43.84 h. The maximum observed concentration (Cmax) and area under the curve (AUC) varied slightly more than dose-proportionally over the dose range from 2.5 to 400 mg. The fraction of drug excreted in urine ranged from 8.39% to 24.77%. Mean DPP-4 inhibition at 24 h after dosing ranged from 97.7% to 99.5%, and DPP-4 inhibition was >80% for 72 h at doses from 25 to 400 mg. DPP-4 inhibition was >80% for 1 week in the group receiving 400 mg. CONCLUSION Yogliptin was well tolerated in healthy subjects, with no dose-limiting toxicity observed in the range from 2.5 to 600 mg. Yogliptin inhibited plasma DPP-4 activity for 72 h at single doses of 25-200 mg and for 1 week at 400 mg, suggesting that once-weekly dosing of yogliptin is possible in type 2 diabetes patients. TRIAL REGISTRATION ChiCTR-IIR-17010311 (Chictr.org).
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Affiliation(s)
- Zhong-Ping Gou
- Institute of Drug Clinical Trials, West China Hospital, Sichuan University, Chengdu 610041, People's Republic of China
| | - Zhen-Lei Wang
- Institute of Drug Clinical Trials, West China Hospital, Sichuan University, Chengdu 610041, People's Republic of China
| | - Xiu-Fang Liang
- Institute of Drug Clinical Trials, West China Hospital, Sichuan University, Chengdu 610041, People's Republic of China
| | - Li Zheng
- Institute of Drug Clinical Trials, West China Hospital, Sichuan University, Chengdu 610041, People's Republic of China
| | - Ying Wang
- Institute of Drug Clinical Trials, West China Hospital, Sichuan University, Chengdu 610041, People's Republic of China
| | - Ping Feng
- Institute of Drug Clinical Trials, West China Hospital, Sichuan University, Chengdu 610041, People's Republic of China.
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Li R, Zi MJ, Gou ZP, Zhao YL, Zhang WT, Lu F, Cao WY, Zhao YP, Li QN, Zhao Y, Wang SG, Gao HY, Sun MY, Luo XD, Xiong ZL, Gao R. Pharmacokinetics and safety evaluation in healthy Chinese volunteers of alkaloids from leaf of Alstonia scholaris: A multiple doses phase I clinical trial. Phytomedicine 2019; 61:152828. [PMID: 31055046 DOI: 10.1016/j.phymed.2019.152828] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 01/05/2019] [Accepted: 01/09/2019] [Indexed: 02/05/2023]
Abstract
BACKGROUND Alstonia scholaris (Apocynaceae) was reported to be a rich source of indole alkaloids, which exhibited remarkably bioactivities. The leaf of A. scholaris has been used in 'dai' ethno-medicine for treatment of respiratory diseases, and the defined indole alkaloids from leaf of A. scholaris has been registered as investigational new botanical drug (No. 2011L01436) and was approved for phase I/II clinical trials by China Food and Drug Administration (CFDA). PURPOSE The aim of the trial is to evaluate the safety and explore the relationship of dosing frequency and pharmacokinetics after oral administration of capsule of alkaloids from leaf of A. scholaris (CALAS) at different doses. METHODS In this randomized, open-labelled, single-center clinical trial, the safety and pharmacokinetics of CALAS were assessed in eligible healthy Chinese volunteers after oral administration of different doses. Each volunteer (n = 10 per group) received single dose of CALAS from 20 mg, 40 mg, 80 mg to 120 mg orally. The pharmacokinetics of CALAS was investigated in healthy Chinese subjects' plasma by a fully-validated LC-MS/MS method. Safety was assessed biochemically and clinically throughout the study, and drug re-excitation research was conducted to verify the correlation between investigational product and minor adverse events. The trial was registered on August 26, 2015 (http://www.chictr.org.cn/showproj.aspx?proj=11736), number ChiCTR-IPR-15006976. RESULTS 40 subjects completed the study, and as a result, vallesamine had the highest concentration in plasma of healthy volunteers, and the AUC exposure level in each compounds in turn is vallesamine > scholaricine > 19-epischolaricine > picrinine. For the safety evaluation of CALAS, two cases of minor adverse events were observed during the trial, but the drug re-excitation research indicated that these two adverse events were related to the individual's physiological variation. CONCLUSION Pharmacokinetic characteristics of each ingredient showed different patterns. 19-epischolaricine, vallesamine and picrinine were match to the linear pharmacokinetic characteristics, but scholaricine conformed to the characteristics of nonlinear pharmacokinetics. The CALAS was safe in healthy subjects under the current dose regimen.
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Affiliation(s)
- Rui Li
- Clinical Pharmacology Institute, Xiyuan Hospital, China Academy of Chinese Medicine Science, Beijing, 100091, China
| | - Ming-Jie Zi
- Clinical Pharmacology Institute, Xiyuan Hospital, China Academy of Chinese Medicine Science, Beijing, 100091, China
| | - Zhong-Ping Gou
- Institute of Drug Clinical Trials, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Yun-Li Zhao
- State Key Laboratory of Phytochemistry and Plant Resources in West China, Kunming Institute of Botany, Chinese Academy of Sciences, Kunming, Yunnan Province, 650201, China
| | - Wan-Tong Zhang
- Clinical Pharmacology Institute, Xiyuan Hospital, China Academy of Chinese Medicine Science, Beijing, 100091, China
| | - Fang Lu
- Clinical Pharmacology Institute, Xiyuan Hospital, China Academy of Chinese Medicine Science, Beijing, 100091, China
| | - Wei-Yi Cao
- Clinical Pharmacology Institute, Xiyuan Hospital, China Academy of Chinese Medicine Science, Beijing, 100091, China
| | - Ying-Pan Zhao
- Clinical Pharmacology Institute, Xiyuan Hospital, China Academy of Chinese Medicine Science, Beijing, 100091, China
| | - Qing-Na Li
- Clinical Pharmacology Institute, Xiyuan Hospital, China Academy of Chinese Medicine Science, Beijing, 100091, China
| | - Yang Zhao
- Clinical Pharmacology Institute, Xiyuan Hospital, China Academy of Chinese Medicine Science, Beijing, 100091, China
| | - Shu-Ge Wang
- Clinical Pharmacology Institute, Xiyuan Hospital, China Academy of Chinese Medicine Science, Beijing, 100091, China
| | - Hong-Yang Gao
- Clinical Pharmacology Institute, Xiyuan Hospital, China Academy of Chinese Medicine Science, Beijing, 100091, China
| | - Ming-Yue Sun
- Clinical Pharmacology Institute, Xiyuan Hospital, China Academy of Chinese Medicine Science, Beijing, 100091, China
| | - Xiao-Dong Luo
- State Key Laboratory of Phytochemistry and Plant Resources in West China, Kunming Institute of Botany, Chinese Academy of Sciences, Kunming, Yunnan Province, 650201, China.
| | - Zhi-Li Xiong
- School of Pharmacy, Shenyang Pharmaceutical University, Shenyang, Liaoning Province, 110016, China.
| | - Rui Gao
- Clinical Pharmacology Institute, Xiyuan Hospital, China Academy of Chinese Medicine Science, Beijing, 100091, China.
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Xiao LH, Chen PR, Gou ZP, Li YZ, Li M, Xiang LC, Feng P. Prostate cancer prediction using the random forest algorithm that takes into account transrectal ultrasound findings, age, and serum levels of prostate-specific antigen. Asian J Androl 2018; 19:586-590. [PMID: 27586028 PMCID: PMC5566854 DOI: 10.4103/1008-682x.186884] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
The aim of this study is to evaluate the ability of the random forest algorithm that combines data on transrectal ultrasound findings, age, and serum levels of prostate-specific antigen to predict prostate carcinoma. Clinico-demographic data were analyzed for 941 patients with prostate diseases treated at our hospital, including age, serum prostate-specific antigen levels, transrectal ultrasound findings, and pathology diagnosis based on ultrasound-guided needle biopsy of the prostate. These data were compared between patients with and without prostate cancer using the Chi-square test, and then entered into the random forest model to predict diagnosis. Patients with and without prostate cancer differed significantly in age and serum prostate-specific antigen levels (P < 0.001), as well as in all transrectal ultrasound characteristics (P < 0.05) except uneven echo (P = 0.609). The random forest model based on age, prostate-specific antigen and ultrasound predicted prostate cancer with an accuracy of 83.10%, sensitivity of 65.64%, and specificity of 93.83%. Positive predictive value was 86.72%, and negative predictive value was 81.64%. By integrating age, prostate-specific antigen levels and transrectal ultrasound findings, the random forest algorithm shows better diagnostic performance for prostate cancer than either diagnostic indicator on its own. This algorithm may help improve diagnosis of the disease by identifying patients at high risk for biopsy.
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Affiliation(s)
- Li-Hong Xiao
- Institute of Clinical Trials, West China Hospital, Sichuan University, Chengdu, China.,Department of Epidemiology and Biostatistics, West China School of Public Health, Sichuan University, Chengdu, China
| | - Pei-Ran Chen
- Department of Epidemiology and Biostatistics, West China School of Public Health, Sichuan University, Chengdu, China
| | - Zhong-Ping Gou
- Institute of Clinical Trials, West China Hospital, Sichuan University, Chengdu, China
| | - Yong-Zhong Li
- Department of Ultrasound, West China Hospital, Sichuan University, Chengdu, China
| | - Mei Li
- Institute of Clinical Trials, West China Hospital, Sichuan University, Chengdu, China
| | - Liang-Cheng Xiang
- Department of Epidemiology and Biostatistics, West China School of Public Health, Sichuan University, Chengdu, China
| | - Ping Feng
- Institute of Clinical Trials, West China Hospital, Sichuan University, Chengdu, China
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Zhong H, Zhang W, Qin M, Gou Z, Feng P. Validation of cystatin C-based equations for evaluating residual renal function in patients on continuous ambulatory peritoneal dialysis. Nephrol Dial Transplant 2018; 32:1032-1040. [PMID: 27190348 DOI: 10.1093/ndt/gfw096] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Accepted: 03/24/2016] [Indexed: 02/05/2023] Open
Abstract
Background Residual renal function needs to be assessed frequently in patients on continuous ambulatory peritoneal dialysis (CAPD). A commonly used method is to measure creatinine (Cr) and urea clearance in urine collected over 24 h, but collection can be cumbersome and difficult to manage. A faster, simpler alternative is to measure levels of cystatin C (CysC) in serum, but the accuracy and reliability of this method is controversial. Our study aims to validate published CysC-based equations for estimating residual renal function in patients on CAPD. Methods Residual renal function was measured by calculating average clearance of urea and Cr in 24-h urine as well as by applying CysC- or Cr-based equations published by Hoek and Yang. We then compared the performance of the equations against the 24-h urine results. Results In our sample of 255 patients ages 47.9 ± 15.6 years, the serum CysC level was 6.43 ± 1.13 mg/L. Serum CysC level was not significantly associated with age, gender, height, weight, body mass index, hemoglobin, intact parathyroid hormone, normalized protein catabolic rate or the presence of diabetes. In contrast, serum CysC levels did correlate with peritoneal clearance of CysC and with levels of prealbumin and high-sensitivity C-reactive protein. Residual renal function was 2.56 ± 2.07 mL/min/1.73 m 2 based on 24-h urine sampling, compared with estimates (mL/min/1.73 m 2 ) of 2.98 ± 0.66 for Hoek's equation, 2.03 ± 0.97 for Yang's CysC-based equation and 2.70 ± 1.30 for Yang's Cr-based equation. Accuracies within 30%/50% of measured residual renal function for the three equations were 29.02/48.24, 34.90/56.86 and 31.37/54.90. Conclusion The three equations for estimating residual renal function showed similar limits of agreement and differed significantly from the measured value. Published CysC-based equations do not appear to be particularly reliable for patients on CAPD. Further development and validation of CysC-based equations should take into account peritoneal clearance of CysC and other relevant factors.
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Affiliation(s)
- Hui Zhong
- Department of Nephrology, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Wei Zhang
- Department of Epidemiology and Biostatistics, West China School of Public Health, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Min Qin
- Department of Nephrology, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - ZhongPing Gou
- Institute of Clinical Trials, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Ping Feng
- Institute of Clinical Trials, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
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Xiao LH, Chen PR, Li M, Gou ZP, Xiang LC, Li YZ, Feng P. [Tree-Augmented NaÏve Bayesian network model for predicting prostate cancer]. Zhonghua Nan Ke Xue 2016; 22:506-510. [PMID: 28963838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To evaluate the integrated performance of age, serum PSA, and transrectal ultrasound images in the prediction of prostate cancer using a Tree-Augmented NaÏve (TAN) Bayesian network model. METHODS We collected such data as age, serum PSA, transrectal ultrasound findings, and pathological diagnoses from 941 male patients who underwent prostate biopsy from January 2008 to September 2011. Using a TAN Bayesian network model, we analyzed the data for predicting prostate cancer, and compared them with the gold standards of pathological diagnosis. RESULTS The accuracy, sensitivity, specificity, positive prediction rate, and negative prediction rate of the TAN Bayesian network model were 85.11%, 88.37%, 83.67%, 70.37%, and 94.25%, respectively. CONCLUSIONS Based on age, serum PSA, and transrectal ultrasound images, the TAN Bayesian network model has a high value for the prediction of prostate cancer, and can help improve the clinical screening and diagnosis of the disease.
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Affiliation(s)
- Li-Hong Xiao
- Department of Epidemiology and Biostatistics, West China School of Public Health; Sichuan University, Chengdu, Sichuan 610041, China
| | - Pei-Ran Chen
- Department of Epidemiology and Biostatistics, West China School of Public Health; Sichuan University, Chengdu, Sichuan 610041, China
| | - Mei Li
- National Institute for Clinical Drug Trials, West China Hospital; Sichuan University, Chengdu, Sichuan 610041, China
| | - Zhong-Ping Gou
- National Institute for Clinical Drug Trials, West China Hospital; Sichuan University, Chengdu, Sichuan 610041, China
| | - Liang-Cheng Xiang
- Department of Epidemiology and Biostatistics, West China School of Public Health; Sichuan University, Chengdu, Sichuan 610041, China
| | - Yong-Zhong Li
- Department of Ultrasonography, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Ping Feng
- National Institute for Clinical Drug Trials, West China Hospital; Sichuan University, Chengdu, Sichuan 610041, China
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Liu SY, Tian HM, Liao DQ, Chen YF, Gou ZP, Xie XY, Li XJ. The effect of gliquidone on KATP channels in pancreatic β-cells, cardiomyocytes, and vascular smooth muscle cells. Diabetes Res Clin Pract 2015; 109:334-9. [PMID: 26044612 DOI: 10.1016/j.diabres.2015.05.036] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2014] [Revised: 01/30/2015] [Accepted: 05/02/2015] [Indexed: 02/05/2023]
Abstract
AIMS Sulfonylurea drugs exert an insulinotropic effect through ATP-sensitive potassium (KATP) channel inhibition in pancreatic islet cells. These channels are also expressed in cardiomyocytes and vascular smooth muscle cells (VSMCs), suggesting potential for adverse cardiovascular effects. We evaluated the effects of Gliquidone (Glq) on sulfonylurea receptors in HIT-T15 cells (SUR1), cardiomyocytes (SUR2A), and VSMCs (SUR2B). METHODS The concentration-dependent effects of Glq (0.001-500 μM) on KATP channels were assessed using whole-cell patch clamp in HIT-T15 cells, rat cardiomyocytes, and VSMCs. Parallel studies using Glibenclamide (Glb) (0.001-10 μM) and Gliclazide (Glc) (0.01-500 μM)were conducted as controls. RESULTS In HIT-T15 cells, Glb exhibited the lowest IC50 (0.03 μM), as compared to Glq (0.45μM) and Glc (1.21μM). However, Glq had higher IC50 in cardiomyoctes and VSMCs, as compared to Glb (119.1 vs. 0.01 and 149.7 vs. 0.09 μM, respectively), suggesting that Glq is more selective to β-cells than Glb. Thus, Glq may have fewer side effects in cardiomyoctes and VSMCs. CONCLUSIONS Glq is a highly selective SUR secretagogue with moderate affinity to β-cells, but low affinity to cardiomyocytes and VSMCs. Our data also reveal the non-selective nature of Glb, as evidenced by high binding affinity to KATP channels in all the three cell types examined.
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Affiliation(s)
- Shu-Yi Liu
- Division of Endocrinology and Metabolism Internal Medicine, West China Hospital, Sichuan University, Chengdu, China; Division of Endocrinology & Metabolism, The First People's Hospital of Chengdu, Chengdu, China
| | - Hao-Min Tian
- Division of Endocrinology and Metabolism Internal Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Da-Qing Liao
- Laboratory of Anesthesia and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Yan-Fang Chen
- Laboratory of Anesthesia and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Zhong-Ping Gou
- Division of Endocrinology and Metabolism Internal Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Xiao-Ying Xie
- Division of Endocrinology and Metabolism Internal Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Xiu-Jun Li
- Division of Endocrinology and Metabolism Internal Medicine, West China Hospital, Sichuan University, Chengdu, China.
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Qiu H, Fu P, Fan W, Zuo C, Feng P, Shi P, Cao L, Liu F, Zhou L, Chen F, Zhong H, Gou Z, Liang Y, Shi M. Treatment of Primary Chronic Glomerulonephritis with Rehmannia Glutinosa Acteosides in Combination with the Angiotensin Receptor Blocker Irbesartan: A Randomized Controlled Trial. Phytother Res 2013; 28:132-6. [PMID: 23519822 DOI: 10.1002/ptr.4973] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2012] [Revised: 02/20/2013] [Accepted: 02/21/2013] [Indexed: 02/05/2023]
Affiliation(s)
- HongYu Qiu
- Department of Nephrology, West China Hospital; Sichuan University; Chengdu Sichuan P. R. China
| | - Ping Fu
- Department of Nephrology, West China Hospital; Sichuan University; Chengdu Sichuan P. R. China
| | - WenXing Fan
- Department of Nephrology, West China Hospital; Sichuan University; Chengdu Sichuan P. R. China
| | - Chuan Zuo
- Department of Nephrology, West China Hospital; Sichuan University; Chengdu Sichuan P. R. China
| | - Ping Feng
- Institute of Clinical Trials, West China Hospital; Sichuan University; Chengdu Sichuan P.R. China
| | - Peng Shi
- Nephrology Department of Traditional Chinese Medicine; Military 451 Hospital Xi'an Shanxi P.R. China
| | - Lina Cao
- Department of Nephrology, Xian Yang Central Hospital; Xianyang Shanxi P.R. China
| | - Fang Liu
- Department of Nephrology, West China Hospital; Sichuan University; Chengdu Sichuan P. R. China
| | - Li Zhou
- Department of Nephrology, West China Hospital; Sichuan University; Chengdu Sichuan P. R. China
| | - Feng Chen
- Department of Nephrology, West China Hospital; Sichuan University; Chengdu Sichuan P. R. China
| | - Hui Zhong
- Department of Nephrology, West China Hospital; Sichuan University; Chengdu Sichuan P. R. China
| | - ZhongPing Gou
- Institute of Clinical Trials, West China Hospital; Sichuan University; Chengdu Sichuan P.R. China
| | - YaPing Liang
- Department of Nephrology, West China Hospital; Sichuan University; Chengdu Sichuan P. R. China
| | - Mei Shi
- Department of Nephrology, West China Hospital; Sichuan University; Chengdu Sichuan P. R. China
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