Circadian clock disruption has been linked to
diseases ranging from metabolic syndrome to cancer. Therefore, the circadian
system has become an attractive target for research and clinical care
innovations. The authors show that the orphan G-protein-coupled receptor Gpr176
is involved in light entrainment of the circadian clock through a mechanism
requiring two related neuropeptides, neuromedin U and neuromedin S. It is
suggested by the authors that simultaneous modulation of these neuropeptides and Gpr176 may constitute a potential
therapeutic option for modulating the circadian clock.
Despite the
usefulness of nanoparticles, there are now safety concerns about their use. Therefore,
the importance of evaluating the safety of vulnerable generations such as
pregnant women and infants, who are highly sensitive to chemical substances,
has been pointed out worldwide. From this perspective, to analyze the risk from
nanoparticles to vulnerable generations, nano-safety science and nano-safety
design research has been conducted. The findings of these studies will lead not
only to develop a nanotechnology that will enable the sustainable use of
nanoparticles; they will also contribute to future developments in the field of
health science.
Recently, therapeutic drug monitoring is
recommended for many drugs even though the procedure is not covered by health
insurance. This Current Topic focuses on four areas: (1) anticancer drugs, (2)
anti-infective agents, (3) antipsychotics/antidepressants, and (4) antibody
drugs. Among the drugs that are not approved for insurance coverage in Japan,
the drugs for which TDM is recommended and drugs that are likely to be approved
in the future are summarized in a review, which include their pharmacokinetic
characteristics and the usefulness of TDM.
Antibodies that specifically target biomarkers are
essential in clinical diagnosis. Genetic engineering has assisted in designing novel antibodies that offer greater antigen-binding
affinities, thus providing more sensitive immunoassays. Authors have succeeded
in generating a single-chain Fv fragment (scFv) targeted estradiol-17b (E2) with more than 370-fold improved
affinity (Ka 3.2 ´ 1010
M-1), based on a strategy focusing the
complementarity-determining region 3 in the VH domain (VH-CDR3).
This improvement is the greatest reported for mutagenesis targeting
anti-steroid antibodies. The scFv mutant enabled an enzyme-linked immunosorbent
assay that provided sensitive dose-response
curves for determining E2, the midpoint of which was 4.46 pg/assay.
Fracture Risk Assessment Tool (FRAX) is a
well-known scoring system for predicting the probability of fragility fractures
(FF). However, among the factors used in FRAX, glucocorticoid is the only
medication factor. Authors assessed the risk of FF at each clinical department
using FRAX and medication patterns. As a result, the departments included in
the high-risk group by FRAX were not necessarily the same as the departments
included in the top group, based on the administered medications. Authors
recommend the use of FRAX together with prescribed medications on hospital-wide
surveillance of fracture risk assessment.
For the patient, the national health
insurance of Japan is a wonderful system which can be proud to the world.
Efficiency of medical care is an important issue to make this system
sustainable into the future. Nivolumab, a breakthrough cancer drug, is widely
effective, but its high price raises efficiency concerns. Authors performed
model-based cost-effectiveness analyses in first-line and late-line treatment
for advanced gastric cancer. The first-line treatment had an incremental
cost-effectiveness ratio of more than 7 times that of the late-line treatment.
Authors showed challenges between economics and best practices in healthcare.
Changes
in drug-metabolizing activity via pregnane X receptor (PXR) is one of the
mechanisms involved in drug-drug interactions. The authors reported cases in
which the anticoagulant effects of warfarin were reversibly attenuated by the
concomitant administration of rifampicin or bosentan, which are potent PXR
ligands. However, no recovery of the response to warfarin was observed in the
patients switched from bosentan to macitentan, which is considered not to
activate PXR in clinical settings. The authors describe the importance of
long-term monitoring and additional examinations to clarify the sustained mechanism
for the drug interaction with warfarin, when switching from bosentan to
macitentan.
The dust extinction coefficient measured by
light detection and ranging (LIDAR) has been used as an indicator of exposure
to Asian dust in many epidemiological studies; however, few reports exist which
explore the relationship between the dust extinction coefficient and the
distribution of airborne particles near the ground surface. In this study,
authors repot that the dust extinction coefficient is a useful indicator of
Asian dust near the ground surface; however, as harmful air pollutants
occasionally move with Asian dust, it is necessary to monitor these pollutants
near the ground surface when conducting an epidemiological study on the health
effect of airborne particles.
Circadian
rhythms influence various physiological functions, including drug distribution
and efficacy. However, the influence of circadian
rhythms on the blood-brain barrier (BBB) remains unclear. Ogata et
al. comprehensively investigated diurnal protein changes in
mouse BBB by quantitative proteomics analysis. Expression
of proteins associated with transport and physical barrier at the BBB remained constant
throughout the day, whereas expression of proteins involved in protein
synthesis, angiogenesis, and energy metabolism varied diurnally. These findings
may help predict
the biological responses to circadian changes in the BBB and brain drug
distribution.
An
administration plan for vancomycin in bedridden elderly patients has not been
established. This study evaluated the prediction accuracy of the
Bayesian-derived area under the concentration-time curve (AUC) of vancomycin
using creatinine-based equations for estimating kidney function in such
patients. In this paper, the authors showed that the Bayesian approach using the
estimated creatinine clearance calculated by substituting the serum creatinine
level + 0.2 into the Cockcroft-Gault equation has the highest prediction
accuracy for the AUC in bedridden elderly patients. These results may
contribute to improving the efficacy and safety of vancomycin in such patients.
Recently, chemotherapy-induced
secondary sarcopenia has emerged as an important clinical issue; however, the
underlying mechanisms are poorly understood. In this study, the authors focused
on the possible involvement of mitochondrial disturbances in cisplatin-induced
muscle atrophy using a cellular model. They concluded that mitochondrial
dysfunction and the resultant generation of excessive reactive oxygen species
(ROS), but not energy disruption, play a central role in cisplatin-induced
C2C12 myotube atrophy. These results suggest that mitochondrial protection
and/or ROS scavenging may be promising strategies for preventing muscle atrophy
associated with cisplatin-based chemotherapy.
Sacran, a type of new sulfated polysaccharide, is a biomaterial with
excellent water solubility and safety, and is expected to be used in
pharmaceuticals of the future. In the present study,
sacran suppressed oxidative stress and inhibited the progression of chronic
kidney disease (CKD). Sacran also had a multifaceted effect on the progression
of CKD by altering the mix of intestinal microflora as a prebiotic in addition
to the above effects. Thus, sacran is expected to have an effective
nephroprotective effect especially when oxidative stress initially appears at
the early stage of renal failure.
Hepatocellular carcinoma is one of the most frequent
cancers. Sinomenine (SIN) is a compound derived from Sinomenium
acutum. Authors’ investigations have found that SIN suppressed SK-Hep-1
cells’ proliferation, enhanced the collapse of potential of the mitochondrial
membrane, triggered cell apoptosis, down-regulated PI3K p85α, AKT1, BCL-2,
Pro-Caspase 9, Pro-Caspase 3 expressions, and up-regulated Cleaved Caspase 9
and Cleaved Caspase 3 expressions. In addition, insulin-like growth factor-1 could reverse the high
apoptosis of SK-Hep-1 cells induced by SIN. Therefore, authors revealed that inhibition
of PI3K/AKT1 signaling cascade by SIN induced hepatocellular carcinoma cells
apoptosis.
Atrial
enlargement often provides arrhythmogenic substrates, leading to the induction of
atrial fibrillation. The
authors examined the
anatomical, molecular biological, and
electrophysiological characteristics of remodeled atria in rats with 8- and
12-week of aorto-venocaval shunt
(AVS). It is noteworthy that marked electrophysiological changes were detected
only in the AVS-12W rat despite obvious increments in atrial and ventricular
tissue weights and altered gene expression in the AVS-8W rat, which suggests
that the electrical remodeling observed in the atrium is preceded by structural
remodeling after AVS surgery. These findings provide important information on experimental evidence regarding
the timing of generation of arrhythmogenic substrate in the atria.
Breast cancer are originated from cancer
stem cells (CSCs), which contribute to drug resistance and recurrence. The
authors examined
the effects of transforming growth factor beta (TGFβ) signaling on
proliferation of breast CSCs. TGFβ induced the proliferation of CSCs via
phosphorylation of sphingosine kinase 1 (SphK1) via a Smad-independent manner
and subsequent production of sphingosine-1-phosphate (S1P). Moreover, Notch
pathway was involved in the S1P response via S1P receptor 3. These results suggest
that TGFβ-SphK1-S1P-Notch signaling pathway is a novel therapeutic target in
breast cancer.
Hepatic stellate cells (HSCs) are a key
player in the pathogenesis of hepatic fibrosis including cirrhosis. The
development of hepatic fibrosis is associated with enhanced calcium signaling in
HSCs. However, the regulatory mechanism of calcium signaling in HSCs is largely
unknown. In addition, there is no specific therapeutic drug for hepatic
fibrosis currently. This report reveals that calcium-sensing receptors are
expressed in human HSCs and function in the regulation of calcium signaling and
cell proliferation. These findings help to elucidate the molecular mechanism of
hepatic fibrosis and develop a potential therapeutic target for hepatic
fibrosis.
Organic cation transporter 2 (OCT2) and
multidrug and toxin extrusion 1 and 2-K (MATE1/2-K) are critically involved in
renal secretion, pharmacokinetics (PK), and toxicity of cationic drugs.
Drug-drug interactions (DDIs) at OCT2 and/or MATE1/2-K have been shown to
result in clinical impacts on PK, therapeutic efficacy
and are probably involved in the renal accumulation of drugs. In this work, an
overview of OCT2 and MATE1/2-K is presented. The primary structure, membrane
location, functional properties, and clinical impact of OCT2 and MATE1/2-K are
described. In addition, clinical aspects of
DDIs in OCT2 and MATE1/2-K and their involvement in drug nephrotoxicity are
compiled.
The
severe acute respiratory syndrome
coronavirus 2 (SARS-CoV-2) Omicron variant has multiple receptor-binding
domain (RBD) mutations. Some of these mutations can increase infectivity and
reduce antibody affinity. In this study, the authors successfully developed a
rapid screening assay to simultaneously identify RBD mutations in the Omicron
and Delta variants using high-resolution melting (HRM) analysis. As this
HRM-based genotyping assay does not require sequence-specific probes, unlike the
TaqMan probe assay, it is easy to perform and cost-effective. This simple
method may contribute to the rapid identification and prevention of the potential
widespread infection of SARS-CoV-2 variants.
It has long been known that the chronic skin lesions
of atopic dermatitis (AD) patients show increased amounts of Th1 cells in
addition to Th2 cells. However, it has remained unclear whether these Th1 cells
actually participate in the exacerbation of skin inflammation. In this paper,
the authors showed that Langerhans cells (LCs) augmented CCL5 production by
responding to Th1 cytokine, IFN-g while presenting antigen to Th cells, and that this
augmentation of CCL5 production would contribute to infiltration of eosinophils
and other Th1 cells into skin lesions, followed by expansion of chronic
inflammation in the skin.
Breed and organ-dependent sex differences in the mRNA amounts of several drug
transporters in the liver and kidney were found in pigs. In Meishan pigs, the
sex differences in the amounts of hepatic MDR1, OATP1B3, and OCT1 mRNAs and in those
of renal MRP2, OAT1, OAT2, OAT3, and OCT2 mRNAs were found. However, no such
sex differences were observed in Landrace pigs. Furthermore,
additional experiments using castrated and/or testosterone propionate-treated
pigs suggested that breed-dependent sex differences in the gene expression of
drug transporters, especially hepatic OCT1 and renal OAT1, were primarily due
to the difference in serum testosterone concentration.