BACKGROUND: Daratumumab, a monoclonal antibody targeting CD38, has been approved for use with standard myeloma regimens. An evaluation of subcutaneous daratumumab combined with bortezomib, lenalidomide, and dexamethasone (VRd) for the treatment of transplantation-eligible patients with newly diagnosed multiple myeloma is needed. METHODS: In this phase 3 trial, we randomly assigned 709 transplantation-eligible patients with newly diagnosed multiple myeloma to receive either subcutaneous daratumumab combined with VRd induction and consolidation therapy and with lenalidomide maintenance therapy (D-VRd group) or VRd induction and consolidation therapy and lenalidomide maintenance therapy alone (VRd group). The primary end point was progression-free survival. Key secondary end points were a complete response or better and minimal residual disease (MRD)-negative status. RESULTS: At a median follow-up of 47.5 months, the risk of disease progression or death in the D-VRd group was lower than the risk in the VRd group. The estimated percentage of patients with progression-free survival at 48 months was 84.3% in the D-VRd group and 67.7% in the VRd group (hazard ratio for disease progression or death, 0.42; 95% confidence interval, 0.30 to 0.59; P<0.001); the P value crossed the prespecified stopping boundary (P = 0.0126). The percentage of patients with a complete response or better was higher in the D-VRd group than in the VRd group (87.9% vs. 70.1%, P<0.001), as was the percentage of patients with MRD-negative status (75.2% vs. 47.5%, P<0.001). Death occurred in 34 patients in the D-VRd group and 44 patients in the VRd group. Grade 3 or 4 adverse events occurred in most patients in both groups; the most common were neutropenia (62.1% with D-VRd and 51.0% with VRd) and thrombocytopenia (29.1% and 17.3%, respectively). Serious adverse events occurred in 57.0% of the patients in the D-VRd group and 49.3% of those in the VRd group. CONCLUSIONS: The addition of subcutaneous daratumumab to VRd induction and consolidation therapy and to lenalidomide maintenance therapy conferred a significant benefit with respect to progression-free survival among transplantation-eligible patients with newly diagnosed multiple myeloma. (Funded by the European Myeloma Network in collaboration with Janssen Research and Development; PERSEUS ClinicalTrials.gov number, NCT03710603; EudraCT number, 2018-002992-16.).
- MeSH
- bortezomib aplikace a dávkování škodlivé účinky MeSH
- dexamethason aplikace a dávkování škodlivé účinky MeSH
- lenalidomid aplikace a dávkování škodlivé účinky MeSH
- lidé MeSH
- mnohočetný myelom * farmakoterapie MeSH
- monoklonální protilátky aplikace a dávkování škodlivé účinky MeSH
- progrese nemoci MeSH
- protokoly antitumorózní kombinované chemoterapie * škodlivé účinky terapeutické užití MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- klinické zkoušky, fáze III MeSH
- randomizované kontrolované studie MeSH
Biofilm formation is an effective survival strategy of plant-associated microorganisms in hostile environments, so the application of biofilm-forming and exopolysaccharide (EPS)-producing beneficial microbes to plants has received more attention in recent years. This study examined the ability of biofilm and EPS production of Bacillus subtilis and Bacillus thuringiensis strains under different NaCl concentrations (0, 50, 100, 200, and 400 mmol/L), pH values (5.5, 6.5, 7.5, and 8.5), and phosphate levels (0, 25, 50, and 100 mmol/L at 0 and 400 mmol/L NaCl). B. subtilis BS2 and B. thuringiensis BS6/BS7 strains significantly increased biofilm formation in a similar pattern to EPS production under salt stress. B. subtilis BS2/BS3 enhanced biofilm production at slightly acidic pH with a lower EPS production but the other strains formed considerably more amount of biofilm and EPS at alkaline pH. Interestingly, higher levels of phosphate substantially decreased biofilm and EPS production at 0 mmol/L NaCl but increased biofilm formation at 400 mmol/L salt concentration. Overall, contrary to phosphate, salt and pH differently influenced biofilm and EPS production by Bacillus strains. EPS production contributed to biofilm formation to some extent under all the conditions tested. Some Bacillus strains produced more abundant biofilm under salt and pH stress, indicating their potential to form in vivo biofilms in rhizosphere and on plants, particularly under unfavorable conditions.
- MeSH
- Bacillus subtilis fyziologie metabolismus účinky léků MeSH
- Bacillus thuringiensis fyziologie účinky léků MeSH
- bakteriální polysacharidy * metabolismus biosyntéza MeSH
- biofilmy * účinky léků růst a vývoj MeSH
- chlorid sodný * farmakologie metabolismus MeSH
- fosfáty * metabolismus farmakologie MeSH
- koncentrace vodíkových iontů MeSH
- Publikační typ
- časopisecké články MeSH
The relative inhibitory activities of diazabicyclooctanes (avibactam, relebactam, zidebactam, nacubactam, durlobactam), boronic acid derivatives (vaborbactam, taniborbactam, xeruborbactam), and penicillin-based sulfone derivative enmetazobactam were evaluated against several intrinsic and acquired class C β-lactamases. By contrast to vaborbactam and enmetazobactam, taniborbactam, xeruborbactam, and all diazabicyclooctanes demonstrated effective activities against most AmpC enzymes. Notably, durlobactam exhibited the most pronounced inhibitory effect. Interstingly, the chromosomal AmpC of Acinetobacter baumannii was the least sensitive enzyme to the newly developed β-lactamase inhibitors.
- MeSH
- Acinetobacter baumannii * účinky léků enzymologie MeSH
- antibakteriální látky * farmakologie chemie MeSH
- azabicyklické sloučeniny * farmakologie chemie MeSH
- bakteriální proteiny * antagonisté a inhibitory metabolismus MeSH
- beta-laktamasy * metabolismus MeSH
- bicyklické sloučeniny heterocyklické farmakologie chemie MeSH
- cyklooktany MeSH
- inhibitory beta-laktamasy * farmakologie chemie MeSH
- kyseliny boronové * farmakologie chemie MeSH
- laktamy MeSH
- mikrobiální testy citlivosti * MeSH
- peniciliny farmakologie chemie MeSH
- piperidiny MeSH
- sulfony farmakologie chemie MeSH
- Publikační typ
- časopisecké články MeSH
Autoři v článku prezentují epidemiologii, rizikové faktory přispívající ke vzniku urolitiáz, věnují se dále laboratornímu vyšetření u litiatiků, včetně problematiky analýzy složení konkrementů a jeho významu. Hlavním cílem článku je předložení metod neinvazivní léčby jednotlivých typů litiázy, především metafylaxe u pacientů s litiázou, a to jak režimových opatřeních, tak i užití farmak, které přispívají ke snížení četností recidiv litiázy, ale i komplikacím, které jsou s tímto onemocněním spojené.
The authors present the epidemiology, risk factors contributing to the development of urolithiasis, laboratory examination in lithiatic patients, including the analysis of the composition of concrements and its significance. The main goal of the article is to present the methods of non-invasive treatment of different types of lithiasis, especially metaphylaxis in patients with lithiasis, both regimen measures and the use of drugs that contribute to reducing the frequency of recurrences of lithiasis, as well as complications associated with this disease
- MeSH
- alopurinol farmakologie terapeutické užití MeSH
- analýza moči metody MeSH
- cystinurie farmakoterapie komplikace MeSH
- difrakce rentgenového záření metody MeSH
- diuretika farmakologie terapeutické užití MeSH
- hydroxyapatit terapeutické užití MeSH
- hyperkalciurie farmakoterapie komplikace MeSH
- hyperoxalurie farmakoterapie komplikace MeSH
- hyperurikemie farmakoterapie komplikace MeSH
- infekce močového ústrojí etiologie komplikace MeSH
- kaliumcitrát farmakologie terapeutické užití MeSH
- kaménky etiologie klasifikace terapie MeSH
- klinické laboratorní techniky metody MeSH
- lidé MeSH
- oxaláty škodlivé účinky MeSH
- rizikové faktory MeSH
- urolitiáza * diagnóza farmakoterapie prevence a kontrola MeSH
- vápník dietní terapeutické užití MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
Obor medicinální chemie se často potýká s problémem suboptimálních vlastností aktivních látek. Za účelem zlepšení těchto vlastností byla vyvinuta řada důmyslných přístupů tvorby proléčiv. Proléčivo je inaktivovaná forma léčiva, která dočasně modifikuje jeho vlastnosti. V těle je pak proléčivo (nejčastěji enzymaticky) transformováno zpět na aktivní léčivo. Proléčiva mohou upravit řadu vlastností jako např. absorpci, rozpustnost, či cílené doručení do tkáně. Poměr proléčiv mezi schválenými léky v posledních letech stoupá, což podtrhuje význam této strategie pro medicinální chemii i klinické využití.
The field of medicinal chemistry is often struggling with suboptimal properties of active compounds. To address this issue, many sophisticated prodrug approaches have been developed. Prodrug is an inactive form of a drug which temporarily alters its properties. In the body, the prodrug is (most often enzymatically) transformed back to the parent active drug. Prodrugs can modify variety of properties such as absorption, solubility, or tissue targeted delivery. The number of prodrugs among approved drugs has been rising in the past years which underlines the importance of prodrugs for medicinal chemistry and clinical use.
Changes in the protonation state of lyophilized proteins can impact structural integrity, chemical stability, and propensity to aggregate upon reconstitution. When a buffer is chosen, the freezing/drying process may result in dramatic changes in the protonation state of the protein due to ionization shift of the buffer. In order to determine whether protonation shifts are occurring, ionizable probes can be added to the formulation. Optical probes (dyes) have shown dramatic ionization changes in lyophilized products, but it is unclear whether the pH indicator is uniform throughout the matrix and whether the change in the pH indicator actually mirrors drug ionization changes. In solid-state NMR (SSNMR) spectroscopy, the chemical shift of the carbonyl carbon in carboxylic acids is very sensitive to the ionization state of the acid. Therefore, SSNMR can be used to measure ionization changes in a lyophilized matrix by employing a small quantity of an isotopically-labeled carboxylic acid species in the formulation. This paper compares the apparent pH of six trehalose-containing lyophilized buffer systems using SSNMR and UV-Vis diffuse reflectance spectroscopy (UVDRS). Both SSNMR and UVDRS results using two different ionization probes (butyric acid and bromocresol purple, respectively) showed little change in apparent acidity compared to the pre-lyophilized solution in a sodium citrate buffer, but a greater change was observed in potassium phosphate, sodium phosphate, and histidine buffers. While the trends between the two methods were similar, there were differences in the numerical values of equivalent pH (pHeq) observed between the two methods. The potential causes contributing to the differences are discussed.
- MeSH
- fosfáty * chemie MeSH
- histidin * chemie MeSH
- koncentrace vodíkových iontů MeSH
- kyselina citronová chemie MeSH
- lyofilizace * metody MeSH
- magnetická rezonanční spektroskopie * metody MeSH
- pufry MeSH
- spektrofotometrie ultrafialová metody MeSH
- trehalosa * chemie MeSH
- Publikační typ
- časopisecké články MeSH
WHAT IS THIS SUMMARY ABOUT?: This summary describes the first analysis of the PERSEUS study, which looked at adults with multiple myeloma that had never been treated before, also called newly diagnosed multiple myeloma. Multiple myeloma is a type of cancer in the blood, specifically in plasma cells within the soft, spongy tissue in the center of most bones, called the bone marrow. Researchers wanted to see if adding daratumumab (D) to a standard treatment of three other medicines called VRd, which stands for bortezomib (V), lenalidomide (R), and dexamethasone (d), could stop the multiple myeloma from getting worse and help participants live longer without multiple myeloma.Half of the participants were assigned to the treatment plan with daratumumab; they received D-VRd during initial treatment phases (induction and consolidation), followed by daratumumab as well as lenalidomide (D-R) in the maintenance phase. The other half of participants received treatment without daratumumab; they received VRd induction and consolidation followed by lenalidomide alone (R) maintenance. In addition, all participants were able to receive an autologous stem cell transplant, a procedure used to further help reduce multiple myeloma. WHAT WERE THE RESULTS?: At the time of this analysis of PERSEUS, about 4 years after participants started the study, participants who received D-VRd treatment followed by D-R maintenance had a better response to treatment (as measured by specific markers of multiple myeloma) and were more likely to be alive and free from their multiple myeloma getting worse in comparison to participants who received VRd followed by R maintenance. Side effects (unwanted or undesirable effects of treatment) in both treatment groups were in line with the known side effects of daratumumab and VRd. WHAT DO THE RESULTS MEAN?: The results of the PERSEUS study showed that including daratumumab in D-VRd induction/consolidation and D-R maintenance was better for treating multiple myeloma than the current standard VRd treatment followed by R maintenance alone in adults with a new diagnosis of multiple myeloma who were also able to receive an autologous stem cell transplant. Of importance, there were no unexpected side effects in either group.Clinical Trial Registration: NCT02874742 (GRIFFIN) (ClinicalTrials.gov).
- MeSH
- bortezomib * aplikace a dávkování terapeutické užití MeSH
- dexamethason * aplikace a dávkování terapeutické užití MeSH
- dospělí MeSH
- klinické zkoušky, fáze II jako téma MeSH
- lenalidomid * aplikace a dávkování terapeutické užití MeSH
- lidé středního věku MeSH
- lidé MeSH
- mnohočetný myelom * farmakoterapie diagnóza MeSH
- monoklonální protilátky * aplikace a dávkování terapeutické užití MeSH
- protokoly antitumorózní kombinované chemoterapie * terapeutické užití škodlivé účinky MeSH
- randomizované kontrolované studie jako téma MeSH
- senioři MeSH
- výsledek terapie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- informační letáky pro pacienty MeSH
Hydrogen sulfide (H2S) is an endogenously produced signaling molecule that belongs to the group of gasotransmitters along with nitric oxide (NO) and carbon monoxide (CO). H2S plays a pivotal role in male reproductive processes. It is produced in various tissues and cells of the male reproductive system, including testicular tissue, Leydig and Sertoli cells, epididymis, seminal plasma, prostate, penile tissues, and sperm cells. This review aims to summarize the knowledge about the presence and effects of H2S in male reproductive tissues and outline possible therapeutic strategies in pathological conditions related to male fertility, e. g. spermatogenetic disorders and erectile dysfunction (ED). For instance, H2S supports spermatogenesis by maintaining the integrity of the blood-testicular barrier (BTB), stimulating testosterone production, and providing cytoprotective effects. In spermatozoa, H2S modulates sperm motility, promotes sperm maturation, capacitation, and acrosome reaction, and has significant cytoprotective effects. Given its vasorelaxant effects, it supports the erection of penile tissue. These findings suggest the importance and therapeutic potential of H2S in male reproduction, paving the way for further research and potential clinical applications.
- MeSH
- erektilní dysfunkce farmakoterapie metabolismus MeSH
- lidé MeSH
- mužská infertilita metabolismus farmakoterapie MeSH
- mužské pohlavní orgány metabolismus účinky léků MeSH
- rozmnožování * účinky léků fyziologie MeSH
- spermatogeneze * účinky léků MeSH
- spermie účinky léků metabolismus MeSH
- sulfan * metabolismus farmakologie MeSH
- testis metabolismus účinky léků MeSH
- zvířata MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
Laccase-producing fungus (MY3) was successfully isolated from soil samples collected from Mansoura Governorate, Egypt. This fungal isolate has shown a high laccase production level over other isolated fungi. The identity of this isolate was determined by the molecular technique 18SrRNA as Curvularia lunata MY3. The enzyme purification was performed using ammonium sulfate precipitation followed by Sephacryl S-200 and DEAE-Sepharose column chromatography. The denatured enzyme using SDS-PAGE had a molar mass of 65 kDa. The purified laccase had an optimum temperature at 40 °C for enzyme activity with 57.3 kJ/mol activation energy for 2,2'-azino-bis-3-ethylbenzothiazoline-6-sulfonic acid (ABTS) oxidation. The enzyme had an optimum pH of 5.0, and it has shown a high stability at the acidic range (4.5 to 5.5). Mn2+ and Mg2+ ions enhanced the enzyme activity, while most of the enzyme activity was inhibited by Hg2+. Some compounds such as 2-mercaptoethanol, L-cysteine, and sodium azide at a concentration of 10 mmol/L had shown a high suppression effect on the enzyme activity. The enzyme strongly oxidized ABTS and syringaldazine and moderately oxidized DMP and guaiacol. The antimicrobial activity of the purified enzyme towards three pathogenic strains (Escherichia coli ATCC-25922, Staphylococcus aureus NRRLB-767, and Candida albicans ATCC-10231) was evaluated for the potential use as an antimicrobial therapeutic enzyme.
