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  • Chun-qing WANG, Zhi-jie CHEN, Ying-li ZHANG
    Chinese Journal of Clinical Pharmacology. 2025, 41(16): 2257-2262.
    Objective

    To study the efficacy and safety of allisartan isoproxil tablet combined with indapamide tablet in the treatment of patients with mild to moderate essential hypertension and coronary heart disease.

    Methods

    Patients with mild to moderate essential hypertension and coronary heart disease were divided into treatment group and control group using the cohort method. The control group was given oral indapamide tablets 2.5 mg once a day based on the conventional treatment regimen. The treatment group was given allisartan isoproxil tablets 240 mg once a day in addition to the control group’s regimen for a total of 12 weeks. The clinical efficacy, 24-hour blood pressure variability, cardiac function, vascular endothelial function and safety evaluation of the two groups were compared.

    Results

    A total of 105 patients were enrolled, including 54 patients in treatment group and 51 patients in control group. After treatment, the total clinical effective rate of the treatment group was 90.74% (49 cases/54 cases), and that of control group was 72.55% (37 cases/51 cases), which was significantly higher in treatment group than in control group (P<0.05). After treatment, the daytime (d) systolic blood pressure variability (SBPV) levels in treatment group and control group were (11.32±2.13) and (12.48±2.26) mmHg, respectively; the nighttime (n) SBPV levels were (10.03±1.79) and (10.82±2.10) mmHg, respectively; the d diastolic blood pressure variability (DBPV) levels were (8.66±1.51) and (9.36±1.57) mmHg, respectively; the nDBPV levels were (8.05±1.32) and (8.68±1.62) mmHg, respectively; the 24 h SBPV levels were (10.85±2.20) and (11.96±2.05) mmHg, respectively; the 24 h DBPV levels were (9.67±1.93) and (10.66±1.92) mmHg, respectively; the brain natriuretic peptide (BNP) levels were (83.47±10.53) and (89.41±13.19) ng·L-1, respectively; the endothelin-1 (ET-1) levels were (55.44±9.27) and (60.36±10.86) ng·L-1, respectively; and the Apelin levels were (36.44±6.41) and (34.22±4.37) ng·mL-1, respectively. The above metrics showed significant differences between the two groups (P<0.05,P<0.01). The adverse drug reactions in treatment group included diarrhea, fever, fatigue, palpitations, soreness in both knee joints, cough, insomnia, decreased appetite and orthostatic hypotension. The adverse drug reactions in control group included diarrhea, headache, decreased appetite, insomnia and orthostatic hypotension. The total incidence of adverse drug reactions in treatment group was 22.22% (12 cases /54 cases), and that in control group was 17.65% (9 cases /51 cases). There was no statistically significant difference (P>0.05).

    Conclusion

    The application of allisartan isoproxil combined with indapamide in treatment of patients with mild to moderate essential hypertension and coronary heart disease can achieve significant therapeutic effects, regulate 24-hour blood pressure variability, improve cardiac function, vascular endothelial function, and quality of life, also demonstrate good safety.

  • Jie JIANG, Wen-ya GUO, Jing-xuan LIU, Xiao-fei GAO, Xiao-li ZHANG, Li-hua YAO, Yu-hua LI
    Chinese Journal of Clinical Pharmacology. 2025, 41(16): 2293-2298.
    Objective

    To investigate the effect of emodin (Emo) on chemotherapy resistance of human leukemia K562/adriamycin-resistant (K562/ADR) cells and its mechanism.

    Methods

    K562/ADR cells were assigned to control group and experimental -L, -M, -H groups. Experimental -L, -M, -H groups were incubated with Emo at concentrations of 5, 10, and 20 μmol·L-1, respectively. Control group was treated with 0.1% dimethyl sulfoxide. Methyl thiazolyl tetrazolium (MTT) assay was used to detect the effect of Emo on chemotherapy resistance in K562/ADR cells. Fluorescence analysis was used to detect the intracellular accumulation of adriamycin. Flow cytometry was used to detect the cell cycle and apoptosis. Polymerase chain reaction was used to detect the mRNA expression level of P-glycoprotein (P-gp). In addition, Western blot was used to detect the protein expression level of P-gp and nuclear factor-kappa B (NF-κB) pathway related proteins.

    Results

    The half maximal inhibitory concentrations (IC50) of K562/ADR cells to adriamycin in experimental -M, -H groups and control group were (20.91±2.03), (11.79±0.89) and (38.00±2.61) μg·ml-1; the intracellular adriamycin-associated mean fluorescence intensities (×104) were (5.22±0.66), (7.47±0.77) and (2.69±0.69); the proportions of G0/G1 phase cells were (37.81±3.47)%, (28.05±2.86)% and (51.18±5.06)%; the proportions of S phase cells were (19.89±2.98)%, (15.24±2.21)% and (32.15±3.20)%; the proportions of G2/M phase cells were (40.65±3.33)%, (55.75±4.55)% and (13.63±2.29)%; the cell apoptosis rates at 48 hours were (39.91±3.51)%, (46.26±4.06)% and (21.45±1.92)%; the relative expression levels of P-gp mRNA were 68.10±9.61, 31.01±8.90 and 100.00±12.22; the relative expression levels of P-gp protein were 77.01±8.31, 63.65±7.72 and 100.00±7.07; the relative expression levels of p65 (RelA/p65) in nucleus were 126.10±8.17, 157.58±11.87 and 100.00±8.55; the relative expression levels of phosphorylated-inhibitor of nuclear factor κB protein α (p-IκBα) in cytoplasm were 132.45±13.46, 150.97±9.47 and 100.00±7.35; the relative expression levels of IκBα in cytoplasm were 82.10±5.95, 73.20±6.39 and 100.00±5.84; the relative expression levels of phosphorylated-inhibitor of kappa B kinase α/β (p-IKKα/β) in cytoplasm were 126.23±6.63, 120.61±7.70 and 100.00±7.96, respectively. Compared the above indexes of the experimental -M and experimental -H groups with those of the control group, and the differences were statistically significant (P<0.05, P<0.01, P<0.001).

    Conclusion

    Emo can inhibit adriamycin chemotherapy resistance in K562/ADR cells by activating the NF-κB pathway and subsequently down-regulating the expression of P-gp.

  • Ting-zhao LIU, Wang HU, Wen ZHANG, Feng ZHANG, Sheng-long ZHANG, Yang CAO, Shun-wang HUANG, Huan ZHOU
    Chinese Journal of Clinical Pharmacology. 2025, 41(16): 2330-2334.
    Objective

    To evaluate the bioequivalence of the test preparation and the reference preparation in a single dose of vortioxetine hydrobromide tablets under fasting and fed conditions in healthy volunteers.

    Methods

    A randomized, open-ended, single-dose, two-cycle, double-cross bioequivalence trial design was adopted, and 28 subjects were enrolled in the fasting group and the fed group, respectively, and 1 tablet of the test preparation and the reference preparation were taken in the fasting or fed state each cycle. The concentration of vortioxetine in plasma was determined by liquid chromatography-tandem mass spectrometry (LC-MS/MS) method. The main pharmacokinetic parameters were calculated by Phoenix WinNonlin 8.1, and the bioequivalence was evaluated.

    Results

    The t1/2 for the fasting single oral administration of the test preparation and the reference preparation were (61.74±23.90) and (58.22±18.61)h, the median Tmax were (7.33±2.15) and (7.61±3.89) h, the Cmax were (7.32±1.90) and (7.46±1.98) ng·mL-1, and the AUC0-72 h were (312.61±92.95) and (310.00±93.84) h·ng·mL-1, respectively. The statistical results of the 90% confidence intervals of the main pharmacokinetic parameters Cmax and AUC0-72 h were 92.75%-103.71% and 97.47%-104.43%, respectively, all of which were within the range of 80.00%-125.00%, and the safety of the tested preparation and the reference preparation was good when taken orally on an empty stomach. The t1/2 of single oral administration after prandial administration of the tested preparation and the reference preparation were (77.60±33.87) and (81.61±45.24) h, the median Tmax were (8.06±3.02) and (7.77±2.45)h, the Cmax were (7.54±2.08) and (7.76±2.00) ng·mL-1, and the AUC0-72 h were (319.75±87.71) and (326.03±86.64) h·ng ·mL-1, respectively. The 90% confidence intervals of Cmax, AUC0-72 h were 89.00%-105.32% and 92.21%-102.72%, respectively, which were in the range of 80.00%-125.00%.

    Conclusion

    In the state of fasting and fed single oral administration, the two kinds of vortioxetine hydrobromide tablets have good bioequivalence.

  • Qian-you SHEN, Jun-li SONG, Yun REN, Zi-chang NIU, Shao-xia WANG, Hao-ping MAO
    Chinese Journal of Clinical Pharmacology. 2025, 41(16): 2305-2310.
    Objective

    To investigate the improving effect of ginseng (GS) on metoprolol(meto) induced bradycardia in mice with chronic heart failure(CHF)and its molecular mechanism.

    Methods

    The CHF model in C57BL/6J mouse was established through left anterior descending coronary artery ligation. Mice were randomly divided into 6 groups, including sham group(underwent the same surgical procedure without coronary artery ligation), model group, control group(26 mg·kg-1·d-1 metoprolol), experimental-low group(26 mg·kg-1·d-1 metoprolol + 1.3 g·kg-1·d-1 GS), experimental-midium group(26 mg·kg-1·d-1 metoprolol + 2.6 g·kg-1·d-1 GS)and experimental-high group(26 mg·kg-1·d-1 metoprolol + 5.2 g·kg-1·d-1 GS). Each group contained 9 mice. After continuous administration for 8 weeks, heart rate changes were monitored using non-invasive blood pressure monitors in small animals; transcriptome sequencing was employed to analyze differentially expressed genes in cardiac tissues with functional enrichment analysis; calcium ion concentration in myocardial tissue was measured using a calorimetric assay; Western blot analysis was used to detect relative expression levels of sarcoplasmic reticulum calcium ATPase 2a(SERCA2a), phosphorylated phospholamban(p-PLB)and sodium-calcium exchanger 1(NCX1)in myocardial tissue.

    Results

    The heart rates of sham group, model group, control group and experimental-L, -M, -H groups were(528.61±60.86),(448.67±84.58),(260.07±74.97),(352.84±40.47),(436.27±90.84)and(501.91±43.11)beats·min-1, respectively. Control group was compared with model group, experimental-L, -M, -H groups were compared with control group, the differences showed statistical significance in heart rates(P<0.05,P<0.01). Transcriptome gene ontology(GO)analysis revealed that differentially expressed genes were significantly enriched in pathways related to myocardial contraction and calcium ion transmembrane transport(all P<0.05). The myocardial tissue calcium ion concentrations in sham group, model group, control group and experimental-L, -M, -H groups were(30.09±2.36),(35.97±1.15),(16.15±2.37),(19.59±1.04), (23.64±0.54)and(28.54±2.82)mmol·L-1,respectively. Compared with control group, experimental-L, -M, -H groups all showed significantly increase(P<0.01, P<0.05). The relative expression levels of SERCA2a in sham group, model group, control group and experimental-L, -M, -H groups were 1.00±0.14, 0.83±0.05, 1.23±0.12, 1.00±0.03, 0.98±0.05 and 0.90±0.11, respectively; the relative expression levels of p-PLB were 1.38±0.24, 1.05±0.19, 2.12±0.35, 1.08±0.24, 0.54±0.57,and 0.52±0.13; while the relative expression levels of NCX1 were 1.00±0.13, 1.08±0.20, 1.69±0.34, 1.06±0.35, 1.15±0.22 and 0.81±0.21. Compared with model group, the relative expression levels of all 3 proteins in control group showed significant increases. Except for SERCA2a in experimental -L group and NCX1 in experimental -M group, the relative expression levels of the above three proteins in the experimental group were significantly lower than that in the control group (P<0.01, P<0.05).

    Conclusion

    Meto may induce bradycardia adverse drug reaction by increasing the p-PLB/PLB ratio and elevating the expression levels of SERCA2a and NCX1 proteins, which reduces intracellular free calcium ion concentration in cardiomyocytes. Ginseng could significantly down regulate the p-PLB/PLB ratio, increase the protein expression levels of SERCA2a and NCX1, and up regulate the concentration of intracellular free calcium ion, so as to improve Meto induced bradycardia, suggesting that it may antagonize the negative frequency effect of Meto by remodeling the calcium cycle homeostasis.

  • Cai-dong WU, Wan-xi HOU, Kai-hong ZANG
    Chinese Journal of Clinical Pharmacology. 2025, 41(16): 2317-2323.
    Objective

    To investigate the protective effect and mechanism of astragaloside Ⅳ (AS-Ⅳ) on intestinal injury and secondary liver injury in rats with ulcerative colitis (UC) induced by trinitrobenzene sulfonic acid (TNBS).

    Methods

    Wistar rats were randomly divided into normal control group, UC model group and AS-Ⅳ experimental low, medium and high dose groups, with 10 rats in each group. The UC rat model was prepared by TNBS enema. AS-Ⅳ (25, 50, 100 mg·kg-1) or sulfasalazine (SASP, 300 mg·kg-1) was administered intragastrically for 6 consecutive days starting from the second day after modeling. The general condition, colonic histopathological score, and liver function of the rats were examined. The levels of inflammatory factors in serum, colon and liver tissues were detected by enzyme-linked immunosorbent assay (ELISA). The expressions of tight junction proteins (ZO-1, Occludin) in colon and antioxidant enzymes in liver tissues were detected by Western blot.

    Results

    In the normal group, model group, low, medium and high dose experimental groups, the serum TNF-α levels were (246.30±23.39), (308.70±61.39), (279.10±45.76), (240.80±16.61) and (233.60±30.14) pg·mL-1, and the serum IL-1β levels were (23.93±14.82), (82.42±20.84), (69.46±22.23), (40.92±11.21) and (35.42±10.34) pg·mL-1,respectively. The intestinal TNF-α levels were (101.60±11.18), (158.70±23.47), (146.40±17.90), (115.70±21.06) and (91.84±21.57) pg·mL-1, and the intestinal IL-1β levels were (724.60±78.73), (1 043.00±106.32), (836.35±103.35), (774.60±133.68) and (694.50±40.84) pg·mL-1,respectively. The relative expression levels of tight junction protein ZO-1 in colon tissue were 1.01±0.01, 0.48±0.01, 0.46±0.01, 0.61±0.09 and 1.15±0.10, and the relative expression levels of tight junction protein Occludin in colon tissue were 1.00±0.01, 0.64±0.11, 0.57±0.13, 0.73±0.10 and 1.02±0.13,respectively. The levels of TNF-α in liver tissues were (1 727.00±223.70), (2 008.00±220.40), (1 762.00±45.19), (1 723.00±49.45), and (1 680.00±103.10) pg·mg-1, and the levels of IL-1β in liver tissues were (1 317.00±331.40), (2 158.00±730.90), (1 546.00±258.90), (1 806.00±523.40), and (1 121.00±84.62) pg·mg-1. The MDA levels in liver tissues were (0.98±0.15), (1.51±0.29), (1.29±0.30), (1.15±0.12) and (1.06±0.21) nmol·mg-1, the reduced glutathione (GSH) levels in liver tissues were (8.46±0.60), (5.84±0.49), (6.30±0.27), (7.48±0.50) and (8.07±0.60) μmol·gProt-1, the glutathione peroxidase (GSH-PX) levels in liver tissues were (666.90±68.39), (481.00±19.16), (562.80±45.61), (620.20±12.13) and (658.80±18.11) U·mgProt-1.The above indicators in the medium and high dose experimental groups were statistically significant compared with the model group (all P<0.05).

    Conclusion

    AS-IV can effectively improve intestinal and liver injury in rats with UC induced by TNBS. The mechanism may be related to repairing intestinal mucosal barrier, inhibiting inflammatory response and improving liver antioxidant function.

  • Bing ZHAO, Rong-rong LI, Qian XU, Yong-qi LIU, Jian-zheng HE, Zhi-ming ZHANG
    Chinese Journal of Clinical Pharmacology. 2025, 41(16): 2374-2378.

    Acute lung injury (ALI) is a severe respiratory disease. Given the limited existing treatment methods, it is urgent to explore new therapies. Pyroptosis plays a crucial role in the onset of ALI. Traditional Chinese medicine can regulate the pathways related to pyroptosis, reduce the inflammatory response, and improve acute lung injury, thus providing new strategies for the treatment of ALI. This article systematically reviews the mechanisms by which pyroptosis causes ALI in alveolar macrophages, neutrophils, and pulmonary vascular endothelial cells, summarizes the published literature from 2019 to 2024, and explores the action mechanisms of active ingredients and compound prescriptions of traditional Chinese medicine in the treatment of ALI, aiming to provide a theoretical basis for the research and development of new drugs.

  • Xiang GAO, Yi-bing SHI, Chun-qing LIU, Xi WANG, Xuan ZHANG, Hua ZHU
    Chinese Journal of Clinical Pharmacology. 2025, 41(16): 2357-2362.

    Bone-related infections represent a significant challenge in orthopedic practice, and the penetration efficacy of antimicrobials into bone tissue serves as a critical determinant of therapeutic outcomes. This review systematically summarizes the bone penetration characteristics of clinically used antimicrobial agents. Current evidence indicates that most β-lactam antibiotics demonstrate bone penetration rates ranging from 10% to 50%, while fluoroquinolones exhibit higher penetration at 30%-100%. Vancomycin and teicoplanin display penetration rates between 10% and 40%. Notably, clindamycin, linezolid and rifampicin achieve penetration rates exceeding 30%. Multiple factors influence drug penetration characteristics, including anatomical bone site variations, local blood perfusion status, patients’ pathophysiological conditions, as well as administration routes and dosage regimens.

  • Jing SONG, He-ru ZHAO, Ling HE, Jian-fang LIU
    Chinese Journal of Clinical Pharmacology. 2025, 41(16): 2335-2339.
    Objective

    To evaluate the bioequivalence and safety of colchicine tablets under fasting and fed conditions in Chinese healthy participants.

    Methods

    A single-center, randomized, open, single-dose, two-formulation, two-period, two-sequence crossover design was adopted, enrolling 72 healthy participants, with 36 healthy participants in each group for fasting and fed conditions. Single oral dose 0.5 mg of test formulation (T) or the reference formulation (R) was taken across two periods,respectively. Plasma concentration of colchicine was determined using ultra-high performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS). The pharmacokinetic parameters were calculated and the bioequivalence was evaluated using the non-compartmental model in Phoenix WinNonlin 8.2 software.

    Results

    The main pharmacokinetic parameters of a single oral colchicine tablet under fasting condition for T and R were as follows: Cmax were (2.70±0.88) and (2.54±0.87) ng·mL-1tmax were 0.98 (0.48, 2.00) and 0.98 (0.73, 2.48) h,t1/2 were (29.54±5.46) and (29.67±4.86) h,AUC0-t were (18.40±5.30) and (18.00±5.10) h·ng·mL-1,AUC0-∞ were (21.80±5.90) and (20.70±4.90) h·ng·mL-1, respectively. The main pharmacokinetic parameters under fed condition for T and R were as follows: Cmax were (2.49±0.84) and (2.58±1.00) ng·mL-1tmax were 1.48 (0.73, 3.98) and 1.48 (0.73, 4.00) h,t1/2 were (31.79±4.69) and (30.65±4.91) h,AUC0-t were (19.80±4.30) and (19.90±5.00) h·ng·mL-1,AUC0-∞ were (23.20±5.00) and (23.10±5.20) h·ng·mL-1, respectively. The geometric mean ratios of Cmax, AUC0-t and AUC0-∞ of the T and R formulations under fasting and fed conditions with a 90% confidence interval ranged from 80.00% to 125.00%.

    Conclusion

    Under both fasting and fed conditions, the colchicine tablet test formulation and reference formulation were bioequivalent in Chinese healthy subjects, and both were shown to be safe.

  • Xiang-qing SONG, Shi-peng YAN, Mi HAN, Mei-zi ZENG, Tao YANG, Wu-lin ZHANG, Yu TAN, Ming-hui LONG
    Chinese Journal of Clinical Pharmacology. 2025, 41(16): 2379-2385.

    Vancomycin is the first-line drug for treating infections caused by methicillin-resistant gram positive bacteria in patients with malignant hematological diseases. However, due to significant differences in the physiological and pathological characteristics of these patients compared to the general population, the pharmacokinetic behavior of vancomycin in the body may undergo significant changes. These changes may lead to unpredictable therapeutic effects, increased safety risks, and the evolution of bacterial resistance. Personalized dosing strategies may offer potential solutions to address these issues. Nevertheless, at present, there is a lack of unified, guideline-based, or consensus-driven reference standards for personalized dosing in these patients, particularly adult patients, and relevant research data remain insufficient. This review systematically summarizes the current status of pharmacokinetic studies on vancomycin in adult patients with malignant hematological diseases and focuses on the analysis of population pharmacokinetic models and their application progress. Additionally, this paper provides a detailed discussion of the current technical approaches available for vancomycin personalized dosing, including techniques based on therapeutic drug monitoring, clinical decision support systems, novel technical methods, and the latest dynamic dosing techniques developed by our research team based on individualized dosing models. Through an organized review of existing research, this paper identifies the challenges faced in achieving broader implementation of personalized dosing. It is hoped that this study will provide valuable insights for achieving personalized vancomycin dosing in patients with malignant hematological diseases, thereby advancing clinical practice and technological development in this field.

  • Yong-qing ZHENG, Zhi-gang JIAO, Teng-yan TANG, Shu-juan REN
    Chinese Journal of Clinical Pharmacology. 2025, 41(16): 2275-2280.
    Objective

    To explore the clinical efficacy of fusidic acid ointment in patients with acne vulgaris who underwent non-ablative fractional 1 565 nm laser treatment.

    Methods

    Patients with common acne who received non-peeling fractional 1 565 nm laser treatment were divided into treatment group and control group. Treatment group was treated with fusidic acid ointment, 3 times a day, while control group was not treated with additional treatment.The lesion severity, skin sebum secretion, skin stratum corneum water content, clinical efficacy, matrix metalloproteinase 1 (MMP-1), matrix metalloproteinase tissue inhibitor-1 (TIMP-1), MMP-1/TIMP-1 ratio, skin elasticity indicators (R2, R5, R7), facial acne comprehensive grading system (global acne grading system, GAGS) score and acne-specific quality of life questionnaire (Acne-QOL) score were compared between the two groups.

    Results

    100 patients with acne vulgaris who received non exfoliative dot matrix 1 565 nm laser were enrolled, including 50 cases in treatment group and 50 cases in control group. After treatment, the total clinical effective rate of treatment group was 96.00% (48 cases/50 cases), and that of control group was 74.00% (37 cases/50 cases), the difference was statistically significant (P<0.05). After 3 months treatment, the skin oil secretion of treatment group and control group were (53.79±7.23) and (69.21±10.67) μg·cm-2, respectively; the moisture content of cuticle were (34.21±5.15)% and (29.68±3.92)%, respectively; MMP-1 were (1.02±0.28) and (1.24±0.43) μg·mL-1, respectively; TIMP-1 were (1.62±0.24) and (1.43±0.20) μg·mL-1, respectively; MMP-1/TIMP-1 were 0.63±0.10 and 0.87±0.15, respectively; the R2 were (53.77±8.75)% and (49.11±7.64)%, respectively; the R5 were (53.88±8.58)% and (49.67±7.69)%, respectively; the R7 were (32.55±6.05)% and (28.39±5.44)%, respectively; the GAGS scores were (13.78±2.69) and (17.83±3.35) points, respectively; the Acne-QOL scores were (105.56±5.58) and (90.21±6.32) points, respectively. After treatment, the above indexes in treatment group were significantly lower than those in control group (all P<0.05). The adverse drug reactions in treatment group and control group were dry, tingling, scaling and flushing. The total incidence of adverse drug reactions in treatment group was 10.00% (5 cases/50 cases) and in control group was 16.00% (8 cases/50 cases). There was no significant difference in the incidence of adverse drug reactions between the two groups (P>0.05).

    Conclusion

    Fusidic acid ointment could significantly improve the dynamic balance of MMP-1/TIMP-1, skin elasticity and skin physiological indexes in patients with acne vulgaris receiving non-ablative fractional 1 565 nm laser, with good safety.