Repurposing

Repuring
  • 文章类型: Journal Article
    最近,四跨膜蛋白CD151已被确定为参与包括细胞粘附在内的转移过程的重要生物学靶标。肿瘤进展过程,在不同类型的癌症中,如乳腺癌和胶质母细胞瘤。这在Silico研究中考虑了来自食品和药物管理局数据库的1603种化合物,在进行ADMET分析后,我们选择了853个配体,用于对接分析。最有前途的配体是从对接研究中选出的,基于两个标准:(a)对CD151蛋白的亲和力最低,(b)它们与QRD基序相互作用,位于第二个胞外环。此外,我们通过MD模拟以及自由能MM-PBSA计算研究了蛋白质-配体复合物的稳定性。从这些结果来看,洛哌丁胺和格列吡嗪被确定为评价最好的药物。我们建议需要进行体外分析以确认我们的计算机模拟预测研究。
    Recently tetraspanin CD151 has been identified as an important biological target involved in metastatic processes which include cell adhesion, tumor progression processes, and so forth in different types of cancers, such as breast cancer and glioblastoma. This in Silico study considered 1603 compounds from the Food and Drug Administration database, after performing an ADMET analysis; we selected 853 ligands, which were used for docking analysis. The most promising ligands were selected from docking studies, based on two criteria: (a) showed lowest affinity to the CD151 protein and (b) they interact with the QRD motif, located in the second extracellular loop. Furthermore, we investigate the stability of the protein-ligand complexes through MD simulations as well as free energy MM-PBSA calculations. From these results, loperamide and glipizide were identified as the best evaluated drugs. We suggest an in vitro analysis is needed to confirm our in silico prediction studies.
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  • 文章类型: Journal Article
    背景:微生物感染主要由革兰氏阳性和革兰氏阴性细菌引起,影响全球数百万人。迫切需要探索现有分子或发现针对细菌感染的新化学实体(NCE)。
    目的:当前调查的主要目的是使用高性能计算研究,针对革兰氏阳性和革兰氏阴性细菌的各种靶标,探索最近获得美国FDA批准的药物(2019-2023)。
    目的:本研究旨在找出最近美国FDA批准的药物中的潜在药物作为针对细菌感染的再利用候选药物。
    方法:使用文献研究确定了革兰氏阳性和革兰氏阴性细菌的靶标,而配体是从过去5年FDA批准的药物清单中选择的。Further,药物和靶标分别通过Schrödinger的LigPrep和蛋白质制备向导模块(释放2023-1)制备。Schrödinger的GlideDock和Desmond模块分别用于分子对接研究和分子动力学模拟。
    结果:在过去五年中,共有202种药物被发现在FDA的清单中。在他们当中,根据其性质选择77种药物进行对接研究。总共21种药物在细菌靶标的活性位点显示出药物的能量上有利的结合构象。使用分子动力学(MD)模拟详细研究了这些药物的相互作用。MD模拟结果表明,革兰氏阴性菌的拓扑异构酶II与三氯苯达唑(抗蠕虫)的动态构象稳定,而solriamfetol(用于阻塞性睡眠呼吸暂停)在革兰氏阳性菌的限制性内切核酸酶活性位点显示出稳定的动态构象。
    结论:所鉴定的药物可用于对抗革兰氏阳性和革兰氏阴性细菌感染。然而,需要进一步的实验研究来证实它们的抗菌潜力。
    BACKGROUND: Microbial infections are mostly caused by Gram-positive as well as Gram-negative bacteria affecting millions of people worldwide. There is an urgent need to explore existing molecules or discover new chemical entities (NCEs) against bacterial infection.
    OBJECTIVE: The main objective of the current investigation is to explore recently US-FDA- approved drugs (2019-2023) against various targets of Gram-positive and Gram-negative bacteria using high-performance computational studies.
    OBJECTIVE: The current study aims to find out the potential drugs of recently US-FDA-approved drugs as repurposing candidates against bacterial infections.
    METHODS: The targets of Gram-positive and Gram-negative bacteria were identified using literature studies whereas ligands were selected from the FDA-approved drug lists of the last 5 years. Further, the drugs and targets were prepared through the LigPrep and Protein Preparation Wizard modules of Schrödinger (release 2023-1) respectively. The GlideDock and Desmond modules of Schrödinger were used for the molecular docking study and molecular dynamics simulation respectively.
    RESULTS: A total of 202 drugs were found in the FDA lists which were approved in the last five years. Out of them, 77 drugs were selected for docking study based on their properties. A total of 21 drugs have shown energetically favored binding conformation of drugs in the active site of bacterial targets. The interaction of these drugs was studied in detail using molecular dynamics (MD) simulation. The MD simulation results have shown stable dynamic conformation of triclabendazole (anti-helminthic) with topoisomerase II of gram-negative bacteria whereas solriamfetol (for obstructive sleep apnea) has shown stable dynamic conformation in the active site of restriction endonuclease of gram-positive bacteria.
    CONCLUSIONS: The identified drugs can be repurposed against Gram-positive and Gramnegative bacterial infections. However, further experimental studies are required to confirm their antibacterial potential.
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  • 文章类型: Journal Article
    醋氯芬酸(ACF)是一种广泛使用的非甾体抗炎药(NSAID),以其治疗疼痛和炎症的有效性而闻名。最近的研究表明,ACF具有抗增殖特性,抑制癌细胞在各种癌细胞系中的生长。香茅醇,一种在精油中发现的单萜醇,表现出抗氧化特性和活性,如抑制细胞生长和乙酰胆碱酯酶抑制。在这项研究中,目的是配制和评估醋氯芬酸/香茅油纳米乳剂对黑色素瘤的抗增殖作用。香茅油的最佳浓度,使用伪三元相图确定吐温80和TranscutolHP。对配制的纳米乳液的液滴尺寸进行了表征,zeta电位,热物理稳定性,和体外释放。所选择的配方(F1)由香茅油(1克%)组成,吐温80(4gm%),和Transcutol生命值(1gm%)。F1呈球形外观,药物含量高,小液滴尺寸,和可接受的负ζ电位。通过差示扫描量热法证实了纳米乳剂中药物的无定形状态,而FTIR分析表明其均一的溶解度。纳米乳剂显示出显著的抗增殖活性,与单独的醋氯芬酸或香茅醇相比,IC50值较低。流式细胞术分析显示细胞周期停滞和纳米乳液诱导的细胞凋亡增加。计算机模拟研究提供了对观察到的抗肿瘤活性的潜在分子机制的见解。总之,开发的醋氯芬酸/香茅油纳米乳液表现出有效的细胞毒性和促凋亡作用,提示其作为黑色素瘤治疗的再利用抗增殖药的潜力。在未来的计划中,建议进一步进行动物模型研究以进行验证。
    Aceclofenac (ACF) is a widely used non-steroidal anti-inflammatory drug (NSAID) known for its effectiveness in treating pain and inflammation. Recent studies have demonstrated that ACF possesses antiproliferative properties, inhibiting the growth of cancer cells in various cancer cell lines. Citronellol, a monoterpenoid alcohol found in essential oils, exhibits antioxidant properties and activities such as inhibiting cell growth and acetylcholinesterase inhibition. In this study, the objective was to formulate and evaluate an aceclofenac/citronellol oil nanoemulsion for its antiproliferative effects on melanoma. The optimal concentrations of citronellol oil, Tween 80, and Transcutol HP were determined using a pseudoternary phase diagram. The formulated nanoemulsions were characterized for droplet size, zeta potential, thermophysical stability, and in vitro release. The selected formula (F1) consisted of citronellol oil (1 gm%), Tween 80 (4 gm%), and Transcutol HP (1 gm%). F1 exhibited a spherical appearance with high drug content, small droplet size, and acceptable negative zeta potential. The amorphous state of the drug in the nanoemulsion was confirmed by Differential Scanning Calorimetry, while FTIR analysis indicated its homogenous solubility. The nanoemulsion showed significant antiproliferative activity, with a lower IC50 value compared to aceclofenac or citronellol alone. Flow cytometric analysis revealed cell cycle arrest and increased apoptosis induced by the nanoemulsion. In silico studies provided insights into the molecular mechanism underlying the observed antitumor activity. In conclusion, the developed aceclofenac/citronellol oil nanoemulsion exhibited potent cytotoxicity and pro-apoptotic effects, suggesting its potential as a repurposed antiproliferative agent for melanoma treatment. In a future plan, further animal model research for validation is suggested.
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  • 文章类型: Journal Article
    COVID-19大流行的爆发已经蔓延到世界各地,影响几乎所有国家和领土。目前的双盲,随机化,安慰剂对照,II期临床试验旨在评估甲苯咪唑作为COVID-19门诊患者辅助治疗的临床疗效和安全性.招募患者并将其分为两组:甲苯咪唑治疗组和安慰剂组。甲苯咪唑和安慰剂组的年龄相匹配,性别,和全血计数(CBC),并在基线时进行鉴别和肝肾功能检查。第三天,C反应蛋白(CRP)水平较低(2.03±1.45vs.5.45±3.95,p<0.001)和周期阈值(CT)水平较高(27.21±3.81vs.在第三天,甲苯咪唑组的24.40±3.09,p=0.046)明显高于安慰剂组。此外,与基线日相比,甲苯咪唑组第3天CRP下降,CT显著增加(分别为p<0.001和p=0.008)。在甲苯达唑组(r=-0.491,p=0.039),但在安慰剂组中(r=0.051,p=0.888),淋巴细胞和CT水平之间存在显着负相关。在这项临床试验中,甲苯咪唑治疗增加了COVID-19门诊患者的先天免疫,使炎症恢复到正常水平的速度快于安慰剂组。我们的发现增加了关于重新利用抗寄生虫治疗的临床和微生物学益处的研究,特别是甲苯咪唑,用于SARS-CoV-2感染和其他病毒感染。
    The outbreak of the COVID-19 pandemic has spread throughout the world, affecting almost all nations and territories. The current double-blind, randomized, placebo-controlled, phase II clinical trial sought to evaluate the clinical efficacy and safety of mebendazole as an adjuvant therapy for outpatients with COVID-19. The patients were recruited and divided into two groups: a Mebendazole-treated group and placebo group. The mebendazole and placebo groups were matched for age, sex, and complete blood count (CBC) with differential and liver and kidney function tests at baseline. On the third day, the C-reactive protein (CRP) levels were lower (2.03 ± 1.45 vs. 5.45 ± 3.95, p < 0.001) and the cycle threshold (CT) levels were higher (27.21 ± 3.81 vs. 24.40 ± 3.09, p = 0.046) significantly in the mebendazole group than in the placebo group on the third day. Furthermore, CRP decreased and CT dramatically increased on day three compared to the baseline day in the mebendazole group (p < 0.001 and p = 0.008, respectively). There was a significant inverse correlation between lymphocytes and CT levels in the mebendazole group (r = -0.491, p = 0.039) but not in the placebo group (r = 0.051, p = 0.888). Mebendazole therapy increased innate immunity and returned inflammation to normal levels in COVID-19 outpatients faster than it did in the placebo group in this clinical trial. Our findings add to the growing body of research on the clinical and microbiological benefits of repurposing antiparasitic therapy, specifically mebendazole, for SARS-CoV-2 infection and other viral infections.
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  • 文章类型: Journal Article
    背景:近年来,在癌症环境中重新使用已批准的药物引起了越来越多的兴趣。氨甲环酸是一种抗纤维蛋白溶解药物,由于其在动物研究中的抗炎和抗癌作用,最近被建议作为抗癌药物。在这项研究中,我们旨在研究氨甲环酸对丹麦女性黑色素瘤的预防作用.
    方法:在这项嵌套病例对照研究中,我们确定了2000-2015年期间18-60岁的女性首次黑色素瘤病例,并将其年龄与10名女性对照进行匹配.使用条件逻辑回归估计氨甲环酸过量或大量使用(≥100,000mg)的黑色素瘤的比值比(OR)。
    结果:共有7986名患有黑色素瘤的女性符合纳入研究的条件,并与79,860名对照组相匹配。大多数暴露病例和对照暴露于低累积剂量的氨甲环酸,相当于连续治疗约5天(1000毫克,每天3次),用于假定的主要适应症。即,月经过多.与黑色素瘤相关的粗OR为1.04(95%CI0.98-1.11,p=0.20),调整后的OR为1.03(0.97-1.10,p=0.32)。我们没有发现剂量反应模式或效应测量随年龄的变化,组织学类型,本地化,或临床阶段。然而,长期服用累积剂量的氨甲环酸(≥100,000mg)与黑色素瘤的风险增加相关(调整后的OR为1.23,95%,CI0.96-1.56),与不使用相比。
    结论:我们发现丹麦女性使用氨甲环酸与黑色素瘤风险之间没有关联。这可以用潜在的剂量或生物学因素来解释,和零星的使用模式。在长期使用者中发现黑色素瘤的风险较高,这可能是由于监测偏见。
    Repurposing already approved drugs in a cancer setting has gained increasing interest in recent years. Tranexamic acid is an anti-fibrinolytic drug that has recently been suggested as an anti-cancer drug due to its anti-inflammatory and anti-carcinogenic effects in animal studies. In this study, we aimed to investigate the possible melanoma-preventive role of tranexamic acid in Danish women.
    In this nested case-control study, we identified female cases 18-60 years with first-time melanoma during 2000-2015 and age-matched them with 10 female controls. The odds ratio (OR) of melanoma with tranexamic acid ever- or high use (≥ 100,000 mg) was estimated using conditional logistic regression.
    A total of 7986 women with incident melanoma were eligible for study inclusion and were matched to 79,860 controls. Most exposed cases and controls were exposed to low cumulative doses of tranexamic acid corresponding to around 5 days of continuous treatment (1000 mg 3 times daily) for the presumed main indication, i.e., menorrhagia. The crude OR associating tranexamic ever use with melanoma was 1.04 (95% CI 0.98-1.11, p = 0.20), and the adjusted OR was 1.03 (0.97-1.10, p = 0.32). We found no dose-response pattern or effect measure modification by age, histologic type, localization, or clinical stage. However, prolonged use with cumulative doses of tranexamic acid (≥ 100,000 mg) was associated with an increased risk of melanoma (adjusted OR 1.23,95 %, CI 0.96-1.56), compared with non-use.
    We found no association between tranexamic acid use and the risk of melanoma in Danish women. This could be explained by underlying dose- or biological factors, and sporadic use patterns. A higher risk of melanoma was seen among prolonged users which could be due to surveillance bias.
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  • 文章类型: Journal Article
    kansasii分枝杆菌(Mkn)在免疫功能正常和免疫功能低下的患者中均引起结核病样肺部感染。目前针对Mkn感染的标准疗法是漫长且难以坚持的。虽然β-内酰胺是最重要的一类抗生素,占全球抗生素市场的65%,传统上,他们因治疗分枝杆菌感染而被解雇,因为它们被认为对分枝杆菌无活性。对β-内酰胺作为抗分枝杆菌剂的新兴趣已显示出其对几种分枝杆菌物种的活性,包括结核分枝杆菌,M.溃疡或M.脓肿;然而,缺乏针对Mkn的信息。在这项研究中,我们确定了几种β-内酰胺对Mkn的体外活性。选择32种药物,包括所有β-内酰胺化学类别(青霉素,头孢菌素,碳青霉烯类和monobactams)与三种β-内酰胺酶抑制剂(克拉维酸盐,他唑巴坦和阿维巴坦)通过MIC测定对22Mkn菌株进行了评估。青霉素加克拉维酸盐以及第一代和第三代头孢菌素是对Mkn最具活性的β-内酰胺。组合时间杀伤试验显示,阿莫西林-克拉维酸和头孢羟氨苄与一线Mkn治疗的良好相互作用。阿莫西林-克拉维酸和头孢羟氨苄是很容易获得的口服药物,并且耐受性良好,具有出色的安全性和药代动力学特征,可能构成Mkn治疗的有希望的替代选择。
    Mycobacterium kansasii (Mkn) causes tuberculosis-like lung infection in both immunocompetent and immunocompromised patients. Current standard therapy against Mkn infection is lengthy and difficult to adhere to. Although β-lactams are the most important class of antibiotics, representing 65% of the global antibiotic market, they have been traditionally dismissed for the treatment of mycobacterial infections, as they were considered inactive against mycobacteria. A renewed interest in β-lactams as antimycobacterial agents has shown their activity against several mycobacterial species, including M. tuberculosis, M. ulcerans or M. abscessus; however, information against Mkn is lacking. In this study, we determined the in vitro activity of several β-lactams against Mkn. A selection of 32 agents including all β-lactam chemical classes (penicillins, cephalosporins, carbapenems and monobactams) with three β-lactamase inhibitors (clavulanate, tazobactam and avibactam) were evaluated against 22 Mkn strains by MIC assays. Penicillins plus clavulanate and first- and third-generation cephalosporins were the most active β-lactams against Mkn. Combinatorial time-kill assays revealed favorable interactions of amoxicillin-clavulanate and cefadroxil with first-line Mkn treatment. Amoxicillin-clavulanate and cefadroxil are oral medications that are readily available, and well tolerated with an excellent safety and pharmacokinetic profile that could constitute a promising alternative option for Mkn therapy.
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  • 文章类型: Journal Article
    我们评估了磷酸二酯酶-5抑制剂,包括西地那非和他达拉非,可能与降低阿尔茨海默病和相关痴呆的发病率相关,通过一项关于Medicare索赔和基于细胞培养的表型分析的患者级队列研究。我们比较了在通过倾向评分匹配控制76个混杂变量后,肺动脉高压患者启动磷酸二酯酶-5抑制剂后与启动内皮素受体拮抗剂后阿尔茨海默病和相关痴呆的发生率。在四种单独的分析方法中,旨在解决特定类型的偏见,包括信息审查,反向因果关系,和结果错误分类,我们没有观察到使用磷酸二酯酶-5抑制剂降低阿尔茨海默病和相关痴呆风险的证据;风险比(95%置信区间):0.99(0.69-1.43),1.00(0.71-1.42),0.67(0.43-1.06),和1.15(0.57-2.34)。在大多数基于细胞培养的表型分析中,我们也没有观察到西地那非改善与阿尔茨海默病相关的分子异常的证据。这些结果没有为磷酸二酯酶-5抑制剂有望重新用于阿尔茨海默病和相关痴呆的假设提供支持。
    We evaluated the hypothesis that phosphodiesterase-5 inhibitors, including sildenafil and tadalafil, may be associated with reduced incidence of Alzheimer\'s disease and related dementia using a patient-level cohort study of Medicare claims and cell culture-based phenotypic assays. We compared incidence of Alzheimer\'s disease and related dementia after phosphodiesterase-5 inhibitor initiation versus endothelin receptor antagonist initiation among patients with pulmonary hypertension after controlling for 76 confounding variables through propensity score matching. Across four separate analytic approaches designed to address specific types of biases including informative censoring, reverse causality, and outcome misclassification, we observed no evidence for a reduced risk of Alzheimer\'s disease and related dementia with phosphodiesterase-5 inhibitors;hazard ratio (95% confidence interval): 0.99 (0.69-1.43), 1.00 (0.71-1.42), 0.67 (0.43-1.06), and 1.15 (0.57-2.34). We also did not observe evidence that sildenafil ameliorated molecular abnormalities relevant to Alzheimer\'s disease in most cell culture-based phenotypic assays. These results do not provide support to the hypothesis that phosphodiesterase-5 inhibitors are promising repurposing candidates for Alzheimer\'s disease and related dementia.
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  • 文章类型: Journal Article
    直接抑制感染性生物的生长与免疫调节以抵消免疫抑制环境可能是有益的治疗方法。在这里,我们开发了一个sulfuretin类似物文库,该文库具有抑制免疫抑制性PGE2产生的潜在能力,并引起对利什曼原虫donovani的直接生长抑制;利什曼原虫是致命的内脏利什曼病的主要致病因子.在探索的文库成员中,在环B和A处具有不同的甲氧基和/或羟基取代模式,类似物1i在环A处保留C6-羟基部分,但具有甲氧基部分代替硫素环B的极性二羟基部分,以及类似物1q在环B上保留硫磺素的极性二羟基部分,但在环A处引入C6-甲氧基部分而不是C6-羟基部分,是最有希望的热门化合物。细胞毒性评估表明,类似物1i具有诱导寄生虫而不是宿主细胞死亡的安全性。计算机模拟提供了它们与利什曼原虫富马酸还原酶可能结合的见解。目前的研究提出了硫磺素类似物1i和1q作为潜在的命中化合物,用于进一步开发针对内脏利什曼病的多功能治疗剂。
    Direct growth inhibition of infectious organisms coupled with immunomodulation to counteract the immunosuppressive environment might be a beneficial therapeutic approach. Herein, a library of sulfuretin analogs were developed with potential capabilities to inhibit production of the immunosuppressive PGE2 and elicit direct growth inhibition against Leishmania donovani; the major causative agent of the fatal visceral leishmaniasis. Amongst explored library members bearing diverse methoxy and/or hydroxy substitution patterns at rings B and A, analog 1i retaining the C6-hydroxy moiety at ring-A, but possessing methoxy moieties in place of the polar dihydroxy moieties of sulfuretin ring-B, as well as analog 1q retaining the sulfuretin\'s polar dihydroxy moieties at ring-B, but incorporating a C6-methoxy moiety instead of the C6-hydroxy moiety at ring-A, were the most promising hit compounds. Cytotoxicity evaluation suggested that analog 1i possesses a safety profile inducing the death of the parasite rather than host cells. In silico simulation provided insights into their possible binding with Leishmania donovani fumarate reductase. The current investigation presents sulfuretin analogs 1i and 1q as potential hit compounds for further development of multifunctional therapeutic agents against visceral leishmaniasis.
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  • 文章类型: Journal Article
    近年来,在涉及建立已知药物的新治疗用途的药物发现过程中,药物重新定位策略获得了相当多的关注。与此相符,我们已经确定地高辛是一种强心苷,作为一种有效的可溶性环氧化物水解酶(sEH)酶抑制剂,采用硅高通量筛选方案,并使用体外无细胞sEH抑制试验和啮齿动物体内临床前研究进一步证实其在痛觉过敏中的再利用,炎症,和相关疾病。口服剂量为0.2mg/kg的地高辛显著降低了(p<.0001)通过使用热板(3.6±1.9)和甩尾试验(7.58±0.9)诱导的小鼠的异常性疼痛。此外,剂量为0.2mg/kg的地高辛显着减少(94%,p<.0001)在乙酸诱导的大鼠腹部收缩中。Further,地高辛还显示出解热活性(37.04±0.2,p<.0001),并在角叉菜胶诱导的大鼠爪水肿中显示出显着减少(0.60±0.06)。此外,组织病理学评估显示地高辛治疗减轻了水肿,中性粒细胞浸润,肺组织肺泡间隔增厚。这些发现是新颖的,突出了将地高辛重新用作治疗痛觉过敏的新线索的新见解。炎症,和相关疾病。
    In recent years, the drug repositioning strategy has gained considerable attention in the drug discovery process that involves establishing new therapeutic uses of already known drugs. In line with this, we have identified digoxin a cardiac glycoside, as a potent inhibitor of soluble epoxide hydrolase (sEH) enzyme employing in silico high throughput screening protocols and further confirmed using in vitro cell-free sEH inhibitory assay and in vivo preclinical studies in rodents for its repurposing in hyperalgesia, inflammation, and related disorders. Oral administration of digoxin at dose 0.2 mg/kg significantly reduced (p < .0001) the allodynia in mice induced by using hot plate (3.6 ± 1.9) and tail-flick test (7.58 ± 0.9). In addition, digoxin at a dose of 0.2 mg/kg showed marked reduction (94%, p < .0001) in acetic acid-induced abdominal contraction in rats. Further, digoxin also demonstrated antipyretic activity (37.04 ± 0.2, p < .0001) and showed notable reduction (0.60 ± 0.06) in carrageenan-induced paw edema in rats. Also, the histopathological evaluation revealed that digoxin treatment attenuated the edema, neutrophil infiltration, and alveolar septal thickening in lung tissue. These findings are novel and highlight the newer insights towards repurposing digoxin as a new lead in the treatment of hyperalgesia, inflammation, and related disorders.
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  • 文章类型: Journal Article
    尽管以前对他汀类药物的研究,阿司匹林,二甲双胍,和血管紧张素转换酶抑制剂(ACEI)/血管紧张素II受体阻滞剂(ARB),几乎没有人研究它们所有可能的组合用于癌症的化学预防。本研究旨在全面分析所有组合的复合化学预防效果。在这项病例对照研究中,健康记录是从台湾健康与福利数据科学中心的索赔数据库中检索的。符合条件的病例以1:4的比例与对照的年龄和性别相匹配。根据药物使用情况将病例和对照组分为16个暴露组。总共确认了601,733例癌症病例。发现癌症风险(以调整后的比值比表示;99%置信区间)显着降低:单独使用他汀类药物的所有癌症的总体风险(0.864;0.843,0.886),阿司匹林单药(0.949;0.939,0.958),和ACEI/ARBs(0.982;0.978,0.985)使用者;二甲双胍单药使用者的前列腺癌(0.924;0.889,0.962)和女性乳腺癌(0.967;0.936,1.000);胃肠道,肺,阿司匹林和/或ACEI/ARBs使用者的肝癌;他汀类药物使用者的肝癌(0.433;0.398,0.471)。总之,结果发现,这些药物的多次使用对癌症预防没有协同作用。使用两种(他汀类药物和阿司匹林,他汀类药物和二甲双胍,他汀类药物和ACEI/ARB,阿司匹林和ACEIS/ARBs)在某些组合中显示出化学预防作用,虽然使用四个,总的来说,没有。
    Despite previous studies on statins, aspirin, metformin, and angiotensin-converting-enzyme inhibitors (ACEIs)/angiotensin II receptor blockers (ARBs), little has been studied about all their possible combinations for chemoprevention against cancers. This study aimed to comprehensively analyze the composite chemopreventive effects of all the combinations. In this case-control study, health records were retrieved from claims databases of Taiwan\'s Health and Welfare Data Science Center. Eligible cases were matched at a 1:4 ratio with controls for age and sex. Both cases and controls were categorized into 16 exposure groups based on medication use. A total of 601,733 cancer cases were identified. Cancer risks (denoted by adjusted odds ratio; 99% confidence interval) were found to be significantly decreased: overall risk of all cancers in statin-alone (0.864; 0.843, 0.886), aspirin-alone (0.949; 0.939, 0.958), and ACEIs/ARBs (0.982; 0.978, 0.985) users; prostate (0.924; 0.889, 0.962) and female breast (0.967; 0.936, 1.000) cancers in metformin-alone users; gastrointestinal, lung, and liver cancers in aspirin and/or ACEIs/ARBs users; and liver cancer (0.433; 0.398, 0.471) in statin users. In conclusion, the results found no synergistic effect of multiple use of these agents on cancer prevention. Use of two (statins and aspirin, statins and metformin, statins and ACEIs/ARBs, and aspirin and ACEIS/ARBs) showed chemopreventive effects in some combinations, while the use of four, in general, did not.
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