p-Hydroxyamphetamine (p-OHA) is an active metabolite of amphetamine (AMPH) and methamphetamine (METH), and can be detected in the brain for a relatively long period after high-dose administration of AMPH in rodents. p-OHA may be involved in the abnormal behavior observed during the withdrawal period after a chronic administration of AMPH or METH. Therefore, the author investigated the effect of an intracerebroventricular (i.c.v.) administration of p-OHA on the changes of locomotor activity and prepulse inhibition (PPI) in the acoustic startle response in rodents. The i.c.v. administration of p-OHA significantly increased locomotor activity in mice. This effect was prevented by a pretreatment with a dopamine (DA) uptake inhibitor. Furthermore, local infusion of p-OHA into the nucleus accumbens (NAc) significantly increased locomotor activity in rats. Together these results suggest that dopaminergic systems in the rodent NAc may play important roles in p-OHA-induced locomotor activity. Next, the author tested the effects of the i.c.v. administration of p-OHA on PPI in mice. p-OHA induced PPI disruptions that were significantly improved by the pretreatment with a typical or an atypical antipsychotic, D₂ or D₄ receptor antagonists, respectively. p-OHA-induced PPI disruptions were also improved by a serotonin (5-HT)_2A receptor antagonist, a 5-HT synthesis inhibitor or a 5-HT neurotoxin. These results suggest that p-OHA-induced PPI disruptions were mediated by DA and 5-HT release and subsequent stimulation of D₂, D₄ and 5-HT_2A receptors. Our recent series of reports indicate that the study of p-OHA may provide new insights into drug abuse as well as psychiatric disorders such as schizophrenia.

The transition-metal-catalyzed cycloisomerization of unsaturated compounds, such as alkynes, alkenes, allenes, and nitriles, is a powerful tool for constructing polycyclic frameworks found in many biologically active natural products and pharmaceuticals. However, this approach predominantly relies on precious transition metals, such as rhodium and iridium. Thus, the development of cycloisomerization reactions using less expensive, less toxic, and environmentally friendly transition metals that are abundantly found in the earth has attracted considerable attention in recent years. In this article, we reviewed our recent studies on the synthesis of various polycyclic compounds via cycloisomerization enabled by the cobalt/photoredox dual catalysis. Our research has demonstrated the excellent efficiency of the cobalt/photoredox dual catalyst system for the cycloisomerization of 1,6-diyne derivatives. We constructed tricyclic cyclohexadiene frameworks, which are found in many biologically active natural products such as 11-O-debenzoyltashironin, perforanoid A, and jiadifenolide, using 1,6,11-enediynes as substrates for the cobalt-catalyzed cycloisomerization. Using a chiral ligand, (S)-Segphos, we achieved an enantioselective reaction that allowed access to enantio-enriched tricyclic cyclohexadiene products. Furthermore, we discovered that a novel cascade cyclization of 1,6-diynyl esters, enabled by the cobalt/photoredox dual catalysis, provided various cyclic compounds via the formation of vinylallene intermediates.

Here, we sought to investigate the usefulness of time-domain NMR (TD-NMR) for evaluating the physical properties of drug formulations. TD-NMR measures NMR relaxation and is mainly performed using a bench-top low-field NMR system (e.g., 20 MHz); thus, it does not require any specific sample shape for measurement if the sample is not gas. Taking advantage of these features, TD-NMR has been widely used for quality control in food science. However, it has rarely been used in the pharmaceutical field. The T₁ and T₂ relaxations are not spectra like those obtained by a high-field NMR system (e.g., 300–600 MHz) but only curves in which the NMR signal recovers or decays according to a specific rule. Therefore, selecting the equation used in the fitting analysis is crucial to estimate the time constants, T₁ and T₂ relaxation times. As the result of a series of studies, the T₁ relaxation measurement by TD-NMR was shown to help evaluate the crystallinity of drugs in solid dosage forms and the miscibility of a drug and excipient in a binary mixture. The T₂ relaxation measurement was also helpful for quantitatively evaluating the solid form of drugs in a physical mixture with or without moisture adsorption. TD-NMR is an excellent technique widely applied to evaluating the physical properties of various formulations, whether solid or liquid, and is expected to be applied to process analysis and quality control in the pharmaceutical field.

Most drugs are metabolized and detoxified in the liver. Therefore, human hepatocytes are essential for pharmacokinetic and toxicity tests in pharmaceutical research. Although primary human hepatocytes (PHHs) are the main cell source used as a human liver model, major drawbacks include the limited supply of PHHs and their functional deterioration due to long-term culture. Many studies have been conducted to overcome these problems or develop new hepatocyte sources. In particular, stem cells with cell proliferative potential are expected to be useful in pharmaceutical research, as they can supply many homogeneous specific somatic cells through differentiation and maturation. Here, we describe recent advances in the use of hepatocyte-like cells derived from human embryonic stem (ES) cells or induced pluripotent stem (iPS) cells and human liver organoids. The hepatocyte differentiation method from human ES/iPS cells by some strategies has been improved. However, the hepatic functions in human hepatocyte-like cells derived from ES/iPS cells are still lower than those in PHHs. Similarly, although human liver organoids show long-term proliferation, their hepatic functions remain low. Human ES/iPS cells and liver organoids could overcome the limited supply of PHHs, but improving their hepatic function is essential. We believe that stem cell culture technology will be useful for generating a functional hepatocyte source for medical applications.

Interstitial lung disease (ILD) is a serious adverse event common to many molecular targeted anticancer drugs. The development of ILD significantly reduces the QOL of patients and results in treatment discontinuation. Because the development of ILD is also associated with therapeutic efficacy, the establishment of prediction strategies for ILD is important. We have focused on signal transducer and activator of transcription 3 (STAT3) as an important mechanistic factor in ILD induced by molecular targeted drugs. Our study aimed to establish mechanism-based ILD prediction strategies; therefore, we investigated the hypothesis that a genetic polymorphism in STAT3 is a predictive factor of the incidence of ILD induced by mammalian target of rapamycin (mTOR) inhibitors, a class of molecular targeted drugs associated with a higher incidence of ILD. Our clinical study clearly demonstrated that the rate of ILD induced by mTOR inhibitors was significantly higher in patients with the G allele homozygous genotype of STAT3 −1697C>G compared with those with other genotypes. The cumulative incidence of ILD in patients with the G allele homozygous genotype was significantly higher compared with that in patients carrying other genotypes. Furthermore, our in vitro study indicated that the epithelial-to-mesenchymal transition (EMT), a pre-process of tissue fibrosis, was induced by an mTOR inhibitor in lung alveolar epithelial cell lines carrying the G allele homozygous genotype which was associated with a higher risk of ILD. Our study provided a novel predictive strategy for the development of ILD induced by molecular targeted drugs.

Rat sarcoma virus (RAS) guanyl nucleotide-releasing protein 2 (RASGRP2) is recognized to activate only RAS-related protein (RAP) in blood cell lineages. Previously, we identified Xenopus rasgrp2 (xrasgrp2), which is upregulated during angiogenesis, and serves as a novel angiogenesis-related gene in undifferentiated cells from Xenopus embryos. Additionally, we revealed the expression of RASGRP2 in human vascular endothelial cells (VECs); however, its role remains unclear. In this study, we aimed to investigate the involvement of RASGRP2 in apoptosis and vascular permeability of VECs, which play crucial roles in angiogenesis and disease progression. We established a vascular endothelial cell line stably overexpressing RASGRP2 to mimic its increased expression during angiogenesis and to analyze RASGRP2 signaling in detail. We found that RASGRP2 activates not only RAP1 but also RAS-related (R-RAS) and R-RAS2. Furthermore, we clarified the anti-apoptotic mechanism by which RASGRP2 inhibits the production of reactive oxygen species by nicotinamide adenine dinucleotide phosphate oxidase via RAP1 signaling, and the translocation of activated B-cell lymphoma 2-associated X protein to the mitochondria by R-RAS signaling. In addition, RASGRP2 suppresses vascular permeability by protecting against vascular endothelial-cadherin disturbance through the activation of RAP1 and R-RAS signals. These findings suggest that RASGRP2 activates both RAP1 and R-RAS in human VECs and induces multiple signal transduction pathways, thereby inhibiting apoptosis and vascular hyperpermeability. Therefore, RASGRP2 in VECs may function as a protective factor to maintain healthy blood vessels. However, further analysis is warranted to explore its potential as a therapeutic target for vascular disorders.

The onset and progression of liver diseases and cancer have shown to be affected by over-active macrophages and fibroblasts. Therefore, developing methods to suppress the activation of these cells has become an urgent task. Prior to this study, a mannosylated-albumin (Man-HSA) that targets mannose receptors expressed in hepatic macrophages (Kupffer cells) or fibroblasts was created. Here, we report on the development of medical treatments based on Man-HSA. To target the reactive oxygen species or inflammation derived from Kupffer cells, we developed a nano-antioxidant, i.e., polythiolated (SH)-Man-HSA, by introducing thiol groups into Man-HSA, or a nano-anti-inflammatory drug, i.e., Man-HSA-IFNα2b, by fusing Man-HSA and IFNα2b. SH-Man-HSA or Man-HSA-IFNα2b attenuated Kupffer cell-derived oxidative stress or inflammation, respectively, resulting in the suppression of liver damage and overall improvement of the survival rate in mice with acute and chronic liver injuries. Tumor-associated macrophages (TAM) and cancer-associated fibroblasts (CAF), both of which are present in the stroma of intractable cancers, also express mannose receptors. Thus, mono-polyethylene glycol modified Man-HSA (monoPEG-Man-HSA) was synthesized as a novel drug delivery carrier targeting TAM/CAF. A complex of monoPEG-Man-HSA with paclitaxel suppressed tumor growth by decreasing the number of TAM/CAF and the stroma area. For the present study, we focused on the mannose receptors expressed in macrophages and fibroblasts, and developed drug delivery carriers that target these cells. Considering the excellent drug-carrying capacity and high biocompatibility of HSA, it is expected that this research will pave the way for innovative pharmacotherapy to treat unmet medical needs, i.e., intractable liver diseases and cancer.

The purpose of this narrative review was to clarify the current status and issues of scientific evidence for functionality in the Foods with Function Claims system based on previous research. From the introduction of the system in April 2015 to January 1, 2023, there were 6606 notifications, of which 6297 (95.3) were systematic reviews (SRs) and 309 (4.7%) were clinical trials (CTs). SRs were identified the following problems: i) inadequate description based on the first version of PRISMA checklist, and ii) very low levels of quality assessment in the first version of AMSTAR checklist and AMSTAR 2. CT was reported to have the following problems: i) inconsistencies between the protocol and the content in the paper (non-compliance), ii) high risk of bias, and iii) not described based on the CONSORT 2010 checklist. Since SRs and randomized controlled trials (RCTs) often have low-quality notifications, it is necessary to correctly communicate this information to consumers in order to make appropriate purchasing decisions.

Inflammatory bowel disease (IBD) is an autoimmune disease that inflames the intestinal tract and reduces patient quality of life. In recent years, prescriptions of biologics and Janus kinase inhibitors have made outpatient pharmacists indispensable to clinics and hospitals. Therefore, we retrospectively investigated the effectiveness of immunopharmacist outpatient services in treating IBD. The survey spanned between January 2019 and December 2020 and included patients who had visited an IBD-specialized outpatient clinic. The endpoints were the number of pharmaceutical and accepted interventions, improvement rates, and cost-effectiveness of the pharmacist outpatient services. The definition of pharmaceutical intervention involves the pharmacist outpatient clinic, which refers to the number of prescription proposals made to doctors, and the dispensing room, which refers to the number of inquiries made to doctors. The survey included 139 patients, and 579 assessments were performed in the pharmacist outpatient clinic. Out of 352 pharmaceutical interventions by the outpatient pharmacist group, 341 (96.9%) were accepted by physicians. Similarly, out of 74 pharmaceutical interventions by the dispensing group, 54 (73.0%) were accepted by physicians (p<0.0001). The overall improvement rate of pharmaceutical interventions was 93.5%. The immunopharmacist outpatient clinic was found to be cost-effective, with an estimated value of 44068000 yen. In IBD outpatient services, clinical pharmacists and physicians are integral members of the medical care team and have a positive impact on drug treatment outcomes.

Recently, a novel quantitative method using relative molar sensitivity (RMS) was applied to quantify the ingredients of drugs and foods. An important development in this regard can be observed in the Japanese Pharmacopoeia (JP) 18, where the quantification of perillaldehyde, an unstable compound, in crude drug “Perilla Herb,” was revised to incorporate the RMS method. In this study, the primary objective was to improve the tester safety and reduce the amount of reagents used in the JP test. To achieve this, the quantification of three toxic Aconitum monoester alkaloids (AMAs) was explored using the RMS method, employing a single reference compound for all three targets. These AMAs, namely benzoylmesaconine hydrochloride, benzoylhypaconine hydrochloride, and 14-anisoylaconine hydrochloride, which are the quantitative compounds of Kampo extracts containing Aconite Root (AR), were quantified using the reference compound benzoic acid (BA). Reliable RMS values were obtained using both ¹H-quantitative NMR and HPLC/UV. Using the RMS of three AMAs relative to the BA, the AMA content (%) in commercial AMAs quantitative reagents were determined without analytical standards. Moreover, the quantitative values of AMAs using the RMS method and the calibration curve method using the three analytical standards were similar. Additionally, similar values were achieved for the three AMAs in the Kampo extracts containing AR using the RMS and the modified JP18 calibration curve methods. These results suggest that the RMS method is suitable for quantitative assays of the Kampo extracts containing AR and can serve as an alternative to the current method specified in the JP18.

LM1010 HPLC is an emerging automated method designed for use in clinical settings. The aim of this study was to compare the analytical performance of LM1010 with the performance of traditional HPLC and LC-MS/MS in the measurement of plasma concentrations of imatinib. Seventy-eight plasma samples from 20 patients (14 men and 6 women) were collected. Plasma concentrations of imatinib in samples from the same patient were analyzed simultaneously using LM1010, HPLC and LC-MS/MS (LSI Medience Corporation). Strong correlations were seen in pairwise comparisons of results from the LM1010 and HPLC methods, the LM1010 and LC-MS/MS methods, and the LC-MS/MS and HPLC methods (Spearman’s r=0.936, 0.906, and 0.953, respectively); however, the results from the LC-MS/MS method showed a positive proportional bias in comparison with the results from the LM1010 and HPLC methods, according to Deming analyses (slope=1.064 and 1.105, respectively). In Bland–Altman analyses, the LC-MS/MS method showed a positive mean bias of 98.6 and 112 ng/mL in comparison with the LM1010 and HPLC methods, respectively. Notably, results obtained using the LM1010 method were comparable to those using the HPLC method (positive mean bias=13.6 ng/mL; 95% confidence interval, −7.9–35.1 ng/mL). Biochemical parameters or drugs taken concomitantly with imatinib were not found to affect the bias of the LM1010 method. The LM1010 method can be applied to routine therapeutic drug monitoring of imatinib.

Patients undergoing chemotherapy for cancer frequently experience fatigue, which can significantly lower their quality of life and interfere with treatment. However, the risk factors for the occurrence of chemotherapy-induced fatigue (CIF) are unclear. In this study, we investigated the occurrence of CIF in 415 patients newly treated with chemotherapy at Fukuoka University Hospital between December 2020 and July 2022, and analyzed the factors that influence the occurrence of fatigue. The observation period was defined as the two-week period starting from the day after the induction of chemotherapy, and we collected data retrospectively from medical records. Fatigue was assessed based on Common Terminology Criteria for Adverse Events (CTCAE) version 5.0 by pharmacists who interviewed patients. The prevalence of fatigue was 56.4% (234/415). Nausea and vomiting, anorexia, hypoalbuminemia, and a high blood urea nitrogen/creatinine (BUN/Cr) ratio were extracted as risk factors for CIF. The prevalence of fatigue in 95 patients with nausea and vomiting was 83.2% (79/95), of whom 74.7% (59/79) had concomitant anorexia. Patients with nausea and vomiting had a high prevalence of both fatigue and anorexia, indicating that control for nausea and vomiting is crucial for the prevention of CIF. The serum albumin level reflects the nutritional status of patients approximately three weeks before chemotherapy, and BUN/Cr ≥20 indicates dehydration. Patients with a poor nutritional status or dehydration should be closely monitored for fatigue before and during treatment. These findings offer new prospects for healthcare providers to avoid or reduce CIF and improve patients’ quality of life by early control of CIF risk factors.

Pharmacists are required to provide and collect medication information based on patients’ health literacy and communication abilities to provide effective pharmaceutical care. Due to a lack of understanding of hearing loss and awareness of the inconvenience that patients with hearing loss face, appropriate actions for effective communication in medication education are not fully implemented. An e-learning system consisting of two courses, a learning course and an evaluation course, has been developed. The learning course explains hearing loss and appropriate actions in medication education and investigates pharmacists’ recognition of medication education, while the evaluation course assesses the implementation of necessary actions in medication education and changes in pharmacists’ recognition of medication education with patients compared to before the e-learning. From February to September 2022, 41 pharmacists completed the learning course, with 22 advancing to the evaluation course. Prior to learning, they had difficulty in communicating with patients with hearing loss. However, after the learning course, their confidence in medication education improved with a better understanding of hearing loss and practice of appropriate actions. They also felt that pharmacists who were unfamiliar with the system should understand hearing loss and take actions tailored to patients’ hearing loss. Further examination may be needed of the effects of the e-learning on patients with hearing loss.