The design of a novel series of muscarinic receptor antagonists leading to AZD8683, a potential inhaled treatment for COPD

A novel series of muscarinic receptor antagonists was developed, with the aim of identifying a compound with high M₃ receptor potency and a reduced risk of dose-limiting side effects with potential for the treatment of COPD.Initial compound modifications led to a novel cycloheptyl series, which was improved by focusing on a quinuclidine sub-series. A wide range of N-substituents was evaluated to determine the optimal substituent providing a high M₃ receptor potency, high intrinsic clearance and high human plasma protein binding. Compounds achieving in vitro study criteria were selected for in vivo evaluation. Pharmacokinetic half-lives, inhibition of bronchoconstriction and duration of action, as well as systemic side effects, induced by the compounds were assessed in guinea-pig models.Compounds with a long duration of action and good therapeutic index were identified and AZD8683 was selected for progression to the clinic.     

Discovery of triazines as potent,selective and orally active PDE4 inhibitors

Expanding on HTS hit 4 afforded a series of [1,3,5]triazine derivatives as novel PDE4 inhibitors. The SAR development and optimization process with the emphasis on ligand efficiency and physicochemical properties led to the discovery of compound 44 as a potent, selective and orally active PDE4 inhibitor.     

脉冲震荡肺功能在稳定期COPD治疗中的应用价值

目的:探讨脉冲震荡肺功能(Impulse oscillometry,IOS)在稳定期COPD患者中应用价值及其和常规肺功能检测指标的相关性。方法:62例重度稳定期COPD患者,同时选择健康对照组人群40例纳入研究。经噻托溴铵联合沙美特罗替卡松治疗,将重度COPD患者缓解至中度。检测治疗前后常规肺功能指标(FEV1/FVC、FEV1)和IOS指标(ZRS、Fres、R5、X5、R20),分析常规肺功能指标和IOS各指标的相关性。结果:COPD患者FEV1和FEV1/FVC和对照组相比明显降低,差异有统计学意义(P0.05),观察组治疗后FEV1和FEV1/FVC明显改善,差异有统计学意义(P0.05)。观察组ZRS、Fres、R5、R20各项指标明显高于对照组,差异有统计学意义(P0.05);治疗后ZRS、Fres、R5明显改善,差异有统计学意义(P0.05)。FEV1、FEV1/FVC和ZRS、Fres、R5呈负相关性(P0.05),和X5呈正相关性(P0.05)。结论:脉冲震荡肺功能多项指标和传统肺功能指标有良好的相关性,是一种简便、低配合度、准确的的肺功能新的检测技术手段。     

慢性阻塞性肺病患者急性加重期外周血IL-8、TNF-alpha及IGF-I表达变化 的意义

目的：研究慢性阻塞性肺病（COPD）患者急性加重期外周血白细胞介素-8（IL-8）、肿瘤坏死因子-a（TNF-a）及胰岛素样生长 因子-I（IGF-I）表达变化的临床意义。方法：选取2013 年12 月-2014 年12月我院收治的COPD 急性加重患者100 例为观察组, 选取同期健康体检者100 例为对照组,检测观察组患者治疗前、治疗稳定后及对照组外周血IL-8、TNF-alpha及IGF-I水平。结果：观 察组患者治疗前外周血IL-8、TNF-alpha及IGF-I水平显著高于治疗稳定后,差异有统计学意义（P＜ 0.05）;观察组患者治疗稳定后外 周血IL-8、TNF-alpha及IGF-I水平显著高于对照组,差异有统计学意义（P＜0.05）。结论：COPD 急性加重期外周血IL-8、TNF-琢及 IGF-I水平显著增高,治疗稳定后其水平显著降低,IL-8、TNF-alpha及IGF-I水平对COPD 的诊断和治疗具有重要意义。     

The Cu/Zn superoxide dismutase +35A/C (rs2234694) variant correlates with altered levels of protein carbonyls and glutathione and associates with severity of COPD in a Tunisian population

Chronic obstructive pulmonary disease (COPD) is a major cause of mortality that has been associated with inflammation and oxidative stress. The purpose of the present case–control study was to determine the relationships between oxidative stress-related genetic variants and the risk and severity of COPD, as well as, the influence of these variants on inflammatory and oxidative stress parameters. Genotyping of superoxide dismutase 1 (SOD1) + 35 A/C (rs2234694), catalase [A-21T (rs7943316), C-262T (rs1001179)] and glutathione peroxidase 1 (reduced glutathione (GSH)-Px1) 198Pro/Leu (rs1050450) was carried out in 143 patients with COPD and 216 healthy controls using PCR-RFLP. Serum levels of IL-6 and TNF-α were determined by enzyme-linked immunosorbent assays (ELISA), while the levels of reduced GSH, total antioxidant status (TAS), H₂O₂, lipid peroxides (TBARS) and protein carbonyls (PCs) were determined using spectrophotometric methods. We also evaluated the activities of GSH-Px, catalase, and superoxide dismutase (SOD) in both plasma and erythrocytes. We did not observe significant differences in the genotype and allele frequencies of chosen variants between COPD patients and healthy controls. A significant correlation was retrieved between the SOD1?+?35A/C variant and disease severity (odds ratios (OR) = 0.15, p?=?0.04). In addition, patients having the +35AC genotype presented increased plasma levels of GSH and a reduced level of PCs (p?=?0.03, p?=?0.04, respectively). The present data highlighted the important role of antioxidant enzymes and their genetic variants in the oxidative stress-mediated pathogenesis and progression of COPD.     

沙美特罗/氟替卡松吸入治疗对COPD患者临床疗效及 口咽部菌群和免疫功能的影响

目的研究沙美特罗/氟替卡松吸入治疗对慢性阻塞性肺病(COPD)患者临床疗效及口咽部菌群和免疫功能的影响。方法选取我院2015年1月至2017年12月确诊的COPD II-III级患者92例。按照随机数字表将研究对象随机分为研究组和对照组,每组46例。所有研究对象给予持续低通量吸氧、抗感染、祛痰止咳、解痉平喘等对症支持治疗,并服用盐酸氨溴索治疗。研究组在常规治疗基础上加用沙美特罗/氟替卡松干粉剂。观察患者临床疗效,记录患者肺功能指标并测定CD_4~+细胞、CD_8~+细胞、CD_4~+/CD_8~+、IgA、IgM和IgG水平。采集患者的咽拭子进行培养,计算菌落比例并鉴定种属。结果治疗后,研究组总有效率为93.48%,明显高于对照组的80.43%,差异有统计学意义(P0.05)。肺功能指标显示治疗后两组患者肺功能均有所上升,研究组肺功能指标水平上升幅度大于对照组(P0.05)。治疗后研究组患者CD_4~+细胞和CD_4~+/CD_8~+水平高于对照组,而CD_8~+细胞水平低于照组,差异均有统计学意义(P0.05)。两组患者治疗前后免疫球蛋白水平差异无统计学意义(P0.05)。治疗后研究组患者发现9种细菌,对照组发现6种,各菌株的构成比具有一定差异。结论沙美特罗/氟替卡松对COPD患者临床疗效显著,能有效提升肺功能,改善患者免疫功能,对口咽部菌群的影响较小,提示该吸入治疗方法值得临床应用推广。     

慢阻肺患者运动负荷气道反应性与T细胞亚群的关系

摘要 目的：探讨与分析慢性阻塞性肺疾病（COPD）患者运动负荷气道反应性与T细胞亚群的关系。方法：2020年1月到2022年4月选择在本院诊治的慢阻肺患者88例作为慢阻肺组,同期选择在本院进行健康体检者88例作为健康组,检测两组T细胞亚群含量,判定两组的运动负荷气道反应性情况并进行相关性分析。结果：慢阻肺组的CD8⁺T淋巴细胞比例明显高于健康组,CD3⁺T淋巴细胞、CD4⁺T淋巴细胞比例明显低于健康组（P<0.05）。慢阻肺组的运动负荷气道反应性发生率为20.9 %,明显高于健康组的1.2 %（P<0.05）。在慢阻肺中,Spearsman分析显示运动负荷气道反应性发生率与CD3+T淋巴细胞、CD4⁺T淋巴细胞、CD8⁺T淋巴细胞比例存在相关性（P<0.05）。logistic回归分析显示CD3⁺T淋巴细胞、CD4⁺T淋巴细胞、CD8⁺T淋巴细胞比例都为影响运动负荷气道反应性发生的重要危险因素（P<0.05）。结论：慢阻肺患者多伴随有T细胞亚群异常,也多伴随有运动负荷气道反应性,运动负荷气道反应性与T细胞亚群存在相关性,也表明T细胞亚群紊乱是导致运动负荷气道反应性发生的重要因素。     

Pravastatin sodium attenuated TREM-1-mediated inflammation in human peripheral blood mononuclear cells

Pravastatin sodium on triggering receptor expressed on myeloid cell-1 (TREM-1)-mediated inflammation in human peripheral blood mononuclear cells (PBMCs) has been poorly investigated. In this study, we isolated PBMCs from the peripheral blood samples of patients with chronic obstructive pulmonary disease, treated the cells with pravastatin sodium, and determined a concentration at which more than 90% cells could survive. Then we treated cells with 10?ng/ml of lipopolysaccharide, added with 10, 50, 100?μM of pravastatin sodium combined with or without LR-12, a known TREM-1 inhibitor. The expression of TREM-1 was determined by quantitative RT-PCR. The levels of TREM-1, IL-6, and TNF-α in cell culture supernatant were measured with ELISA. Simultaneously, NF-κB signaling pathway-related protein p-p65 and p-IκBα were detected by Western blot assay. Results demonstrated that pravastatin sodium significantly mitigated lipopolysaccharide-stimulated TREM-1 over-expression at mRNA and protein levels dose-dependently. Elevated IL-6 and TNF-α levels changed synchronously. LR-12 inhibited the TREM-1 over-expression and inflammatory factor production but did not show extra synergistic effect to pravastatin. Lipopolysaccharide induced phospho-p65 and -IκBα over-expression was weakened significantly when cells were treated with pravastatin sodium. In conclusion, pravastatin could inhibit TREM-1-medieted inflammation and NF-κB signaling pathway was involved.     

Potential roles and targeted therapy of the CXCLs/CXCR2 axis in cancer and inflammatory diseases

The chemokine receptor CXCR2 and its ligands are implicated in the progression of tumours and various inflammatory diseases. Activation of the CXCLs/CXCR2 axis activates multiple signalling pathways, including the PI3K, p38/ERK, and JAK pathways, and regulates cell survival and migration. The CXCLs/CXCR2 axis plays a vital role in the tumour microenvironment and in recruiting neutrophils to inflammatory sites. Extensive infiltration of neutrophils during chronic inflammation is one of the most important pathogenic factors in various inflammatory diseases. Chronic inflammation is considered to be closely correlated with initiation of cancer. In addition, immunosuppressive effects of myeloid-derived suppressor cells (MDSCs) against T cells attenuate the anti-tumour effects of T cells and promote tumour invasion and metastasis. Over the last several decades, many therapeutic strategies targeting CXCR2 have shown promising results and entered clinical trials. In this review, we focus on the features and functions of the CXCLs/CXCR2 axis and highlight its role in cancer and inflammatory diseases. We also discuss its potential use in targeted therapies.     

ACOS与同期哮喘和COPD患者住院情况调查分析

目的:分析ACOS与同期哮喘和COPD患者住院情况。方法:采取回顾性方法,收集6年内住院ACOS与同期哮喘和COPD患者年龄、性别、所患疾病种类和住院费用等临床资料,分别进行统计和分类汇总。结果:2009-2014年共有1327哮喘患者住院治疗,其中合并COPD有128人,即ACOS占哮喘患者的9.6%。同期收治的慢性支气管炎1989人、肺气肿1634人,但行肺功能检查确诊COPD的仅367人,其中合并哮喘同样为128人,即ACOS占COPD患者的34.9%。性别方面,ACOS组男性最多,仅与哮喘组比较,P0.05;年龄,ACOS介于哮喘和COPD之间;入住ICU、机械通气治疗,ACOS组最少,仅与COPD组比较,P0.05;人均花费最低,与哮喘和COPD组比较,P0.05;死亡情况ACOS组仅有1人死亡,死亡率3组中最低,但P0.05;共存病情况ACOS在合并II型呼吸衰竭和过敏性鼻炎方面,与哮喘相似;在合并肺炎和支气管扩张方面与COPD相似;在合并I型呼吸衰竭、冠心病、糖尿病和肝、肾功能异常方面,三组比较,组间差异无显著统计学意义,P0.05;只有合并高血压,ACOS组明显低于哮喘和COPD组,而且组间差异有显著统计学意义,P0.05。结论:与哮喘和COPD相比,ACOS有其独特的特点。