FDA, food and drug administration

FDA,食品和药物管理局
  • 文章类型: Journal Article
    革兰氏阳性细菌中的重要细胞功能由称为群体感应肽(QSP)的信号分子控制,被认为是对细菌感染的有希望的治疗干预措施。在细菌系统中,QSP与膜偶联受体结合,然后自动磷酸化并激活细胞内反应调节剂。这些反应调节剂诱导细菌中的靶基因表达。毒力相关分子靶标的药物发现研究中最可靠的趋势之一是使用肽药物或新功能。从这个角度来看,计算方法作为生物学家的辅助辅助手段,其中基于机器学习和计算机分析的方法被开发为用于目标肽鉴定的合适工具。因此,识别或预测这些QSP及其受体和抑制剂的快速可靠的计算资源的开发正受到相当大的关注。人体肠道微生物的Quorumpeps和QuorumSensing(QSHGM)等数据库提供了QSP结构和功能的详细概述。QSPpred等工具和算法,QSPred-FL,iQSP,EnsembleQS和PEPred-Suite已用于QSP和特征表示的通用预测。基于氨基酸组成利用肽特征的编译关键资源的可用性,位置偏好,和基序以及结构和物理化学性质,包括生物膜抑制肽,可以帮助阐明感染性革兰氏阳性病原体中的QSP和膜受体相互作用。在这里,我们提供了适用于检测QSP和QS干扰分子的各种计算方法的全面调查。这篇综述强调了这些方法用于开发针对感染性革兰氏阳性病原体的潜在生物标志物的实用性。
    The vital cellular functions in Gram-positive bacteria are controlled by signaling molecules known as quorum sensing peptides (QSPs), considered promising therapeutic interventions for bacterial infections. In the bacterial system QSPs bind to membrane-coupled receptors, which then auto-phosphorylate and activate intracellular response regulators. These response regulators induce target gene expression in bacteria. One of the most reliable trends in drug discovery research for virulence-associated molecular targets is the use of peptide drugs or new functionalities. In this perspective, computational methods act as auxiliary aids for biologists, where methodologies based on machine learning and in silico analysis are developed as suitable tools for target peptide identification. Therefore, the development of quick and reliable computational resources to identify or predict these QSPs along with their receptors and inhibitors is receiving considerable attention. The databases such as Quorumpeps and Quorum Sensing of Human Gut Microbes (QSHGM) provide a detailed overview of the structures and functions of QSPs. The tools and algorithms such as QSPpred, QSPred-FL, iQSP, EnsembleQS and PEPred-Suite have been used for the generic prediction of QSPs and feature representation. The availability of compiled key resources for utilizing peptide features based on amino acid composition, positional preferences, and motifs as well as structural and physicochemical properties, including biofilm inhibitory peptides, can aid in elucidating the QSP and membrane receptor interactions in infectious Gram-positive pathogens. Herein, we present a comprehensive survey of diverse computational approaches that are suitable for detecting QSPs and QS interference molecules. This review highlights the utility of these methods for developing potential biomarkers against infectious Gram-positive pathogens.
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  • 文章类型: Journal Article
    在过去的两年里,全球监管当局对几种药物中的亚硝胺污染提出了安全问题,包括血管紧张素II受体拮抗剂,组胺-2受体拮抗剂,抗菌剂,和抗糖尿病药物。为了避免依赖这些药物的患者产生致癌和致突变作用,当局已经制定了风险评估方案的具体指南,并提出了药品中亚硝胺杂质的控制限值。在这次审查中,讨论了药物中亚硝胺形成的亚硝化途径和可能的根本原因。介绍了国家监管部门提出的药品中亚硝胺杂质的控制限值。此外,在没有动物致癌性测试中发布AI信息的情况下,针对药物产品N-亚硝胺的替代方法,对实施完善的控制限值的实用和基于科学的策略进行了特别审查。最后,解决了一种新的风险评估策略,用于预测和调查胺前体和胺药物的可能亚硝化,以有效预防亚硝胺污染。
    Over the last two years, global regulatory authorities have raised safety concerns on nitrosamine contamination in several drug classes, including angiotensin II receptor antagonists, histamine-2 receptor antagonists, antimicrobial agents, and antidiabetic drugs. To avoid carcinogenic and mutagenic effects in patients relying on these medications, authorities have established specific guidelines in risk assessment scenarios and proposed control limits for nitrosamine impurities in pharmaceuticals. In this review, nitrosation pathways and possible root causes of nitrosamine formation in pharmaceuticals are discussed. The control limits of nitrosamine impurities in pharmaceuticals proposed by national regulatory authorities are presented. Additionally, a practical and science-based strategy for implementing the well-established control limits is notably reviewed in terms of an alternative approach for drug product N-nitrosamines without published AI information from animal carcinogenicity testing. Finally, a novel risk evaluation strategy for predicting and investigating the possible nitrosation of amine precursors and amine pharmaceuticals as powerful prevention of nitrosamine contamination is addressed.
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  • 文章类型: Journal Article
    未经证实:药物测试通常遵循一刀切的方法,在某些临床情况下是不够的,比如虐待儿童,疏忽,和无意的药物暴露。基于免疫测定的测试结果,它们是非特定的,麻木不仁,远非全面,会给孩子和他们的家庭带来意想不到的后果。
    UNASSIGNED:本回顾性病例系列研究的目的是评估实时(0-1天)综合药物测试在儿科急性护理环境中作为基于免疫测定的测试的替代方法的实用性。
    UNASSIGNED:分析中包括通过质谱测试获得的综合药物测试结果以及2019年至2022年在一个机构中所有儿科病例(0-12年)的相关医疗数据。最终病例系列(n=7)包括来自<3年患者的所有病例,其具有与药物史和/或通过免疫测定的毒理学结果不一致的综合药物测试结果。
    UNASSIGNED:从2019年至2022年,订购了174例尿液和血液样本的质谱综合药物测试,代表97名患者(0-12岁)。其中,76例患者均为<3岁;结果与用药史和免疫测定结果确认一致(n=34),与用药史一致(n=14),免疫测定结果的确认(n=10),负(n=9),或病史不完整(n=2)。其余7例纳入最终病例系列。
    UNASSIGNED:这些病例突出了实时综合药物检测在急性儿科病例中的价值。当检测结果为阴性时,可以从诊断鉴别中排除毒性暴露,并在积极时导致适当的医疗和社会干预。
    UNASSIGNED: Drug testing typically follows a one-size-fits-all approach that is inadequate in some clinical scenarios, such as child maltreatment, neglect, and unintentional drug exposure. Results from immunoassay-based testing, which are non-specific, insensitive, and far from comprehensive, can lead to unintended consequences for children and their families.
    UNASSIGNED: The objective of this retrospective case series study is to evaluate the utility of real-time (0-1 day) comprehensive drug testing as an alternative to immunoassay-based testing in the pediatric acute care setting.
    UNASSIGNED: Comprehensive drug testing results obtained by mass spectrometry testing and associated medical data for all pediatric cases (0-12 years) at one institution from 2019 to 2022 were included in the analysis. The final case series (n = 7) included all cases from patients <3 years with comprehensive drug testing results that were inconsistent with medication history and/or toxicology results by immunoassay.
    UNASSIGNED: Comprehensive drug testing by mass spectrometry was ordered for 174 urine and blood samples representing 97 patients (0-12 years) from 2019 to 2022. Of these, 76 cases were from patients <3 years old; results were consistent with medication history and confirmatory for immunoassay results (n = 34), consistent with medication history (n = 14), confirmatory for immunoassay results (n = 10), negative (n = 9), or medical history was incomplete (n = 2). The remaining 7 cases were included in the final case series.
    UNASSIGNED: The cases highlight the value of real-time comprehensive drug testing in acute pediatric cases. Testing results can rule out toxic exposure from the diagnostic differential when negative, and lead to appropriate medical and social interventions when positive.
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  • 文章类型: Journal Article
    一旦医疗药物和设备被FDA批准上市,它们就可以合法地用于其目的和方式,而不是已经过测试和批准的方式。然而,制造商宣传或推广未经批准的药物和设备用途是非法的。本综述的第1部分重点介绍FDA批准的治疗方法的标签外使用。第2部分涉及药品和设备的非法标签外营销。虽然标签外使用对患者有益,除非谨慎进行标签外使用可能会破坏FDA的重要安全使命,可能使患者暴露于升高的风险而没有证实的益处(或可能没有益处),并且可以降低公司研究标签外使用疗法的安全性和风险的动机。当在老年人等非常脆弱的患者人群中出现标签外使用时,这些问题会进一步加剧。患有精神疾病的患者,孕妇和儿科患者。这篇评论考虑了标签外使用中的道德问题,以及医生考虑药物或设备的标签外处方的重要步骤。
    Once medical drugs and devices are approved for marketing by the FDA they can legally be used for purposes and in ways other than the ones for which they have been tested and approved. However, it is illegal for manufacturers to advertise or promote such unapproved uses of the drugs and devices. Part 1 of this review focuses on off-label use of FDA-approved therapies. Part 2 addresses illegal off-label marketing of drugs and devices. While off-label use can be beneficial to patients, unless carefully undertaken off label use may undermine the important safety mission of the FDA, can expose patients to elevated risks without proven benefits (or possibly no benefit), and can reduce motivation of companies to study the safety and risks of off-label use of therapies. These problems are further amplified when off-label use occurs among very vulnerable patient populations such as the elderly, patients with mental health disorders, pregnant women and pediatric patients. This review considers ethical issues in off-label use, as well as important steps for physicians considering an off-label prescription of a drug or device.
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  • 文章类型: Journal Article
    医学中一些最大的挑战是神经退行性疾病(ND),仍然没有治愈,大部分进展到死亡。一项伴随研究采用了一种工具包方法来记录2001年具有种族医学用途的植物物种,以减轻与ND相关的病理,重点关注其与阿尔茨海默病(AD)的相关性。这项研究旨在寻找对一系列ND具有治疗性生物活性的植物。2001年植物物种中的1339种被发现具有治疗相关的生物活性,如帕金森病,亨廷顿病,AD,运动神经元疾病,多发性硬化症,朊病毒病,Neimann-Pick病,青光眼,弗里德赖希的共济失调和巴滕病。发现了43种生物活性,比如减少蛋白质的错误折叠,神经炎症,氧化应激和细胞死亡,促进神经发生,线粒体生物发生,自噬,长寿,和抗微生物活性。Ethno主导的植物选择比植物物种的随机选择更有效。我们的发现表明,食草植物提供了大量ND治疗潜力的资源。广泛的生物活性验证了工具包方法在挖掘此数据中的有用性。我们发现,许多有文献记载的植物能够调节各种关键ND病理的分子机制,揭示了一种有希望甚至深刻的能力来阻止和逆转神经变性的过程。
    Some of the greatest challenges in medicine are the neurodegenerative diseases (NDs), which remain without a cure and mostly progress to death. A companion study employed a toolkit methodology to document 2001 plant species with ethnomedicinal uses for alleviating pathologies relevant to NDs, focusing on its relevance to Alzheimer\'s disease (AD). This study aimed to find plants with therapeutic bioactivities for a range of NDs. 1339 of the 2001 plant species were found to have a bioactivity from the literature of therapeutic relevance to NDs such as Parkinson\'s disease, Huntington\'s disease, AD, motor neurone diseases, multiple sclerosis, prion diseases, Neimann-Pick disease, glaucoma, Friedreich\'s ataxia and Batten disease. 43 types of bioactivities were found, such as reducing protein misfolding, neuroinflammation, oxidative stress and cell death, and promoting neurogenesis, mitochondrial biogenesis, autophagy, longevity, and anti-microbial activity. Ethno-led plant selection was more effective than random selection of plant species. Our findings indicate that ethnomedicinal plants provide a large resource of ND therapeutic potential. The extensive range of bioactivities validate the usefulness of the toolkit methodology in the mining of this data. We found that a number of the documented plants are able to modulate molecular mechanisms underlying various key ND pathologies, revealing a promising and even profound capacity to halt and reverse the processes of neurodegeneration.
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  • 文章类型: Journal Article
    未经批准:评估CART治疗受者神经精神障碍(NPD)的危险因素。
    未经证实:≥18岁的急性淋巴细胞白血病(ALL)患者,对2018年接受CART治疗的侵袭性B细胞淋巴瘤进行了评估.比较有和没有NPD的患者。
    未经证实:在31.2%的患者中诊断为NPD。与没有NPD的患者相比,NPD患者可能是女性(P=0.035)和ALL(P=0.039).NPD与女性性别(OR=2.03)和ALL的诊断(OR=2.76)显着相关。NPD和结果之间没有关联。
    未经证实:女性和ALL是NPD的危险因素。
    UNASSIGNED: To evaluate risk factors for neuropsychiatric disorders (NPD) in recipients of CART therapy.
    UNASSIGNED: Patients ≥ 18 years with acute lymphoblastic leukemia (ALL), and aggressive B-cell lymphomas who received CART in 2018 were evaluated. Patients with and without NPD were compared.
    UNASSIGNED: NPD was diagnosed in 31.2% of patients. Compared to patients without NPD, patients with NPD were likely to be females (P = 0.035) and have ALL (P = 0.039). NPD was significantly associated with female gender (OR = 2.03) and diagnosis of ALL (OR = 2.76). No association between NPD and outcomes.
    UNASSIGNED: Female gender and ALL were risk factors for NPD.
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  • 文章类型: Journal Article
    这项工作旨在开发新的抗生素涂层/负载抗生素的羟基磷灰石(HAp)支架用于骨科创伤,专门用于治疗骨折固定后的感染。HAp支架由尼罗罗非鱼(Oreochromisniloticus)骨骼制成,并进行了充分表征。HAp支架用12种聚乳酸-乙醇酸共聚物(PLGA)或聚乳酸(PLA)制剂涂覆,与万古霉素混合。万古霉素释放,表面形态,抗菌性能,并进行了支架的细胞相容性。HAp粉末含有与人骨骼中发现的元素相同的元素。该HAp粉末适合作为构建支架的起始材料。脚手架制作后,HAp与β-TCP的比值发生变化,观察到β-TCP向α-TCP的相变。所有抗生素包被/负载抗生素的HAp支架可以将万古霉素释放到磷酸盐缓冲盐水(PBS)溶液中。PLGA涂覆的支架比PLA涂覆的支架获得更快的药物释放曲线。涂层溶液中的低聚合物浓度(20%w/v)比高聚合物浓度(40%w/v)给出更快的药物释放曲线。在PBS中浸没14天后,所有组均显示出痕量的表面侵蚀。大多数提取物可以抑制金黄色葡萄球菌(S.金黄色葡萄球菌)和耐甲氧西林金黄色葡萄球菌(MRSA)。提取物不仅对Saos-2骨细胞没有细胞毒性,而且可以促进细胞生长。该研究表明,可以在临床中使用这些抗生素涂覆的/负载抗生素的支架作为抗生素珠替代物。
    This work aimed to develop new antibiotic-coated/ antibiotic-loaded hydroxyapatite (HAp) scaffolds for orthopaedic trauma, specifically to treat the infection after fixation of skeletal fracture. The HAp scaffolds were fabricated from the Nile tilapia (Oreochromis niloticus) bones and fully characterized. The HAp scaffolds were coated with 12 formulations of poly (lactic-co-glycolic acid) (PLGA) or poly (lactic acid) (PLA), blended with vancomycin. The vancomycin release, surface morphology, antibacterial properties, and the cytocompatibility of the scaffolds were conducted. The HAp powder contains elements identical to those found in human bones. This HAp powder is suitable as a starting material to build scaffolds. After the scaffold fabrication, The ratio of HAp to β-TCP changed, and the phase transformation of β-TCP to α-TCP was observed. All antibiotic-coated/ antibiotic-loaded HAp scaffolds can release vancomycin into the phosphate-buffered saline (PBS) solution. PLGA-coated scaffolds obtained faster drug release profiles than PLA-coated scaffolds. The low polymer concentration in the coating solutions (20%w/v) gave a faster drug release profile than the high polymer concentration (40%w/v). All groups showed a trace of surface erosion after being submerged in PBS for 14 days. Most of the extracts can inhibit Staphylococcus aureus (S. aureus) and methicillin-resistant S. aureus (MRSA). The extracts not only caused no cytotoxicity to Saos-2 bone cells but also can increase cell growth. This study demonstrates that it is possible to use these antibiotic-coated/ antibiotic-loaded scaffolds in the clinic as an antibiotic bead replacement.
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  • 文章类型: Journal Article
    严重急性呼吸道综合征冠状病毒2(SARS-CoV-2)是一种高度传染性和致病性病毒,于2019年12月下旬首次出现。这种SARS-CoV-2导致一种称为“冠状病毒传染病-2019”(COVID-19)的急性呼吸道疾病的感染。世界卫生组织(WHO)于2020年3月11日宣布这次SARS-CoV-2疫情是一次大流行。截至2023年1月31日,SARS-CoV-2记录了超过6700万例病例和超过600万人死亡。最近,SARS-CoV的新突变变体也在全球范围内引起了严重的健康问题,未来的小说变体仍然神秘。由于SARS-CoV-2的感染病例每天都在增加,科学家正在尝试使用多种抗病毒药物和针对SARS-CoV-2的疫苗来对抗这种疾病。据我们所知,这是第一次全面总结SARS-CoV-2传播的动态性质,SARS-CoV-2变体(关注的变体和感兴趣的变体),对SARS-CoV-2使用的抗病毒药物和疫苗一目了然。希望,这篇综述将使研究人员获得关于SARS-CoV-2变体和疫苗的知识,这也将为确定针对即将到来的SARS-CoV-2菌株的有效新型疫苗铺平道路。
    Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a highly contagious and pathogenic virus that first appeared in late December 2019. This SARS-CoV-2 causes an infection of an acute respiratory disease called \"coronavirus infectious disease-2019 (COVID-19). The World Health Organization (WHO) declared this SARS-CoV-2 outbreak a great pandemic on March 11, 2020. As of January 31, 2023, SARS-CoV-2 recorded more than 67 million cases and over 6 million deaths. Recently, novel mutated variants of SARS-CoV are also creating a serious health concern worldwide, and the future novel variant is still mysterious. As infection cases of SARS-CoV-2 are increasing daily, scientists are trying to combat the disease using numerous antiviral drugs and vaccines against SARS-CoV-2. To our knowledge, this is the first comprehensive review that summarized the dynamic nature of SARS-CoV-2 transmission, SARS-CoV-2 variants (a variant of concern and variant of interest), antiviral drugs and vaccines utilized against SARS-CoV-2 at a glance. Hopefully, this review will enable the researcher to gain knowledge on SARS-CoV-2 variants and vaccines, which will also pave the way to identify efficient novel vaccines against forthcoming SARS-CoV-2 strains.
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  • 文章类型: Journal Article
    UASSIGNED:我们的实验室历来在内部进行免疫抑制剂和确定的阿片类药物测试,作为实验室开发的(LDT)基于质谱的测试。然而,与COVID-19大流行相关的人员限制和供应链挑战迫使我们将这项检测转交给国家参考实验室。《有效法案》可能会对实验室开发LDT提出苛刻的要求。为了探索这些额外的监管障碍的潜在影响,我们使用我们自己的LDT测试的丢失来评估对患者护理和医院预算的影响.
    UNASSIGNED:实验室信息系统数据和与测试成本相关的历史数据用于计算周转时间和财务影响。
    UNASSIGNED:转诊检测将免疫抑制剂结果的报告时间平均延长了约一天,在第95百分位数的时间延长了两天。我们估计,自测试停止以来,停止内部阿片类药物测试已经使我们的卫生系统损失了超过50万美元。
    未经评估:阻碍实验室开发内部测试的障碍,特别是在没有FDA批准的替代品的情况下,可以预期会对患者护理和医院财务产生不利影响。
    UNASSIGNED: Our laboratory historically performed immunosuppressant and definitive opioid testing in-house as laboratory developed (LDT) mass spectrometry-based tests. However, staffing constraints and supply chain challenges associated with the COVID-19 pandemic forced us to refer this testing to a national reference laboratory. The VALID Act could impose onerous requirements for laboratories to develop LDTs. To explore the potential effect of these additional regulatory hurdles, we used the loss of our own LDT tests to assess the impact on patient care and hospital budgets.
    UNASSIGNED: Laboratory information systems data and historical data associated with test costs were used to calculate turnaround times and financial impact.
    UNASSIGNED: Referral testing has extended the reporting of immunosuppressant results by an average of approximately one day and up to two days at the 95th percentile. We estimate that discontinuing in-house opioid testing has cost our health system over half a million dollars in the year since testing was discontinued.
    UNASSIGNED: Barriers that discourage laboratories from developing in-house testing, particularly in the absence of FDA-cleared alternatives, can be expected to have a detrimental effect on patient care and hospital finances.
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  • 文章类型: Journal Article
    世界油料作物种植面积趋势,产量,在过去的10年里,产量增长了48%,82%,和240%,分别。关于油氧化导致含油食品的保质期缩短和对油的感官质量的需求,迫切需要开发改善油品质量的方法。这篇重要的评论简要概述了与油氧化的抑制方式有关的最新文献。还探讨了不同抗氧化剂和纳米颗粒递送系统对油氧化的机理。当前的评论提供了有关控制策略的科学发现:(i)设计氧化质量评估模型;(ii)通过抗氧化剂涂层和生态友好型薄膜纳米复合材料进行包装:改善理化性质;(iii)对所选抗氧化剂的抑制作用和潜在机制的分子研究;(iv)探索半胱氨酸/柠檬酸和脂氧合酶途径在不饱和脂肪酸链氧化/片段降解过程中的相互关系。
    World trends in oil crop growing area, yield, and production over the last 10 years exhibited an increase of 48 %, 82 %, and 240 %, respectively. Concerning reduced shelf-life of oil-containing food products caused by oil oxidation and the demand for sensory quality of oil, the development of methods the improvement oil quality is urgently required. This critical review presented a concise overview of the recent literature related to the inhibition ways of oil oxidation. The mechanism of different antioxidants and nanoparticle delivery systems on oil oxidation was also explored. The current review provides scientific findings on control strategies: (i) design oxidation quality assessment model; (ii) packaging by antioxidant coatings and eco-friendly film nanocomposite: ameliorate physicochemical properties; (iii) molecular investigations on inhibitory effects of selected antioxidants and underlying mechanisms; (iv) explore the interrelationship between the cysteine/citric acid and lipoxygenase pathway in the progression of oxidative/fragmentation degradation of unsaturated fatty acid chains.
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