Resistance mechanism

抗性机制
  • 文章类型: Journal Article
    与多粘菌素E甲磺酸钠相关的不良事件在肾毒性的患病率方面具有变异性,神经毒性,和较不频繁的呼吸抑制。近年来,由于多重耐药细菌的增加,它的使用一直是相关的,因为它被认为是最后一线药物,是其主要不良事件和作者之间肾毒性差异的原因。滥用抗生素治疗产生了多种耐药机制,最常见的是与粘菌素有关,杀菌逃逸效果。根据搜索条件,没有发现使用粘菌素的安全性和有效性的随机临床试验,推断适当剂量的应用受专家意见以及回顾性和前瞻性观察研究的支配,这些混杂因素,如患者的严重程度和发生急性肾衰竭的倾向是恒定的。在这次审查中,我们专注于确定肾毒性和细菌耐药性的机制,还有很多事情要知道。
    The adverse events related to sodium colistimethate have had variability regarding the prevalence of nephrotoxicity, neurotoxicity, and less frequent respiratory depression. In recent years, its use has been relevant due to the increase of multidrug-resistant bacteria since it is considered the last-line drug, being its main adverse event and reason for discrepancies between authors\' nephrotoxicity. The indiscriminate use of antibiotic therapy has generated multiple mechanisms of resistance, the most common being related to Colistin, the bactericidal escape effect. Based on the search criteria, no randomized clinical trials were identified showing safety and efficacy with the use of Colistin, inferring that the application of the appropriate dose is governed by expert opinion and retrospective and prospective observational studies, which confounding factors such as the severity of the patient and the predisposition to develop acute renal failure are constant. In this review, we focus on identifying the mechanism of nephrotoxicity and bacterial resistance, where much remains to be known.
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  • 文章类型: Journal Article
    在过去的十年里,致癌驱动突变的鉴定和酪氨酸激酶抑制剂(TKIs)在日常临床实践中的引入已经大大改进了癌基因成瘾的治疗方法,非小细胞肺癌(NSCLC)。在所有NSCLC患者的约3-5%中检测到间变性淋巴瘤激酶(ALK)基因的重排。在克唑替尼的有希望的结果之后,第一代ALK抑制剂(ALK-i),已经开发了其他第二代和最近的第三代TKIs,目前是NSCLC治疗的里程碑,导致患者预后的显著改善。由于临床试验已经证明了每种ALK-I的高疗效,在全身和颅内疾病控制方面,第二代和第三代ALK-I之间的比较研究仍然缺乏,和原发性或继发性ALK-i耐药性不可避免地限制了它们的功效。对ALK-i的抗性可能是由于ALK依赖或ALK独立机制,包括旁路信号通路的激活和组织学转变:这些发现可能在将来选择患者的后续治疗中起重要作用。这篇综述旨在概述ALK-i耐药性的潜在分子改变,并指出液体活检在预测肿瘤反应和监测耐药性突变方面的有希望的作用。本综述的目的还在于总结目前ALK重排NSCLC患者的批准情况。帮助临床医生决定治疗顺序,并加深在ALK-i治疗期间影响患者预后的临床病理和基因组特征的作用。
    During the last decade, the identification of oncogenic driver mutations and the introduction of tyrosine kinase inhibitors (TKIs) in daily clinical practice have substantially revamped the therapeutic approach of oncogene-addicted, non-small cell lung cancer (NSCLC). Rearrangements in the anaplastic lymphoma kinase (ALK) gene are detected in around 3-5% of all NSCLC patients. Following the promising results of Crizotinib, a first-generation ALK inhibitor (ALK-i), other second-generation and more recently third-generation TKIs have been developed and are currently a landmark in NSCLC treatment, leading to a significant improvement in patients prognosis. As clinical trials have already demonstrated high efficacy of each ALK-i, both in terms of systemic and intracranial disease control, comparative studies between second and third generation ALK-i are still lacking, and primary or secondary ALK-i resistance inevitably limit their efficacy. Resistance to ALK-i can be due to ALK-dependent or ALK-independent mechanisms, including the activation of bypass signaling pathways and histological transformation: these findings may play an important role in the future to select patients\' subsequent therapy. This review aims to provide an overview of underlying molecular alterations of ALK-i resistance and point out promising role of liquid biopsy in predicting tumor response and monitoring resistance mutations. The purpose of this review is also to summarize current approval for ALK-rearranged NSCLC patients, to help clinicians in making decisions on therapeutic sequence, and to deepen the role of clinicopathological and genomic characteristics influencing patients\' prognosis during treatment with ALK-i.
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  • 文章类型: English Abstract
    黄瓜的栽培和生产受到假单胞菌引起的霜霉病的严重影响。霜霉病会损害树叶,茎和花序,然后降低黄瓜的产量和质量。本文综述了黄瓜霜霉病的研究进展,包括病原体检测和防御途径,监管因素,病原体抗性候选基因的挖掘,蛋白质组学和基因组分析,和QTL的发展。本综述有助于阐明黄瓜对霜霉病的抗性机制。
    The cultivation and production of cucumber are seriously affected by downy mildew caused by Pseudoperonospora cubensis. Downy mildew damages leaves, stems and inflorescences, and then reduces the yield and quality of cucumber. This review summarized the research advances in cucumber downy mildew, including pathogen detection and defense pathways, regulatory factors, mining of pathogens-resistant candidate genes, proteomic and genomic analysis, and development of QTL remarks. This review may facilitate clarifying the resistance mechanisms of cucumber to downy mildew.
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  • 文章类型: Journal Article
    2007年首次报道了伴有间变性淋巴瘤激酶重排(ALK)的非小细胞肺癌(NSCLC)。ALK重排的NSCLC约占NSCLC的3-8%。ALK重排的晚期NSCLC的一线治疗是靶向ALK的酪氨酸激酶抑制剂(TKI)。随着克唑替尼的发展,第一个ALK-TKI,患者的预后有了很大的改善。目前,FDA批准了五个TKIs。此外,新型TKI的临床试验,ensartinib,以及用于复合ALK突变的第四代ALK-TKI正在进行中。血管生成抑制剂和免疫检查点抑制剂的治疗也在研究中。然而,随着疾病的进展,癌症往往会产生抗性机制。除了ALK突变,其他机制,包括旁路信号通路的激活和组织学转化,造成阻力,这些机制的鉴定对于选择后续治疗很重要。已经报道了对组织和液体活检的研究,并有望成为识别耐药机制的有用工具。本手稿的目的是提供有关ALK-TKIs最近临床试验的信息,血管生成抑制剂,免疫检查点抑制剂,和化疗来描述组织和液体活检作为一种研究ALK-TKIs耐药机制的方法,并提出了一种拟议的治疗算法。
    Non-small cell lung cancer (NSCLC) with anaplastic lymphoma kinase rearrangement (ALK) was first reported in 2007. ALK-rearranged NSCLC accounts for about 3-8% of NSCLC. The first-line therapy for ALK-rearranged advanced NSCLC is tyrosine kinase inhibitors (TKI) targeting ALK. Following the development of crizotinib, the first ALK-TKI, patient prognosis has been greatly improved. Currently, five TKIs are approved by the FDA. In addition, clinical trials of the novel TKI, ensartinib, and fourth-generation ALK-TKI for compound ALK mutation are ongoing. Treatment with angiogenesis inhibitors and immune checkpoint inhibitors is also being studied. However, as the disease progresses, cancers tend to develop resistance mechanisms. In addition to ALK mutations, other mechanisms, including the activation of bypass signaling pathways and histological transformation, cause resistance, and the identification of these mechanisms is important in selecting subsequent therapy. Studies on tissue and liquid biopsy have been reported and are expected to be useful tools for identifying resistance mechanisms. The purpose of this manuscript is to provide information on the recent clinical trials of ALK-TKIs, angiogenesis inhibitors, immune checkpoint inhibitors, and chemotherapy to describe tissue and liquid biopsy as a method to investigate the mechanisms of resistance against ALK-TKIs and suggest a proposed treatment algorithm.
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  • 文章类型: Journal Article
    Weeds, such as Phalaris spp., can drastically reduce the yield of crops, and the evolution of resistance to herbicides has further exacerbated this issue. Thus far, 23 cases of herbicide resistance in 11 countries have been reported in Phalaris spp., including Phalaris minor Retz., Phalaris paradoxa L., and Phalaris brachystachys L., for photosystem II (PS-II), acetyl-CoA carboxylase (ACCase), and acetolactate synthase (ALS)-inhibiting herbicides. This paper will first review the cases of herbicide resistance reported in P. minor, P. paradoxa, and P. brachystachys. Then, the mechanisms of resistance in Phalaris spp. are discussed in detail. Finally, the fitness cost of herbicide resistance and the literature on the management of herbicide-resistant weeds from these species are reviewed.
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  • 文章类型: Journal Article
    Targeted therapy with epidermal growth factor receptor (EGFR)‑tyrosine kinase inhibitors (TKIs) is a standard modality of the 1st‑line treatments for patients with advanced EGFR‑mutated non‑small cell lung cancer (NSCLC), and substantially improves their prognosis. However, EGFR T790M mutation is the primary mechanism of 1st‑ and 2nd‑generation EGFR‑TKI resistance. Osimertinib is a representative of the 3rd‑generation EGFR‑TKIs that target T790M mutation, and has satisfactory efficacy in the treatment of T790M‑positive NSCLC with disease progression following use of 1st‑ or 2nd‑generation EGFR‑TKIs. Other 3rd‑generation EGFR‑TKIs, such as abivertinib, rociletinib, nazartinib, olmutinib and alflutinib, are also at various stages of development. However, the occurrence of acquired resistance is inevitable, and the mechanisms of 3rd‑generation EGFR‑TKI resistance are complex and incompletely understood. Genomic studies in tissue and liquid biopsies of resistant patients reveal multiple candidate pathways. The present review summarizes the recent findings in mechanisms of resistance to 3rd‑generation EGFR‑TKIs in advanced NSCLC, and provides possible strategies to overcome this resistance. The mechanisms of acquired resistance mainly include an altered EGFR signaling pathway (EGFR tertiary mutations and amplification), activation of aberrant bypassing pathways (hepatocyte growth factor receptor amplification, human epidermal growth factor receptor 2 amplification and aberrant insulin‑like growth factor 1 receptor activation), downstream pathway activation (RAS/RAF/MEK/ERK and PI3K/AKT/mTOR) and histological/phenotypic transformations (SCLC transformation and epithelial‑mesenchymal transition). The combination of targeted therapies is a promising strategy to treat osimertinib‑resistant patients, and multiple clinical studies on novel combined therapies are ongoing.
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  • 文章类型: Journal Article
    The prognosis of advanced non-small cell lung cancer (NSCLC) patients has improved in recent decades, especially for patients with an oncogenic driver mutation. Anaplastic lymphoma kinase (ALK) tyrosine kinase inhibitors (TKIs) are effective for patients with the echinoderm microtubule-associated protein-like 4-ALK fusion gene. Several ALK-TKIs have been established: the first-generation ALK-TKI, crizotinib; second-generation ALK-TKIs, alectinib and ceritinib; and third-generation ALK-TKI, lorlatinib. Some ALK-TKIs are effective for tumors that are resistant to other ALK-TKIs; however, as is known in epidermal growth factor receptormutant lung cancer, tumor resistance is inevitable. ALK-positive NSCLCs acquire resistance via various mechanisms, making it a heterogeneous disease. Therefore, it is necessary to develop next-generation treatment strategies, such as the use of next-generation ALK-TKIs for secondary mutations, or combination therapies with ALK-TKIs and other TKIs. In this review, we summarize the development and use of ALK-TKIs, prior pivotal clinical trials, and resistance mechanisms.
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  • 文章类型: Journal Article
    Sequence type 11 (ST11) carbapenem-resistant Klebsiella pneumoniae (CRKP) has become the dominant clone in China. In this review, we trace the prevalence of ST11 CRKP in the China Antimicrobial Surveillance Network (CHINET), the key antimicrobial resistance mechanisms and virulence evolution. The recent emergence of ST11 carbapenem-resistant hypervirulent K. pneumoniae (CR-hvKP) strains in China due to the acquisition of a pLVPK-like virulence plasmid, which may cause severe infections in relatively healthy individuals that are difficult to treat with current antibiotics, has attracted worldwide attention. There is a very close linkage among IncF plasmids, NTEKPC and ST11 K. pneumoniae in China. Hybrid conjugative virulence plasmids are demonstrated to readily convert a ST11 CRKP strain to a CR-hvKP strain via conjugation. Understanding the molecular evolutionary mechanisms of resistance and virulence-bearing plasmids as well as the prevalence of ST11 CRKP in China allows improved tracking and control of such organisms.
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