Quinolone

喹诺酮
  • 文章类型: Journal Article
    全球微生物耐药性严重威胁人类健康,和多靶向化合物被认为有希望对抗微生物抗性。在这项工作中,使用三乙氧基甲烷和取代的苯胺作为起始材料,通过多步反应开发了一系列具有多靶向抗菌潜力的新型噻唑基喹诺酮类药物。其结构经1HNMR确证,13CNMR和HRMS光谱。抗菌评价显示,一些目标化合物能有效抑制微生物生长。尤其是,硫代酰氨基肼基氨基噻唑基喹诺酮8a对耐药金黄色葡萄球菌具有很强的抑制活性,MIC值为0.0047mM,比诺氟沙星活性高5倍。高活性化合物8a表现出可忽略的溶血,在体外和体内没有明显的毒性,耐药性低,以及快速杀菌作用,这表明其良好的可药用性。此外,化合物8a能够有效地破坏细菌膜的完整性,插入DNA并抑制拓扑异构酶IV的活性,提示多靶向作用机制。化合物8a可以与DNA-拓扑异构酶IV复合物形成氢键和疏水相互作用,表明氨基噻唑基部分的插入有利于提高抗菌效率。这些发现表明,作为化学治疗候选物的活性硫代氨基肼酰氨基噻唑基喹诺酮8a显示出解决耐药细菌感染的巨大潜力。
    The global microbial resistance is a serious threat to human health, and multitargeting compounds are considered to be promising to combat microbial resistance. In this work, a series of new thiazolylquinolones with multitargeting antimicrobial potential were developed through multi-step reactions using triethoxymethane and substituted anilines as start materials. Their structures were confirmed by 1H NMR, 13C NMR and HRMS spectra. Antimicrobial evaluation revealed that some of the target compounds could effectively inhibit microbial growth. Especially, carbothioamido hydrazonyl aminothiazolyl quinolone 8a showed strong inhibitory activity toward drug-resistant Staphylococcus aureus with MIC value of 0.0047 mM, which was 5-fold more active than that of norfloxacin. The highly active compound 8a exhibited negligible hemolysis, no significant toxicity in vitro and in vivo, low drug resistance, as well as rapidly bactericidal effects, which suggested its favorable druggability. Furthermore, compound 8a was able to effectively disrupt the integrity of the bacterial membrane, intercalate into DNA and inhibit the activity of topoisomerase IV, suggesting multitargeting mechanism of action. Compound 8a could form hydrogen bonds and hydrophobic interactions with DNA-topoisomerase IV complex, indicating the insertion of aminothiazolyl moiety was beneficial to improve antibacterial efficiency. These findings indicated that the active carbothioamido hydrazonyl aminothiazolyl quinolone 8a as a chemical therapeutic candidate demonstrated immense potential to tackle drug-resistant bacterial infections.
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  • 文章类型: Journal Article
    背景:喹诺酮类抗生素在临床上广泛用于人类治疗和农业。然而,不当和过度使用会导致喹诺酮类药物残留在动物组织中持续存在,潜在的积累在人体内并构成健康风险。研究质谱裂解模式和分子结构特征之间的相关性增强了检测喹诺酮类药物中痕量或未知杂质的分析框架。
    方法:要收集数据,我们在电喷雾正离子模式下采用了三重四极杆线性离子阱质谱。初级质谱扫描用于确认母离子,而二次质谱扫描可以观察到碎片离子。从一级和二级质谱法获得的准确质荷比来推断化合物的裂解特征和途径。
    结果:在软电离条件下,这些化合物通常表现出[M+H-H2O]+的特征碎片离子,[M+H-CO]+,和[M+H-H2O-CO]+。此外,由于修饰组的差异,在每种化合物中观察到细微的变化.例如,脱酸后,哌嗪环结构发生断裂和重排,产生没有中性分子如C2H5N的碎片离子峰,C3H7N,或C4H8N。值得注意的是,在N-1位上具有环丙基取代基的化合物通常表现出由环丙基基团丢失引起的特征性片段(·C3H5)。此外,N-1和C-8位的取代基,当连接形成六元碳环时,容易发生乳沟,释放中性C3H6分子。
    结论:喹诺酮类抗生素在其母细胞核中具有结构相似性,导致部分相似的切割途径。然而,由于官能团的变化,出现了不同的裂解模式。根据质谱裂解模式的不同,可为抗生素的测定检测提供鉴定依据。
    BACKGROUND: Quinolone antibiotics are extensively used clinically for human treatment and in agriculture. However, improper and excessive use can lead to the persistence of quinolone residues in animal tissues, potentially accumulating in the human body and posing health risks. Investigating the correlation between mass spectrometry cleavage patterns and molecular structural features enhances the analytical framework for detecting trace or unknown impurities in quinolones.
    METHODS: To collect data, we employed triple quadrupole linear ion trap mass spectrometry in electrospray positive ion mode. Primary mass spectrometry scanning was utilized to confirm parent ions, while secondary mass spectrometry scanning enabled the observation of fragment ions. The cleavage characteristics and pathways of the compounds were inferred from accurate mass-to-charge ratios obtained from both primary and secondary mass spectrometry.
    RESULTS: Under soft ionization conditions, the compounds generally exhibited characteristic fragment ions of [M+H-H2O]+, [M+H-CO]+, and [M+H-H2O-CO]+. Additionally, subtle variations were observed in each compound due to differences in modifying groups. For instance, upon deacidification, the piperazine ring structure underwent breakage and rearrangement, yielding fragment ion peaks devoid of neutral molecules such as C2H5N, C3H7N, or C4H8N. Notably, compounds featuring a cyclopropyl substituent group at the N-1 position typically exhibited characteristic fragments resulting from the loss of the cyclopropyl radical (⋅C3H5). Moreover, substituents at the N-1 and C-8 positions, when linked to form a six-membered carbocyclic ring, were prone to cleavage, releasing the neutral C3H6 molecule.
    CONCLUSIONS: Quinolone antibiotics share structural similarities in their parent nuclei, leading to partially similar cleavage pathways. Nevertheless, distinct cleavage patterns emerge due to variations in functional groups. According to the difference of mass spectrometry cleavage patterns, it can provide an identification basis for the measured detection of antibiotics.
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    文章类型: Journal Article
    BACKGROUND: According to the World Health Organization, antimicrobial resistance (AMR) is a silent global pandemic that plagues everyone. It makes therapy of infectious diseases more difficult and eventually increases morbidity and mortality.
    OBJECTIVE: The purpose of this work is to examine existing data on plasmid-mediated quinolone resistance (PMQR), to assess the prevalence of PMQR genes in Enterobacterales, and to determine any knowledge gaps from sub-Saharan Africa.
    METHODS: The Preferred Reporting Items of Systematic Reviews and Meta-analyses (PRISMA) standard was followed when conducting this systematic review. The main internet databases examined for pertinent publications were PubMed, Google Scholar, and Ajol. A set of qualifying criteria were used to evaluate the qualified articles. Using the eligibility criteria, 56 full-text articles were chosen for screening.
    RESULTS: Thirty-two (32) articles with the majority originating from West and North Africa and only one article reporting a study carried out in Central Africa were selected for this review. Escherichia coli and Ciprofloxacin were the most reported Enterobacterales and Quinolone respectively. The PMQR genes include qnr (qnrA,qnrB, qnrC, qnrD, and qnrS), aac (6\') Ib, aac (6\') Ib-cr, oqxAB and qepA gene. The most prevalent PMQR gene is the aac (6\') Ib-cr gene (32%) followed by qnrS (26%).
    CONCLUSIONS: This study highlighted the requirement for an efficient antimicrobial resistance surveillance system in the continent and revealed a significant incidence of PMQR genes.
    BACKGROUND: Selon l\'Organisation mondiale de la santé, la résistance aux antimicrobiens (RAM) est une pandémie mondiale silencieuse qui touche tout le monde. Elle rend le traitement des maladies infectieuses plus difficile et finit par augmenter la morbidité et la mortalité.
    OBJECTIVE: L\'objectif de ce travail est d\'examiner les données existantes sur la résistance plasmidique aux quinolones (PMQR), d\'évaluer la prévalence des gènes PMQR chez les Enterobacterales et de déterminer d\'éventuelles lacunes de connaissances en Afrique subsaharienne.
    UNASSIGNED: La norme Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) a été suivie lors de la réalisation de cette revue systématique. Les principales bases de données Internet examinées pour des publications pertinentes étaient PubMed, Google Scholar et Ajol. Un ensemble de critères d\'admissibilité a été utilisé pour évaluer les articles qualifiés. En utilisant les critères d\'éligibilité, 56 articles en texte intégral ont été choisis pour le dépistage.
    UNASSIGNED: Trente-deux (32) articles, dont la majorité provient d\'Afrique de l\'Ouest et du Nord, et un seul article rapportant une étude menée en Afrique centrale, ont été sélectionnés pour cette revue. Escherichia coli et la ciprofloxacine étaient les Enterobacterales et les quinolones les plus signalées respectivement. Les gènes PMQR comprennent les gènes qnr (qnrA, qnrB, qnrC, qnrD et qnrS), aac (6 \') Ib, aac (6 \') Ib-cr, oqxAB et qepA. Le gène PMQR le plus prévalent est le gène aac (6 \') Ib-cr (32 %), suivi de qnrS (26 %).
    CONCLUSIONS: Cette étude a souligné la nécessité d\'un système efficace de surveillance de la résistance aux antimicrobiens sur le continen`t et a révélé une incidence significative des gènes PMQR.
    UNASSIGNED: Enterobacterales, Escherichia coli, Quinolone, Ciprofloxacine, PMQR, \"aac(6\')-Ib\", \"aac(6\')-Ib-cr\", \"qnr\", \"qepA\", \"oqxAB\", \"résistance aux antibiotiques\".
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  • 文章类型: Journal Article
    我们假设食物中允许的氟喹诺酮类药物的残留浓度(可接受的每日摄入量-ADI)可以选择我们常驻微生物群中的环丙沙星耐药性。我们开发了海棠幼虫中慢性大肠杆菌和肺炎克雷伯菌感染的模型,并通过单次给药和每日给药方案将其暴露于ADI剂量的环丙沙星。通过在选择性琼脂平板中分离目标细菌来评估环丙沙星抗性的出现。暴露于环丙沙星单次和每日给药方案的ADI剂量的十分之一,导致肺炎克雷伯菌对环丙沙星耐药性的选择,而不是大肠杆菌。这种耐药性与多西环素和头孢曲松的交叉耐药性有关。全基因组测序显示转录阻遏物的失活突变,ramR和rrf2,以及gyrA和gyrB中的突变。我们发现,环丙沙星的剂量比每天可接受的剂量低10倍,可能会引起肺炎克雷伯菌对环丙沙星的耐药性。这些结果表明,将抗生素耐药性的诱导作为确定食品中ADI和相关的最大残留限量的重要标准是谨慎的。重要意义本研究发现,食物中允许的环丙沙星/恩诺沙星浓度可诱导肺炎克雷伯菌对环丙沙星的从头耐药。这表明,重新考虑用于确定食品中“安全”浓度上限的标准是明智的。
    We hypothesized that the residual concentrations of fluoroquinolones allowed in food (acceptable daily intake-ADIs) could select for ciprofloxacin resistance in our resident microbiota. We developed models of chronic Escherichia coli and Klebsiella pneumoniae infection in Galleria mellonella larvae and exposed them to ADI doses of ciprofloxacin via single dosing and daily dosing regimens. The emergence of ciprofloxacin resistance was assessed via isolation of the target bacteria in selective agar plates. Exposure to as low as one-tenth of the ADI dose of the single and daily dosing regimens of ciprofloxacin resulted in the selection of ciprofloxacin resistance in K. pneumoniae but not E. coli. This resistance was associated with cross-resistance to doxycycline and ceftriaxone. Whole genome sequencing revealed inactivating mutations in the transcription repressors, ramR and rrf2, as well as mutations in gyrA and gyrB. We found that ciprofloxacin doses 10-fold lower than those classified as acceptable for daily intake could induce resistance to ciprofloxacin in K. pneumoniae. These results suggest that it would be prudent to include the induction of antimicrobial resistance as a significant criterion for determining ADIs and the associated maximum residue limits in food.IMPORTANCEThis study found that the concentrations of ciprofloxacin/enrofloxacin allowed in food can induce de novo ciprofloxacin resistance in Klebsiella pneumoniae. This suggests that it would be prudent to reconsider the criteria used to determine \"safe\" upper concentration limits in food.
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  • 文章类型: Journal Article
    在过去的几年中,微生物感染和新的病原体的流行被认为是各种严重和致命的健康危机的病原体。尽管医学上有进步,细菌和真菌感染仍然是医疗保健系统中一个日益严重的问题。随着越来越多的细菌对治疗中使用的抗生素产生耐药性,并且随着更具侵入性的微生物物种对常规抗菌药物产生耐药性。过去二十年的相关出版物,直到2024年,都是从MEDLINE/PubMed系统检索的,Scopus,EMBASE,和使用诸如喹诺酮类药物之类的关键字的WOS数据库,抗感染,抗菌,喹诺酮衍生物的抗菌素耐药性和专利。随着对新型杂环衍生物作为新型抗感染剂的关注,研究人员已经将这些作为药物设计和开发的基本工具进行了探索。在杂环中,喹诺酮类药物被认为对新型衍生物的开发非常重要,甚至能够解决相关的抵抗问题。喹诺酮支架具有双环结构和特定的官能团,如羰基和酸性基团,确实被认为是在药物发现中进一步产生和优化的有价值的功能。此外,在N-1,C-3和C-7位置的取代也在抗感染潜力中具有重要作用。在这篇文章中,我们打算强调最近的喹诺酮衍生物基于SAR方法和抗感染潜力,如抗菌,抗真菌药,抗疟药,抗结核,抗锥虫和抗病毒活性。此外,最近授予的一些关于含喹诺酮衍生物作为抗感染剂的专利也以表格形式突出。适当考虑到这一点,这种支架的未来研究预计将有助于有抱负的科学家获得药理学上重要的线索。
    Prevalence of microbial infections and new rising pathogens are signified as causative agent for variety of serious and lethal health crisis in past years. Despite medical advances, bacterial and fungal infections continue to be a rising problem in the health care system. As more bacteria develop resistance to antibiotics used in therapy, and as more invasive microbial species develop resistance to conventional antimicrobial drugs. Relevant published publications from the last two decades, up to 2024, were systematically retrieved from the MEDLINE/PubMed, SCOPUS, EMBASE, and WOS databases using keywords such as quinolones, anti-infective, antibacterial, antimicrobial resistance and patents on quinolone derivatives. With an approach of considerable interest towards novel heterocyclic derivatives as novel anti-infective agents, researchers have explored these as essential tools in vistas of drug design and development. Among heterocycles, quinolones have been regarded extremely essential for the development of novel derivatives, even able to tackle the associated resistance issues. The quinolone scaffold with its bicyclic structure and specific functional groups such as the carbonyl and acidic groups, is indeed considered a valuable functionalities for further lead generation and optimization in drug discovery. Besides, the substitution at N-1, C-3 and C-7 positions also subjected to be having a significant role in anti-infective potential. In this article, we intend to highlight recent quinolone derivatives based on the SAR approach and anti-infective potential such as antibacterial, antifungal, antimalarial, antitubercular, antitrypanosomal and antiviral activities. Moreover, some recent patents granted on quinolone-containing derivatives as anti-infective agents have also been highlighted in tabular form. Due consideration of this, future research in this scaffold is expected to be useful for aspiring scientists to get pharmacologically significant leads.
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  • 文章类型: Journal Article
    结核分枝杆菌耐药性的趋势和危险因素(M.结核病)在人类免疫缺陷病毒(HIV)感染的活动性结核病患者中进行了分析。收集2010年至2022年在上海市公共卫生临床中心接受治疗的结核分枝杆菌和HIV合并感染患者的临床资料。通过固体或液体培养证实了结核病的诊断。采用比例法进行表型药敏试验,并对一线和二线药物的耐药性进行分析。采用Logistic回归分析确定结核分枝杆菌耐药的相关危险因素。在304例结核分枝杆菌培养和一线药敏试验结果阳性的患者中,114(37.5%)对至少一种一线抗结核药物耐药。93例患者一线和二线药敏试验结果,40人(43%)对至少一种抗结核药物耐药,和20(21.5%),27(29.0%),19(20.4%),16(17.2%),14人(15.1%)对利福平有抗性,链霉素,氧氟沙星,左氧氟沙星,和莫西沙星,分别;17例患者(18.3%)患有耐多药结核病(MDR-TB).在2010年至2021年之间,对链霉素和利福平的耐药率为14.3%至40.0%和8.0%至26.3%,分别,呈逐年上升趋势。2016年至2021年,喹诺酮类药物耐药率在7.7%至27.8%之间波动,总体呈上升趋势。Logistic回归分析显示,年龄<60岁是链霉素耐药的危险因素,单药耐药,和任何耐药性(RR4.139,p=0.023;RR7.734,p=0.047;RR3.733,p=0.009)。复治结核病是利福平耐药的危险因素,氧氟沙星,左氧氟沙星(RR2.984,p=0.047;RR4.517,p=0.038;RR6.277,p=0.014)。HIV/AIDS患者结核分枝杆菌对利福平和喹诺酮类药物的耐药率较高,且呈逐年上升趋势。年龄和既往抗结核治疗史是HIV/AIDS合并结核病患者耐药发展的主要因素。
    Trends in and risk factors for drug resistance in Mycobacterium tuberculosis (M. tuberculosis) in human immunodeficiency virus (HIV)-infected patients with active tuberculosis were analyzed. The clinical data of M. tuberculosis and HIV-coinfected patients treated at the Shanghai Public Health Clinical Center between 2010 and 2022 were collected. The diagnosis of tuberculosis was confirmed by solid or liquid culture. The phenotypic drug susceptibility test was carried out via the proportional method, and the resistance to first-line and second-line drugs was analyzed. Logistic regression analysis was performed to identify associated risk factors for drug resistance in M. tuberculosis. Of the 304 patients with a M. tuberculosis-positive culture and first-line drug susceptibility test results, 114 (37.5%) were resistant to at least one first-line anti-tuberculosis drug. Of the 93 patients with first-line and second-line drug susceptibility test results, 40 (43%) were resistant to at least one anti-tuberculosis drug, and 20 (21.5%), 27 (29.0%), 19 (20.4%), 16 (17.2%), and 14 (15.1%) were resistant to rifampicin, streptomycin, ofloxacin, levofloxacin, and moxifloxacin, respectively; 17 patients (18.3%) had multidrug-resistant tuberculosis (MDR-TB). Between 2010 and 2021, the rate of resistance to streptomycin and rifampicin ranged from 14.3% to 40.0% and from 8.0% to 26.3%, respectively, showing an increasing trend year by year. From 2016 to 2021, the rate of resistance to quinolones fluctuated between 7.7% and 27.8%, exhibiting an overall upward trend. Logistic regression analysis showed that being aged <60 years old was a risk factor for streptomycin resistance, mono-drug resistance, and any-drug resistance (RR 4.139, p = 0.023; RR 7.734, p = 0.047; RR 3.733, p = 0.009). Retreatment tuberculosis was a risk factor for resistance to rifampicin, ofloxacin, of levofloxacin (RR 2.984, p = 0.047; RR 4.517, p = 0.038; RR 6.277, p = 0.014). The drug resistance rates of M. tuberculosis to rifampicin and to quinolones in HIV/AIDS patients were high and have been increasing year by year. Age and a history of previous anti-tuberculosis treatment were the main factors associated with the development of drug resistance in HIV/AIDS patients with tuberculosis.
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  • 文章类型: Journal Article
    疟疾仍然是一种严重和使人衰弱的疾病。恶性疟原虫对多种抗疟药物的高度耐药性的出现和传播带来了对新的治疗方法的迫切需要,这些新的治疗方法将有效地对抗多药耐药性疟疾感染。一个这样的治疗,ELQ-331(MMV-167),4(1H)-喹诺酮ELQ-300的烷氧基碳酸酯前药目前正在疟疾药物风险公司的临床前开发中。ELQ-331或类似化合物的临床开发将需要同位素标记的类似物的可用性。不幸的是,在文献中没有发现这些重要化合物的氘代的合适方法。这里,我们描述了使用氘代乙酸对4(1H)-喹诺酮ELQ-300,其烷氧基碳酸酯前药ELQ-331及其各自的N-氧化物进行氘代的简便且可扩展的方法。
    Malaria continues to be a serious and debilitating disease. The emergence and spread of high-level resistance to multiple antimalarial drugs by Plasmodium falciparum has brought about an urgent need for new treatments that will be active against multidrug resistant malaria infections. One such treatment, ELQ-331 (MMV-167), an alkoxy carbonate prodrug of 4(1H)-quinolone ELQ-300, is currently in preclinical development with the Medicines for Malaria Venture. Clinical development of ELQ-331 or similar compounds will require the availability of isotopically labeled analogs. Unfortunately, a suitable method for the deuteration of these important compounds was not found in the literature. Here, we describe a facile and scalable method for the deuteration of 4(1H)-quinolone ELQ-300, its alkoxycarbonate prodrug ELQ-331, and their respective N-oxides using deuterated acetic acid.
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  • 文章类型: Journal Article
    左氧氟沙星因其广谱抗微生物活性和方便的给药时间表而被广泛使用。然而,其在儿童中使用的相关性仍有待调查。目的探讨严重感染患儿使用左氧氟沙星的疗效和安全性。
    我们对2021年至2022年期间在我院儿科重症监护病房(PICU)静脉注射左氧氟沙星的18岁以下患者进行了回顾性观察研究。患者人口统计学,课程特点,临床有效性,和不良事件相关性通过回顾性表格综述提取.
    我们纳入了25例接受28个疗程左氧氟沙星治疗的患者。这些接受左氧氟沙星治疗的儿童的平均年龄为4.41岁。在11个疗程中,检测到左氧氟沙星治疗后病原微生物检测结果为阴性(39.29%)。炎症标志物的减少,白细胞或C反应蛋白计数,在18个疗程中检测到(64.29%)。治疗期间共发生57起不良事件,其中21例可能与左氧氟沙星有关,无不良事件可能与左氧氟沙星有关。
    使用左氧氟沙星治疗严重感染儿童的有效性是有希望的,特别是治疗多重耐药细菌。据报道,儿童左氧氟沙星治疗期间发生的不良事件相对常见,但是在这项研究中,其中只有一小部分可能与左氧氟沙星有关,它们都不可能与左氧氟沙星有关。
    UNASSIGNED: Levofloxacin is widely used because of its broad-spectrum antimicrobial activity and convenient dosing schedule. However, the relevance of its use in children remains to be investigated. The purpose of this study is to investigate the efficacy and safety of levofloxacin use in children with severe infections.
    UNASSIGNED: We conducted a retrospective observational study of patients <18 years of age who received levofloxacin intravenously in the Pediatric Intensive Care Unit (PICU) of our hospital during the period between 2021 and 2022. Patient demographics, course characteristics, clinical effectiveness, and adverse event correlations were extracted through a retrospective tabular review.
    UNASSIGNED: We included 25 patients treated with 28 courses of levofloxacin. The mean age of these children treated with levofloxacin was 4.41 years. Conversion of pathogenic microbiological test results to negative after levofloxacin treatment was detected in 11 courses (39.29%). A decrease in inflammatory markers, white blood cell or C-reactive protein counts, was detected in 18 courses (64.29%). A total of 57 adverse events occurred during the treatment period, of which 21 were possibly related to levofloxacin and no adverse events were probably related to levofloxacin.
    UNASSIGNED: The effectiveness of levofloxacin use in children with serious infections is promising, especially for the treatment of multidrug-resistant bacteria. Adverse events occurring during the initiation of levofloxacin therapy in children are reported to be relatively common, but in this study, only a small percentage of them were possibly related to levofloxacin, and none of them were highly possibly related to levofloxacin.
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  • 文章类型: Journal Article
    喹诺酮是在C-2或C-4位含有羰基且在C-1位含有氮的杂环化合物。该支架首先被确定为其抗菌性能,已知这些衍生物具有许多药理活性,包括抗癌。在这次审查中,喹啉-2(H)-酮和喹啉-4(H)-酮衍生物被鉴定为抑制参与癌细胞生长的几种不同的蛋白质和酶,如拓扑异构酶,微管,蛋白激酶,磷酸肌醇3-激酶(PI3K)和组蛋白脱乙酰酶(HDAC)。喹诺酮与姜黄素或查尔酮的杂种,2-苯基吡咯并喹啉-4-酮和4-喹诺酮衍生物已证明对癌细胞系的强效力。此外,喹诺酮类药物已被用作蛋白激酶的抑制剂,包括EGFR和VEGFR。因此,这篇综述旨在巩固喹诺酮衍生物的药物化学,并讨论它们在药代动力学特征和潜在靶位点方面的相似性,以了解抗癌喹诺酮类的结构要求。
    Quinolone is a heterocyclic compound containing carbonyl at the C-2 or C-4 positions with nitrogen at the C-1 position. The scaffold was first identified for its antibacterial properties, and the derivatives were known to possess many pharmacological activities, including anticancer. In this review, the quinolin-2(H)-one and quinolin-4(H)-one derivatives were identified to inhibit several various proteins and enzymes involved in cancer cell growth, such as topoisomerase, mi-crotubules, protein kinases, phosphoinositide 3-kinases (PI3K) and histone deacetylase (HDAC). Hybrids of quinolone with curcumin or chalcone, 2-phenylpyrroloquinolin-4-one and 4-quinolone derivatives have demonstrated strong potency against cancer cell lines. Additionally, quinolones have been explored as inhibitors of protein kinases, including EGFR and VEGFR. Therefore, this review aims to consolidate the medicinal chemistry of quinolone derivatives in the pipeline and discuss their similarities in terms of their pharmacokinetic profiles and potential target sites to provide an understanding of the structural requirements of anticancer quinolones.
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  • 文章类型: Systematic Review
    背景:预防性抗菌药物用于肝硬化和上消化道出血患者,独立研究得出结论,它们可以降低感染率,死亡率,这些疾病的再出血。然而,近年来没有关于这种效应的全面评估的报道,关于不同类别的抗生素预防对肝硬化患者的预后影响的现有数据尤其有限.本文的目的是评估预防性抗菌药物对肝硬化和上消化道出血患者的临床疗效。方法:通过Cochrane图书馆检索相关的随机对照研究和队列研究,以评估预防性抗菌药物对肝硬化并上消化道出血患者的价值。EMBASE,MedLine,和WebofScience。搜索期从数据库开始到2023年4月30日。总结相关数据,使用相对风险(RR)值及其95%置信区间(CI)对二分变量进行统计学分析,使用平均差(MD)值及其95%CI对连续变量进行统计学分析.所有分析均使用Revman5.4软件进行。该研究已在PROSPERO网站上注册,注册号为CRD42022343352。结果:26项研究(18项RCT和8项队列研究,包括13,670名参与者),以评估抗菌预防与无抗菌预防或安慰剂的效果。预防性使用抗生素可降低死亡率(RR0.66,95%CI0.51-0.83),感染率(RR0.41,95%CI0.35-0.49),再出血率(RR0.42,95%CI0.31-0.56),和住院时间(MD-5.29,95%CI-7.53,-3.04)。亚组分析显示,喹诺酮类抗菌药物的预防性给药显示出最有利的疗效,其次是头孢菌素。两种干预措施均可有效避免肝硬化和上消化道出血患者常见的感染。结论:根据我们的调查,预防性抗菌药物在患有肝硬化并上消化道出血的患者中具有显著优势。它与死亡率的降低有关,感染发生率,再出血事件,以及住院时间。在预防性抗菌选择中,喹诺酮类药物成为最重要的选择,此后头孢菌素的排名接近。系统审查注册:https://www。crd.约克。AC.uk/prospro/display_record.php?ID=CRD42022343352,标识符CRD42022343352。
    Background: Prophylactic antibacterial drugs are used for patients with liver cirrhosis and upper gastrointestinal bleeding, and independent studies have concluded that they can decrease the rate of infection, mortality, and rebleeding in these diseases. However, no comprehensive assessment of this effect has been reported in recent years and available data pertaining to the prognostic implications of diverse categories of antibiotic prophylaxis in individuals afflicted with cirrhosis are notably limited. The objective of this article is to assess the clinical effectiveness of prophylactic antibacterial drugs for patients with liver cirrhosis and upper gastrointestinal bleeding. Methods: Relevant randomized controlled studies and cohort studies which examined the value of prophylactic antibacterial drugs for patients with liver cirrhosis and upper gastrointestinal bleeding were retrieved via Cochrane Library, EMBASE, MedLine, and Web of Science. The search period was from database inception until 30 April 2023. Summing up the relevant data, the dichotomous variable was statistically analysed using the relative risk (RR) value and its 95% confidence interval (CI) and the continuous variable using the mean difference (MD) value and its 95% CI. All analyses were performed using Revman 5.4 software. The study has been registered on the PROSPERO website under registration number CRD42022343352. Results: Twenty-six studies (18 RCTs and 8 cohort studies, including 13,670 participants) were included to evaluate the effect of antibacterial prophylaxis versus no antibacterial prophylaxis or placebo. Prophylactic antibiotics reduced mortality rates (RR 0.66, 95% CI 0.51-0.83), infection rates (RR 0.41, 95% CI 0.35-0.49), rebleeding rates (RR 0.42, 95% CI 0.31-0.56), and length of hospital stay (MD -5.29, 95% CI -7.53, -3.04). Subgroup analysis revealed that the prophylactic administration of quinolone antimicrobials demonstrated the most favorable efficacy, followed by cephalosporins. Both interventions were effective in averting infections frequently observed in patients with liver cirrhosis and upper gastrointestinal bleeding. Conclusion: Based on our investigation, the prophylactic antibacterial drugs confers noteworthy advantages in patients afflicted by liver cirrhosis with upper gastrointestinal bleeding. It has been associated with reductions in mortality, infection incidence, rebleeding occurrences, and the duration of hospitalization. Among prophylactic antibacterial options, quinolones emerged as the foremost choice, with cephalosporins ranking closely thereafter. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022343352, identifier CRD42022343352.
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