• Title/Summary/Keyword: e-Clinical Trials

Search Result 164, Processing Time 0.023 seconds

Commensal Microbiota and Cancer Immunotherapy: Harnessing Commensal Bacteria for Cancer Therapy

  • Jihong Bae; Kwangcheon Park;You-Me Kim
    • IMMUNE NETWORK
    • /
    • v.22 no.1
    • /
    • pp.3.1-3.21
    • /
    • 2022
  • Cancer is one of the leading causes of death worldwide and the number of cancer patients is expected to continuously increase in the future. Traditional cancer therapies focus on inhibiting cancer growth while largely ignoring the contribution of the immune system in eliminating cancer cells. Recently, better understanding of immunological mechanisms pertaining to cancer progress has led to development of several immunotherapies, which revolutionized cancer treatment. Nonetheless, only a small proportion of cancer patients respond to immunotherapy and maintain a durable response. Among multiple factors contributing to the variability of immunotherapy response rates, commensal microbiota inhabiting patients have been identified as one of the most critical factors determining the success of immunotherapy. The functional diversity of microbiota differentially affects the host immune system and controls the efficacy of immunotherapy in individual cancer patients. Moreover, clinical studies have demonstrated that changing the gut microbiota composition by fecal microbiota transplantation in patients who failed a previous immunotherapy converts them to responders of the same therapy. Consequently, both academic and industrial researchers are putting extensive efforts to identify and develop specific bacteria or bacteria mixtures for cancer immunotherapy. In this review, we will summarize the immunological roles of commensal microbiota in cancer treatment and give specific examples of bacteria that show anticancer effect when administered as a monotherapy or as an adjuvant agent for immunotherapy. We will also list ongoing clinical trials testing the anticancer effect of commensal bacteria.

Adverse Events in Total Artificial Heart for End-Stage Heart Failure: Insight From the Food and Drug Administration Manufacturer and User Facility Device Experience (MAUDE)

  • Min Choon Tan;Yong Hao Yeo;Jia Wei Tham;Jian Liang Tan;Hee Kong Fong;Bryan E-Xin Tan;Kwan S Lee;Justin Z Lee
    • International Journal of Heart Failure
    • /
    • v.6 no.2
    • /
    • pp.76-81
    • /
    • 2024
  • Background and Objectives: Real-world clinical data, outside of clinical trials and expert centers, on adverse events related to the use of SyncCardia total artificial heart (TAH) remain limited. We aim to analyze adverse events related to the use of SynCardia TAH reported to the Food and Drug Administration (FDA)'s Manufacturers and User Defined Experience (MAUDE) database. Methods: We reviewed the FDA's MAUDE database for any adverse events involving the use of SynCardia TAH from 1/01/2012 to 9/30/2020. All the events were independently reviewed by three physicians. Results: A total of 1,512 adverse events were identified in 453 "injury and death" reports in the MAUDE database. The most common adverse events reported were infection (20.2%) and device malfunction (20.1%). These were followed by bleeding events (16.5%), respiratory failure (10.1%), cerebrovascular accident (CVA)/other neurological dysfunction (8.7%), renal dysfunction (7.5%), hepatic dysfunction (2.2%), thromboembolic events (1.8%), pericardial effusion (1.8%), and hemolysis (1%). Death was reported in 49.4% of all the reported cases (n=224/453). The most common cause of death was multiorgan failure (n=73, 32.6%), followed by CVA/other non-specific neurological dysfunction (n=44, 19.7%), sepsis (n=24, 10.7%), withdrawal of support (n=20, 8.9%), device malfunction (n=11, 4.9%), bleeding (n=7, 3.1%), respiratory failure (n=7, 3.1%), gastrointestinal disorder (n=6, 2.7%), and cardiomyopathy (n=3, 1.3%). Conclusions: Infection was the most common adverse event following the implantation of TAH. Most of the deaths reported were due to multiorgan failure. Early recognition and management of any possible adverse events after the TAH implantation are essential to improve the procedural outcome and patient survival.

Safety and efficacy comparison of embolic agents for middle meningeal artery embolization for chronic subdural hematoma

  • Nathaniel R. Ellens;Derrek Schartz;Gurkirat Kohli;Redi Rahmani;Sajal Medha K. Akkipeddi;Thomas K. Mattingly;Tarun Bhalla;Matthew T. Bender
    • Journal of Cerebrovascular and Endovascular Neurosurgery
    • /
    • v.26 no.1
    • /
    • pp.11-22
    • /
    • 2024
  • Objective: To perform a systematic review and meta-analysis evaluating the efficacy of middle meningeal artery embolization in terms of both clinical and radiographic outcomes, when performed with different embolic agents. Methods: A systematic literature review and meta-analysis was performed to evaluate the impact of embolic agents on outcomes for middle meningeal artery (MMA) embolization. The use of polyvinyl alcohol (PVA) with or without (±) coils, N-butyl cyanoacrylate (n-BCA) ± coils, and Onyx alone were separately evaluated. Primary outcome measures were recurrence, the need for surgical rescue and in-hospital periprocedural complications. Results: Thirty-one studies were identified with a total of 1,134 patients, with 786 receiving PVA, 167 receiving n-BCA, and 181 patients receiving Onyx. There was no difference in the recurrence rate (5.5% for PVA, 4.5% for n-BCA, and 6.5% for Onyx, with P=0.71) or need for surgical rescue (5.0% for PVA, 4.0% for n-BCA, and 6.9% for Onyx, with P=0.89) based on the embolic agent. Procedural complications also did not differ between embolic agents (1.8% for PVA, 3.6% for n-BCA, and 1.6% for Onyx, with P=0.48). Conclusions: Rates of recurrence, need for surgical rescue, and periprocedural complication following MMA embolization are not impacted by the type of embolic agent utilized. Ongoing clinical trials may be used to further investigate these findings.

DNA Structural Perturbation Induced by the CPI-Derived DNA Interstrand Cross-linker : Molecular Mechanisms for the Sequence Specific Recognition

  • Park, Hyun-Ju
    • Archives of Pharmacal Research
    • /
    • v.24 no.5
    • /
    • pp.455-465
    • /
    • 2001
  • The highly potent cytotoxic DNA-DNA cross-linker consists of two cyclopropa[c]pyrrolo[3,4-3]indol-4(5H)-ones insoles [(+)-CPI-I] joined by a bisamido pyrrole (abbreviated to "Pyrrole"). The Pyrrole is a synthetic analog of Bizelesin, which is currently in phase II clinical trials due to its excellent in vivo antitumor activity. The Pyrrole has 10 times more potent cytotoxicity than Bizelesin and mostly form DNA-DNA interstrand cross-links through the N3 of adenines spaced 7 bp apart. The Pyrrole requires a centrally positioned GC base pair for high cross-linking reactivity (i.e., $5^1$-T$AT_2$A*-$3^1$), while Bizelesin prefers purely AT-rich sequences (i.e., $5^1$-T$AT_4$A*-$3^1$, where /(equation omitted) represents the cross-strand adenine alkylation and A* represents an adenine alkylation) (Park et al., 1996). In this study, the high-field $^1$H-NMR and rMD studies are conducted on the 1 1-mer DNA duplex adduct of the Pyrrole where the 5′(equation omitted)TAGTTA*-3′sequence is cross-linked by the drug. A severe structural perturbation is observed in the intervening sequences of cross-linking site, while a normal B-DNA structure is maintained in the region next to the drug-modified adenines. Based upon these observations, we propose that the interplay between the bisamido pyrrole unit of the drug and central C/C base pair (hydrogen-bonding interactions) is involved in the process of cross-linking reaction, and sequence specificity is the outcome of those interactions. This study suggests a mechanism for the sequence specific cross-linking reaction of the Pyrrole, and provides a further insight to develop new DNA sequence selective and distortive cross-linking agents.

  • PDF

Eleocharis kuroguwai Ohwi Ameliorates LPS-mediated Inflammation by Suppressing MAPKs Signaling (LPS로 유도된 염증 상태 내에서 MAPKs 세포신호 전달체계를 저해하는 올방개의 항염증 효과)

  • Kim, Kang-Hoon;Bae, Eun Young;Lim, Hyun Goo;Kim, Mi Heui;Oh, Tae-Seok;Lee, Seung Woong
    • Journal of Life Science
    • /
    • v.30 no.5
    • /
    • pp.476-482
    • /
    • 2020
  • In rice agriculture, Eleocharis kuroguwai Ohwi (olbanggae) is a target for herbicidal intervention as a problem weed although it has also long been used clinically as a traditional medicine for jaundice, fever, and blood flow. E. kuroguwai has been evaluated in many clinical trials, but its molecular biological advantages are still unknown. Here, we investigate the anti-inflammatory effects of E. kuroguwai 80% ethanol extracts by screening NO production in LPS-induced macrophage activation. To find the most effective fractions, we partitioned five sub-fractions using HP20 column chromatography, namely 20%, 40%, 60%, 80%, and 100%. Of these, the 60% and 80% sub-fractions were found to significantly inhibit NO production; there were no toxicological effects at any concentration. In addition, the 80% sub-fraction inhibited significantly the iNOS and the mRNA of the pro-inflammatory mediators IL-6, TNF-α, and IL-1β by inhibiting the phosphorylation of JNK and ERK pathways associated with MAPKs signaling. Our results suggest that the 80% E. kuroguwai sub-fraction has the most significant anti-inflammatory effects of inhibiting iNOS and pro-inflammatory mediators and suppressing the phosphorylation of JNK and ERK. Therefore, the 80% sub-fraction of E. kuroguwai extract may be a therapeutic candidate for inflammatory diseases associated with the overexpression of MAPKs.

The Transport of a Hepatoprotective Agent, Isopropryl 2-(1-3-dithiethane-2-ylidene)-2[N-(4-methyl-thiautole-2-yl) carbamoyl] Acetate (YH439), across Caco-2 Cell Monolayers

  • Park, Hyeon-Woo;Chung, Suk-Jae;Lee, Myung-Gull;Shim, Chang-Koo
    • Archives of Pharmacal Research
    • /
    • v.24 no.6
    • /
    • pp.584-589
    • /
    • 2001
  • Isopropryl 2-(1-3-dithiethane-2-ylidene)-2 [N-(4-methyl-thiazole-2-yl) carbamoyl] acetate (YH439) is currently under phase ll clinical trials by the Yuhan Research Center for use as a hepatoprotective agent. Unfortunately, the oral bioavailbility of YH439, which is sparingly soluble in water (i.e., $0.3{\;}\mu\textrm{g}/ml{\;}or{\;}0.91{$\mu}M$ at room temperature), reportedly, is negligibleregardless of the dose administered to rats in the 10-300 mg/kg range. The bioavailability of the compound increased up to 24%, when administered in the form of a micellar solution ($700{\;}\mu\textrm{g}/ml$or 2.1 mM for YH439) at a dose of 10 mg/kg, suggesting that its limited solubility is associated with its negligible bioavailability. In order to obtain additional informmation concerning the bioavailability of YH439, the mechanism(s) involved in gastrointestinal (Gl) absorption were investigated in the present study. For this purpose, the transport of YH430 across a Caco-2 cell monolayer was measured in a $Transwell^{\circledR}$. A permeability of $4.07{\times}10^{-5}{\;}cm/s$ was obtained for the absorptive (i.e., apical to basolateral direction) transport of $0.42{\mu}M$ YH439, implicating that the in vivo Cl absorption is nearly complete. The absorptive transport exhibited a slight concentration-dependency with an intrinsic clearance ($CL_{i}$) of $0.38{\mu}L/{\textrm{cm}^2}/sec$, which accounted for 28.1% of the total intrinsic clearance (i.e., $CL_i$ plus the intrinsic clearance for the linear component) of the transport. Thus, saturation of the absorption process appears to be a minor factor in limiting the bioavailability of the compound. The apparent permeability of YH439 from the basolateral to the apical direction (i.e., efflux, $6.67{\times}10^{-5}{\;}cm/s$) was comparable to that for absorptive transport, but, interestingly, a more distinct concentration-dependency was observed for this transport. However, the efflux does not appear to influence the bioavailability of the compound, as evidenced by the sufficiently high permeability in the absorption direction. Rather, a reportedly extensive first-pass hepatic metabolism appears to be a principal factor in limiting the bioavailability. In this respect, reducing the first-pass metabolism by some means would lead to a higher bioavailability of the compound. Thus, elevation of the absorption rate of YH439 becomes a necessity. From a practical point of view, increasing the concentration of YH439 in the Cl fluid appears to be a feasible way to increase the absorption rate, because the compound is primarily absorbed via a linear mechanism. In summary, the solubilization of YH439, as previously demonstrated for a micellar solution of the compound, appears to be a practical way to increase the oral bioavailability of YH439.

  • PDF

The Survey on the Standardization of Chuna Manual Technique for Operating RCT of Non-acute Low Back Pain (비급성 요통에 대한 무작위대조군 임상연구 수행을 위한 추나표준화 설문조사 보고)

  • Kim, Byung-Jun;Hwang, Eui-Hyoung;Heo, Kwang-Ho;Hwang, Man-Suk;Heo, In;Song, Yun-Kyung;Lee, Jung-Han;Ko, Youn-Seok;Park, Tae-Young;Cho, Jae-Heung;Lee, Eun-Jung;Mun, Su-Jeong;Ha, In-Hyuk;Lee, Min-Ho;Shin, Byung-Cheul
    • The Journal of Churna Manual Medicine for Spine and Nerves
    • /
    • v.10 no.2
    • /
    • pp.13-25
    • /
    • 2015
  • Objectives : To find out the standardized chuna manual technique for non-acute low back pain. Methods : The survey questions were developed by the consensus from the professor who major in Rehabillitation Medicine of Korean Medicine(RMKM). August 15th to september 1st 2015, the questionnaire was given to 23 RMKM doctors by e-mail. 20(90.9%) the questionnaire were retrieved out. Standardized technique of chuna were selected through experts consesus based on questionaire results. Results : Two essential techniques and two selective techniques were selected as standardized Chuna manual technique for lumbar region. Six essential technique and one selective technique were selected as standardized Chuna manual technique for iliac region. Conclusions : This is the first consensus of experts opinion for Chuna manual technique for operating randomized controlled trials(RCT). These reports are helpful for Korean Medicine doctor who operate Chuna manual technique and expected to make clinical evidence of Chuna manual medicine

Bioequivalence of Procezil Tablet 250 mg to $Cefzil^{(R)}$ Tablet 250 mg (Cefprozil 250 mg) (세프질$^{(R)}$ 정 250밀리그람 (세프프로질 250밀리그람)에 대한 프로세질 정 250밀리그람의 생물학적동등성)

  • Kim, Se-Mi;Kang, Min-Sun;Cho, Hea-Young;Lee, Yong-Bok
    • Korean Journal of Clinical Pharmacy
    • /
    • v.20 no.3
    • /
    • pp.255-261
    • /
    • 2010
  • Cefprozil is a broad-spectrum oral beta-lactam cephalosporin consisting of cis- and trans-isomeric mixture whose ratio is approximately 90:10. Cefprozil is used to treat certain infections caused by bacteria such as bronchitis and ear, skin, and throat infections. The purpose of the present study was to evaluate the bioequivalence of two cefprozil tablets, $Cefzil^{(R)}$ tablet 250 mg (BMS Pharmaceutical Korea., Ltd.) and Procezil tablet 250 mg (Hanmi Pharm. Co., Ltd.), according to the guidelines of the Korea Food and Drug Administration (KFDA). The in vitro release of cefprozil from the two cefprozil formulations were tested using KP VIII Apparatus I method with water dissolution media. Thirty five healthy male subjects, $24.00{\pm}1.53$ years in age and $69.77{\pm}9.99$ kg in body weight, were divided into two groups and a randomized $2{\times}2$ cross-over study was employed. After four tablets containing 1000 mg as cefprozil were orally administered, blood samples were taken at predetermined time intervals and the concentrations of cefprozil in serum were determined using HPLC/UV detector. The dissolution profiles of two formulations were similar in water tested dissolution media. The pharmacokinetic parameters such as $AUC_t$, $C_{max}$ and $T_{max}$ on the basis of total-cefprozil were calculated, and computer program (K-BE Test 2002) was utilized for the statistical analysis of the parameters using logarithmically transformed $AUC_t$, $C_{max}$ and untransformed $T_{max}$. The results showed that the differences between two formulations based on the reference drug, $Cefzil^{(R)}$ tablets, were -0.81%, -3.00% and -6.83% for $AUC_t$, $C_{max}$ and $T_{max}$, respectively. There were no sequence effects between two formulations in these parameters. The 90% confidence intervals using logarithmically transformed data were within the acceptance range of log 0.8 to log 1.25 (e.g., log 0.9515~log 1.0454 and log 0.9613~log 1.0465 for $AUC_t$ and $C_{max}$, respectively). Thus, the criteria of the KFDA bioequivalence guideline were satisfied, indicating Procezil tablet was bioequivalent to $Cefzil^{(R)}$ tablet.

Bioequivalence of Bambucol Tablet 10 mg to $Bambec^{(R)}$ Tablet 10 mg (Bambuterol Hydrochloride 10 mg) (밤벡$^{(R)}$ 정 10밀리그람(염산밤부테롤 10밀리그람)에 대한 밤부콜 정 10밀리그람의 생물학적동등성)

  • Cho, Hea-Young;Choi, Ji-Hoon;Yoo, Hee-Doo;Lee, Yong-Bok
    • Korean Journal of Clinical Pharmacy
    • /
    • v.20 no.3
    • /
    • pp.235-241
    • /
    • 2010
  • Bambuterol hydrochloride, dimethylcarbamic acid 5-[2-(1,1-dimethylethyl)amino-1-hydroxyethyl]-1,3-phenylene ester hydrochloride, is the prodrug of active ${\beta}_2$-adrenergic metabolite terbutaline. The purpose of the present study was to evaluate the bioequivalence of two bambuterol hydrochloride tablets, $Bambec^{(R)}$ tablet 10 mg (Yuhan Co., Ltd.) and Bambucol tablet 10 mg (Sam Chun Dang Pharm. Co., Ltd.), according to the guidelines of Korea Food and Drug Administration (KFDA). In vitro release of bambuterol from two bambuterol hydrochloride formulations was tested using KP VIII Apparatus II method with various dissolution media. Twenty eight healthy male Korean volunteers, $23.86{\pm}1.65$ years in age and $68.98{\pm}9.58$ kg in body weight, were divided into two groups and a randomized $2{\times}2$ cross-over study was employed. After two tablets containing 10 mg as bambuterol hydrochloride were orally administered, blood samples were taken at predetermined time intervals, and the concentrations of bambuterol in serum were determined using column switching HPLC with UV detector. The dissolution profiles of two formulations were similar in all tested dissolution media. The pharmacokinetic parameters such as $AUC_t$, $C_{max}$ and $T_{max}$ were calculated, and ANOVA test with K-BE Test 2002 was utilized for the statistical analysis of the parameters using logarithmically transformed $AUC_t$, $C_{max}$ and untransformed $T_{max}$. The results showed that the differences between two formulations based on the reference drug, $Bambec^{(R)}$, were -8.10%, -3.82% and 12.65% for $AUC_t$, $C_{max}$ and $T_{max}$, respectively. There were no sequence effects between two formulations in these parameters. The 90% confidence intervals using logarithmically transformed data were within the acceptance range of log 0.8 to log 1.25 (i.e., log 0.8093~log 1.0302 and log 0.8564~log 1.1280 for $AUC_t$ and $C_{max}$, respectively). Thus, the criteria of the KFDA bioequivalence guideline were satisfied, indicating Bambucol tablet 10 mg was bioequivalent to $Bambec^{(R)}$ tablet 10 mg.

The effect of preheating resin composites on surface hardness: a systematic review and meta-analysis

  • Elkaffas, Ali A.;Eltoukhy, Radwa I.;Elnegoly, Salwa A.;Mahmoud, Salah H.
    • Restorative Dentistry and Endodontics
    • /
    • v.44 no.4
    • /
    • pp.41.1-41.13
    • /
    • 2019
  • Objectives: This paper presents a systematic review and meta-analysis of the effect of preheating on the hardness of nanofilled, nanoceramic, nanohybrid, and microhybrid resin composites. Materials and Methods: An electronic search of papers on MEDLINE/PubMed, ScienceDirect, and EBSCOhost was performed. Only in vitro studies were included. Non-English studies, case reports, clinical trials, and review articles were excluded. A meta-analysis of the reviewed studies was conducted to quantify differences in the microhardness of the Z250 microhybrid resin composite using the Comprehensive Meta-Analysis software. Results: Only 13 studies met the inclusion criteria for this systematic review. The meta-analysis showed that there were significant differences between the non-preheated and preheated modes for both the top and bottom surfaces of the specimens (p < 0.05). The microhardness of the Z250 resin composite on the top surface in the preheated mode (78.1 ± 2.9) was higher than in the non-preheated mode (67.4 ± 4.0; p < 0.001). Moreover, the microhardness of the Z250 resin composite on the bottom surface in the preheated mode (71.8 ± 3.8) was higher than in the non-preheated mode (57.5 ± 5.7, p < 0.001). Conclusions: Although the results reported in the reviewed studies showed great variability, sufficient scientific evidence was found to support the hypothesis that preheating can improve the hardness of resin composites.