Valproic acid

丙戊酸
  • 文章类型: Journal Article
    为了研究miR-23b-3p在抗惊厥活性中的有效性和安全性,阐明miR-23b-3p与Cx43在神经系统中的调控关系,我们建立了氯化锂-毛果芸香碱(PILO)癫痫持续状态(SE)模型。大鼠随机分为以下组:癫痫对照组(PILO),丙戊酸钠(VPA+PILO),重组miR-23b-3p过表达(miR+PILO),miR-23b-3p海绵(海绵+PILO),和加扰序列阴性对照(加扰+PILO)(n=6/组)。经过实验,我们得到了以下结果。在急性期,在VPA+PILO和miR+PILO中,PILO注射后大鼠达到IV期所需的时间显著延长.在SE后的慢性期,VPA+PILO和miR+PILO中自发性复发性癫痫发作(SRS)的频率显著降低.在癫痫发作停止前10分钟,VPA+PILO和miR+PILO中快速波纹(FRs)的平均能量表达显著低于PILO。癫痫发作28天后,Cx43在PILO中的表达显著增加,Beclin1在各组中的表达均显著增高。SE28天后,与PILO组相比,VPA+PILO和miR+PILO组海马CA1区的突触数量明显更高。SE28天后,与PILO组相比,VPA+PILO和miR+PILO组的CA3区海马坏死细胞显著降低。SE后第28天实验组大鼠的生化指标与癫痫对照组相比无显著差异。根据先前的事实,我们可以得出结论,MiR-23b-3p靶向并阻断海马Cx43的表达,可以减少病理性FRs的形成,从而减轻癫痫发作的严重程度,改善癫痫引起的脑损伤。
    In order to investigate the effectiveness and safety of miR-23b-3p in anti-seizure activity and to elucidate the regulatory relationship between miR-23b-3p and Cx43 in the nervous system, we have established a lithium chloride-pilocarpine (PILO) status epilepticus (SE) model. Rats were randomly divided into the following groups: seizure control (PILO), valproate sodium (VPA+PILO), recombinant miR-23b-3p overexpression (miR+PILO), miR-23b-3p sponges (Sponges+PILO), and scramble sequence negative control (Scramble+PILO) (n = 6/group). After experiments, we got the following results. In the acute phase, the time required for rats to reach stage IV after PILO injection was significantly longer in VPA+PILO and miR+PILO. In the chronic phase after SE, the frequency of spontaneous recurrent seizures (SRSs) in VPA+PILO and miR+PILO was significantly reduced. At 10 min before seizure cessation, the average energy expression of fast ripples (FRs) in VPA+PILO and miR+PILO was significantly lower than in PILO. After 28 days of seizure, Cx43 expression in PILO was significantly increased, and Beclin1expression in all groups was significantly increased. After 28 days of SE,the number of synapses in the CA1 region of the hippocampus was significantly higher in the VPA+PILO and miR+PILO groups compared to that in the PILO group. After 28 days of SE ,hippocampal necrotic cells in the CA3 region were significantly lower in the VPA+PILO and miR+PILO groups compared to those in the PILO group. There were no significant differences in biochemical indicators among the experimental group rats 28 days after SE compared to the seizure control group. Based on the previous facts, we can reach the conclusion that MiR-23b-3p targets and blocks the expression of hippocampal Cx43 which can reduce the formation of pathological FRs, thereby alleviating the severity of seizures, improving seizure-induced brain damage.
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  • 文章类型: Journal Article
    自闭症谱系障碍(ASD)是一种神经发育障碍,其特征是多个脑神经化学系统的改变和失衡,特别是5-羟色胺能神经传递.这包括血清素(5-HT)水平的变化,5-HT转运蛋白活性异常,5-HT受体(5-HT7Rs)的合成和表达减少。大脑5-HT系统在ASD发展中的确切作用尚不清楚。关于其参与的证据相互矛盾。最近,我们报道的研究表明,在自闭症样大鼠中,源自中缝核并投射到背侧海马CA1区的5-羟色胺能神经元显着减少。此外,我们已经证明5-HT7Rs的慢性激活逆转了自闭症诱导对突触可塑性的影响.然而,5-HT7Rs在细胞水平上的功能意义尚不完全清楚。这项研究提供了新的证据,表明自闭症诱发后海马CA1子区域中5-HT7R的上调。本说明还表明,在产前暴露于VPA诱导的自闭症大鼠模型中,5-HT7R及其激动剂LP-211的激活可以逆转海马锥体神经元的电生理异常。此外,体内施用LP-211可改善运动协调,新颖的物体识别,和减少自闭症后代的刻板行为。研究结果表明,5-HT7Rs的表达失调可能在ASD的病理生理学中起作用。而像LP-211这样的激动剂有可能被探索作为自闭症谱系障碍的药物治疗。
    Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by alterations and imbalances in multiple brain neurochemical systems, particularly the serotonergic neurotransmission. This includes changes in serotonin (5-HT) levels, aberrations in 5-HT transporter activity, and decreased synthesis and expression of 5-HT receptors (5-HT7Rs). The exact role of the brain 5-HT system in the development of ASD remains unclear, with conflicting evidence on its involvement. Recently, we have reported research has shown a significant decrease in serotonergic neurons originating from the raphe nuclei and projecting to the CA1 region of the dorsal hippocampus in autistic-like rats. Additionally, we have shown that chronic activation of 5-HT7Rs reverses the effects of autism induction on synaptic plasticity. However, the functional significance of 5-HT7Rs at the cellular level is still not fully understood. This study presents new evidence indicating an upregulation of 5-HT7R in the CA1 subregion of the hippocampus following the induction of autism. The present account also demonstrates that activation of 5-HT7R with its agonist LP-211 can reverse electrophysiological abnormalities in hippocampal pyramidal neurons in a rat model of autism induced by prenatal exposure to VPA. Additionally, in vivo administration of LP-211 resulted in improvements in motor coordination, novel object recognition, and a reduction in stereotypic behaviors in autistic-like offspring. The findings suggest that dysregulated expression of 5-HT7Rs may play a role in the pathophysiology of ASD, and that agonists like LP-211 could potentially be explored as a pharmacological treatment for autism spectrum disorder.
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  • 文章类型: Journal Article
    在这项研究中,我们深入研究了复杂的自闭症谱系障碍(ASD)及其与Wnt信号通路紊乱和免疫异常的联系。我们的目的是评估水飞蓟宾的影响,Wnt信号通路和免疫系统的显着调节剂,在丙戊酸(VPA)诱导的ASD斑马鱼模型中观察到的神经行为和分子模式。因为水飞蓟宾是一种疏水性分子,高度不溶于水,它以水飞蓟宾纳米颗粒(纳米水飞蓟宾,NS).在评估生存率后,孵化率,和斑马鱼幼虫的形态暴露于不同浓度的NS,选择合适的浓度。然后,将斑马鱼胚胎同时暴露于VPA(1μM)和NS(100和200μM)120小时。焦虑和注意力不集中的行为和CHD8,CTNNB的表达,GSK3beta,LRP6,TNFα,IL1beta,受精后7天评估BDNF基因。结果表明,较高浓度的NS对生存有不利影响,孵化,形态发育。100和200μMNS的浓度可以改善VPA处理的幼虫的焦虑样行为和学习缺陷,并减少ASD相关的细胞因子(IL1β和TNFα)。此外,仅100μMNS阻止Wnt信号相关因子的基因表达升高(CHD8,CTNNB,GSK3beta,和LRP6)。总之,前120小时的NS治疗可能通过减少促炎细胞因子基因的表达和改变Wnt信号传导成分基因的表达来显示对自闭症样表型的治疗效果。
    In this study, we delved into the intricate world of autism spectrum disorder (ASD) and its connection to the disturbance in the Wnt signaling pathway and immunological abnormalities. Our aim was to evaluate the impact of silibinin, a remarkable modulator of both the Wnt signaling pathway and the immune system, on the neurobehavioral and molecular patterns observed in a zebrafish model of ASD induced by valproic acid (VPA). Because silibinin is a hydrophobic molecule and highly insoluble in water, it was used in the form of silibinin nanoparticles (nanosilibinin, NS). After assessing survival, hatching rate, and morphology of zebrafish larvae exposed to different concentrations of NS, the appropriate concentrations were chosen. Then, zebrafish embryos were exposed to VPA (1 μM) and NS (100 and 200 μM) at the same time for 120 h. Next, anxiety and inattentive behaviors and the expression of CHD8, CTNNB, GSK3beta, LRP6, TNFalpha, IL1beta, and BDNF genes were assessed 7 days post fertilization. The results indicated that higher concentrations of NS had adverse effects on survival, hatching, and morphological development. The concentrations of 100 and 200 μM of NS could ameliorate the anxiety-like behavior and learning deficit and decrease ASD-related cytokines (IL1beta and TNFalpha) in VPA-treated larvae. In addition, only 100 μM of NS prevented raising the gene expression of Wnt signaling-related factors (CHD8, CTNNB, GSK3beta, and LRP6). In conclusion, NS treatment for the first 120 h showed therapeutic effect on an autism-like phenotype probably via reducing the expression of pro-inflammatory cytokines genes and changing the expression of Wnt signaling components genes.
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  • 文章类型: Journal Article
    丙戊酸(VPA)是最有效的抗癫痫药物之一,在妊娠期间将动物暴露于VPA已被用作自闭症谱系障碍(ASD)的模型。许多研究表明,小脑皮质回路中突触传递受损是ASD中出现社交缺陷和重复行为的原因之一。在这项研究中,我们研究了怀孕期间VPA暴露对氨基甲酸乙酯麻醉小鼠触觉刺激诱发的小脑苔藓纤维颗粒细胞(MF-GC)突触传递的影响。三室测试表明,与对照组相比,暴露于VPA小鼠的小鼠表现出社交互动的显着减少。体内电生理记录显示,同侧晶须垫上的一对吹气刺激会引起MF-GC突触传递,N1和N2。与未处理的小鼠相比,暴露于VPA的小鼠中诱发的MF-GC突触反应表现出N1的曲线下面积(AUC)和N2的振幅和AUC的显着增加。选择性N-甲基-D-天冬氨酸(NMDA)受体阻断剂D-APV的小脑表面应用可显着抑制面部刺激诱发的MF-GC突触传递。在D-APV存在的情况下,在VPA暴露的小鼠和未治疗的小鼠中,N1的AUC以及N2的振幅和AUC之间没有显着差异。值得注意的是,阻断含GluN2A亚基,但不含GluN2B亚基,NMDA受体,显着抑制MF-GC突触传递,并将暴露于VPA的小鼠中N1的AUC以及N2的振幅和AUC降低至与未治疗小鼠相似的水平。此外,含GluN2A亚基的NMDA受体在VPA治疗小鼠的GC层中的表达水平高于对照小鼠。这些结果表明,小鼠的妊娠期VPA暴露会产生ASD样行为,伴随着子代小脑MF-GC突触传递的增加和含GluN2A亚基的NMDA受体表达的增加。
    Valproic acid (VPA) is one of the most effective antiepileptic drugs, and exposing animals to VPA during gestation has been used as a model for autism spectrum disorder (ASD). Numerous studies have shown that impaired synaptic transmission in the cerebellar cortical circuits is one of the reasons for the social deficits and repetitive behavior seen in ASD. In this study, we investigated the effect of VPA exposure during pregnancy on tactile stimulation-evoked cerebellar mossy fiber-granule cell (MF-GC) synaptic transmission in mice anesthetized with urethane. Three-chamber testing showed that mice exposed to VPA mice exhibited a significant reduction in social interaction compared with the control group. In vivo electrophysiological recordings revealed that a pair of air-puff stimulation on ipsilateral whisker pad evoked MF-GC synaptic transmission, N1, and N2. The evoked MF-GC synaptic responses in VPA-exposed mice exhibited a significant increase in the area under the curve (AUC) of N1 and the amplitude and AUC of N2 compared with untreated mice. Cerebellar surface application of the selective N-methyl-D-aspartate (NMDA) receptor blocker D-APV significantly inhibited facial stimulation-evoked MF-GC synaptic transmission. In the presence of D-APV, there were no significant differences between the AUC of N1 and the amplitude and AUC of N2 in the VPA-exposed mice and those of the untreated mice. Notably, blockade of the GluN2A subunit-containing, but not the GluN2B subunit-containing, NMDA receptor, significantly inhibited MF-GC synaptic transmission and decreased the AUC of N1 and the amplitude and AUC of N2 in VPA-exposed mice to levels similar to those seen in untreated mice. In addition, the GluN2A subunit-containing NMDA receptor was expressed at higher levels in the GC layer of VPA-treated mice than in control mice. These results indicate that gestational VPA exposure in mice produces ASD-like behaviors, accompanied by increased cerebellar MF-GC synaptic transmission and an increase in GluN2A subunit-containing NMDA receptor expression in the offspring.
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  • 文章类型: Journal Article
    背景:自闭症谱系障碍(ASD)是增长最快的儿童神经精神疾病。患者会经历诸如记忆障碍之类的认知功能障碍以及社交障碍和重复/刻板的运动。我们已经使用了径向臂迷宫(RAM),用于测量自闭症动物模型中的工作和参考记忆错误。此外,胍丁胺的潜在影响,内源性NMDA拮抗剂,对RAM性能和自闭症样行为进行了评估。
    方法:在妊娠第12.5天通过丙戊酸(VPA)给药对自闭症进行建模。在出生后第50-51天,在野外测试(OFT)和三室测试(TCT)中检查了雄性后代的自闭症相关行为。此后,对动物进行RAM(PND55)训练,直到它们在5个连续试验中达到80%正确选择的标准.在获得标准48小时后,在随后的行为测试前30分钟注射胍丁胺,其中包括RAM的保留阶段,OFT,和TCT。
    结果:VPA处理和完整的大鼠在RAM中表现出相同的表现,急性注射胍丁胺可以挽救VPA引起的社交和焦虑样行为,而对RAM没有影响。
    结论:在自闭症大鼠模型中,空间学习,记忆没有改变。胍丁胺在自闭症动物中拯救了社交和焦虑样行为。
    BACKGROUND: Autism spectrum disorder (ASD) is the fastest-growing child neuropsychiatric condition. Cognitive dysfunctions such as memory impairments are experienced by patients along with social disturbances and repetitive/stereotypic movements. We have used the radial arm maze (RAM), for measurement of working and reference memory errors in an animal model of autism. In addition, the potential effects of agmatine, an endogenous NMDA antagonist, on RAM performance and autistic-like behaviors were assessed.
    METHODS: Autism was modeled by valproic acid (VPA) administration at gestational Day 12.5. Autism-associated behaviors in male offspring were examined in an open field test (OFT) and three-chambered test (TCT) on postnatal days 50-51. Thereafter, the animals were trained in the RAM (PND 55) until they attained the criteria of 80% correct choices during five consecutive trials. Forty-eight hours after the acquisition of criteria, agmatine was injected 30 min before subsequent behavioral testing, which included the retention phase of the RAM, OFT, and TCT.
    RESULTS: VPA-treated and intact rats showed the same performance in RAM, and acute injection of agmatine rescued social and anxiety-like behavior induced by VPA without the effect on RAM.
    CONCLUSIONS: In a rat model of autism, spatial learning, and memory did not change. Agmatine rescued social and anxiety-like behavior in autistic animals.
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  • 文章类型: Journal Article
    抑制人巨细胞病毒(HCMV)立即早期(IE)基因表达是建立和维持潜伏储库的关键调控步骤。通过用组蛋白去乙酰化酶抑制剂如丙戊酸(VPA)治疗,病毒IE转录和蛋白质积累可以在潜伏期提高,使感染的细胞对适应性免疫反应可见。然而,潜伏期相关病毒蛋白UL138在支持潜伏期的不完全分化骨髓细胞感染期间抑制VPA增强IE基因表达的能力.UL138还通过抑制cGAS-STING-TBK1DNA传感途径来限制IFNβ转录物的积累。这里,我们证明,在不存在UL138的情况下,cGAS-STING-TBK1途径在不完全分化的骨髓细胞中促进IFNβ积累和VPA反应性IE基因表达。通过遗传或药理抑制使这一途径失活,表现出UL138表达并减少VPA反应性IE转录物和蛋白质积累。这项工作揭示了细胞质病原体传感和病毒裂解期转录的表观遗传控制之间的联系,并表明模式识别受体信号通路的操纵可以帮助MIEP调节策略的细化,以靶向潜伏的病毒储库。
    Repression of human cytomegalovirus (HCMV) immediate-early (IE) gene expression is a key regulatory step in the establishment and maintenance of latent reservoirs. Viral IE transcription and protein accumulation can be elevated during latency by treatment with histone deacetylase inhibitors such as valproic acid (VPA), rendering infected cells visible to adaptive immune responses. However, the latency-associated viral protein UL138 inhibits the ability of VPA to enhance IE gene expression during infection of incompletely differentiated myeloid cells that support latency. UL138 also limits the accumulation of IFNβ transcripts by inhibiting the cGAS-STING-TBK1 DNA-sensing pathway. Here, we show that, in the absence of UL138, the cGAS-STING-TBK1 pathway promotes both IFNβ accumulation and VPA-responsive IE gene expression in incompletely differentiated myeloid cells. Inactivation of this pathway by either genetic or pharmacological inhibition phenocopied UL138 expression and reduced VPA-responsive IE transcript and protein accumulation. This work reveals a link between cytoplasmic pathogen sensing and epigenetic control of viral lytic phase transcription and suggests that manipulation of pattern recognition receptor signaling pathways could aid in the refinement of MIEP regulatory strategies to target latent viral reservoirs.
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  • 文章类型: Journal Article
    在缺血性中风发病机制的主要原因中,氧化应激强烈降低损伤部位干细胞移植率,并禁用以干细胞为基础的治疗作为缺血性卒中的关键治疗方法。为了克服这种治疗限制,预处理已被认为是增强干细胞对氧化应激的适应性和活力的一种可能方法。这里,我们说明了丙戊酸(VPA)和/或雷帕霉素(RAPA)预处理对氧葡萄糖和血清剥夺(OGSD)刺激的毛囊来源干细胞(HFSCs)细胞损伤的保护性影响,并调查了可能的诱导机制.OGSD,作为体外细胞损伤模型,建立HFSCs,并在VPA后使用MTT法观察其活力,RAPA,和OGSD下的VPA-RAPA预处理。评估ROS和MDA的产生以反映氧化应激。采用实时PCR和蛋白质印迹法研究Nrf2的表达。检查了Nrf2相关抗氧化酶的活性,包括NQO1,GPx和GSH水平。分析VEGF和BDNFmRNA表达水平。我们的结果表明,VPA和/或RAPA预处理改善了OGSD诱导的HFSCs活力下降。此外,它们显著抑制了OGSD处理的HFSCs中ROS和MDA的产生.此外,VPA和/或RAPA预处理刺激Nrf2核重新定位和NQO1和GPx活性和GSH量,以及旁分泌因子VEGF和BDNF在OGSD处理的HFSCs中的表达。因此,VPA和/或RAPA预处理提供的保护作用,其中涉及Nrf2调节的氧化应激和VEGF和BDNF表达的调节,显示一个简单的策略来提高缺血性卒中的细胞移植效率.
    Among leading causes of the ischemic stroke pathogenesis, oxidative stress strongly declines rate of stem cell engraftment at the injury site, and disables stem cell-based therapy as a key treatment for ischemia stroke. To overcome this therapeutic limitation, preconditioning has been represented a possible approach to augment the adaptation and viability of stem cells to oxidative stress. Here, we illustrated protective impacts of valproic acid (VPA) and/or rapamycin (RAPA) preconditioning unto oxygen glucose and serum deprivation (OGSD)-stimulated cell damage in hair follicle-derived stem cells (HFSCs) and surveyed the plausible inducement mechanisms. OGSD, as an in vitro cell injury model, was established and HFSCs viability was observed using MTT assay after VPA, RAPA, and VPA-RAPA preconditioning under OGSD. ROS and MDA production was assessed to reflect oxidative stress. Real-time PCR and western blotting were employed to investigate Nrf2 expression. The activity of Nrf2-related antioxidant enzymes including NQO1, GPx and GSH level were examined. VEGF and BDNF mRNA expression levels were analyzed. Our results showed that VPA and/or RAPA preconditioning ameliorated OGSD-induced decline in HFSCs viability. In addition, they considerably prohibited ROS and MDA generation in the OGSD-treated HFSCs. Furthermore, VPA and/or RAPA preconditioning stimulated Nrf2 nuclear repositioning and NQO1 and GPx activity and GSH amount, as well as expression of paracrine factors VEGF and BDNF in OGSD-treated HFSCs. Thus, the protective effects afforded by VPA and/or RAPA preconditioning, which involved Nrf2-modulated oxidant stress and regulation of VEGF and BDNF expression, display a simple strategy to augment cell-transplantation efficiency for ischemic stroke.
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  • 文章类型: Journal Article
    尽管丙戊酸通常具有良好的耐受性,肝毒性是接受长期治疗的患者的常见副作用。然而,丙戊酸相关肝毒性的潜在机制仍然难以捉摸.
    为了研究丙戊酸相关肝毒性的机制和潜在危险因素,招募了165例年龄匹配的儿科患者进行实验室测试和谷氨酸-谷氨酰胺循环分析。
    肝毒性患者的谷氨酸浓度明显高于对照组患者,肝毒性患者谷氨酰胺浓度显著低于对照组(P<0.05)。此外,谷氨酸氨连接酶rs10911021中具有一个突变等位基因的杂合子和具有两个突变等位基因的纯合子基因型的频率在肝毒性组中明显高于对照组(47.1%对32.5%,P=0.010;17.6%对5.2%,分别为P=0.001)。此外,具有一个突变等位基因的杂合携带者和具有两个突变等位基因基因型的谷氨酸-氨连接酶rs10911021的纯合携带者在谷氨酰胺浓度和谷氨酸浓度(分别为P=0.001和P=0.001)和肝功能指标(谷草转氨酶活性,丙氨酸氨基转移酶,和γ-谷氨酰转移酶,P分别为0.001)。此外,logistic回归分析显示谷氨酸-氨连接酶rs10911021(P=0.002,比值比:3.027,95%置信区间,1.521-6.023)和谷氨酸(P=0.001,比值比:2.235,95%置信区间,1.369-3.146)与肝毒性的更大风险相关,而谷氨酰胺浓度与肝毒性呈负相关(P=0.001,比值比:0.711,95%置信区间,0.629-0.804)。
    了解丙戊酸诱导肝毒性的药物基因组风险可能有助于指导患者的具体治疗。我们研究的局限性包括仅从一个位置使用儿童,并在许多患者中同时使用药物。
    谷氨酸-谷氨酰胺循环的扰动与丙戊酸相关的肝毒性相关。此外,谷氨酸-氨连接酶rs10911021,谷氨酸和谷氨酰胺浓度是丙戊酸相关肝毒性的潜在危险因素。
    UNASSIGNED: Although valproic acid is generally well tolerated, hepatotoxicity is a common side effect in patients receiving long-term treatment. However, the mechanisms underlying valproic acid-associated hepatotoxicity remain elusive.
    UNASSIGNED: To investigate the mechanisms and explore the potential risk factors for valproic acid-associated hepatotoxicity, 165 age-matched pediatric patients were recruited for laboratory tests and glutamate-glutamine cycle analysis.
    UNASSIGNED: The concentration of glutamate in patients with hepatotoxicity was significantly greater than that in control patients, while the concentration of glutamine in patients with hepatotoxicity was significantly lower than that in control patients (P ˂ 0.05). In addition, the frequencies of the heterozygous with one mutant allele and homozygous with two mutant alleles genotypes in glutamate-ammonia ligase rs10911021 were significantly higher in the hepatotoxicity group than those in the control group (47.1 percent versus 32.5 percent, P = 0.010; 17.6 percent versus 5.2 percent, P = 0.001, respectively). Moreover, heterozygous carriers with one mutant allele and homozygous carriers with two mutant alleles genotypes of glutamate-ammonia ligase rs10911021 exhibited significant differences in the concentrations of glutamine and glutamate concentrations (P ˂ 0.001 and P = 0.001, respectively) and liver function indicators (activities of aspartate aminotransferase, alanine aminotransferase, and gamma-glutamyl transferase, P ˂ 0.001, respectively). Furthermore, logistic regression analysis indicated that glutamate-ammonia ligase rs10911021 (P = 0.002, odds ratio: 3.027, 95 percent confidence interval, 1.521 - 6.023) and glutamate (P = 0.001, odds ratio: 2.235, 95 percent confidence interval, 1.369 - 3.146) were associated with a greater risk for hepatotoxicity, while glutamine concentrations were negatively associated with hepatotoxicity (P = 0.001, odds ratio: 0.711, 95 percent confidence interval, 0.629 - 0.804).
    UNASSIGNED: Understanding pharmacogenomic risks for valproic acid induced hepatotoxicity might help direct patient specific care. Limitations of our study include the exclusive use of children from one location and concomitant medication use in many patients.
    UNASSIGNED: Perturbation of the glutamate-glutamine cycle is associated with valproic acid-associated hepatotoxicity. Moreover, glutamate-ammonia ligase rs10911021, glutamate and glutamine concentrations are potential risk factors for valproic acid-associated hepatotoxicity.
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  • 文章类型: Journal Article
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  • 文章类型: Journal Article
    目的:比较2014年和2019年被诊断患有边缘性人格障碍的育龄妇女的丙戊酸钠配药,以发现新西兰奥特罗阿的处方做法是否因国际建议而发生变化。
    方法:将来自药品收集的国家配药数据与来自PRIMHD(国家心理健康和成瘾数据库)的诊断数据相关联,以识别在新西兰奥特罗阿被诊断为边缘性人格障碍的人,他们被配药了精神药物。比较了2014年至2019年育龄妇女丙戊酸钠的分配。比较了种族之间的分配率。
    结果:2014年,被诊断为边缘性人格障碍的育龄妇女中有10%服用了丙戊酸钠。2019年,这一比例降至6%(p<0.001)。2014年,种族差异很大,18.1%的毛利妇女和15.8%的太平洋妇女使用丙戊酸钠,而新西兰欧洲人为7.4%。这一差距在2019年有所缩小,6.4%的毛利女性和12.5%的太平洋女性使用丙戊酸钠,而新西兰欧洲人为5.6%。
    结论:这些研究结果表明,国际建议和指南在改变临床实践和减少种族不平等方面是有效的。鉴于暴露于丙戊酸钠的后代的显著风险,我们对在边缘性人格障碍中使用丙戊酸钠的标签外处方提出了警告。
    OBJECTIVE: To compare sodium valproate dispensing in women of childbearing age diagnosed with borderline personality disorder in 2014 and 2019 to discover if prescribing practices in Aotearoa New Zealand have changed in response to international recommendations.
    METHODS: National dispensing data from the Pharmaceutical Collection were linked with diagnostic data from PRIMHD (the national mental health and addiction database) to identify people diagnosed with borderline personality disorder in Aotearoa New Zealand who were dispensed psychotropic medication. Dispensing of sodium valproate for women of childbearing age was compared between 2014 and 2019. Rates of dispensing were compared between ethnicities.
    RESULTS: In 2014, 10% of women of childbearing age diagnosed with borderline personality disorder were dispensed sodium valproate. This reduced to 6% of women in 2019 (p<0.001). In 2014, there was substantial ethnic disparity with 18.1% of Māori women and 15.8% of Pacific women dispensed sodium valproate compared with 7.4% of New Zealand Europeans. This disparity reduced in 2019, with 6.4% of Māori women and 12.5% of Pacific women dispensed sodium valproate compared with 5.6% of New Zealand Europeans.
    CONCLUSIONS: These findings suggest that international recommendations and guidelines have been effective in changing clinical practice and reducing ethnic inequities. Given the significant risk to offspring exposed to sodium valproate, we echo warnings against off-label prescribing of sodium valproate in borderline personality disorder.
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