Article
Pharmacology & Pharmacy
Jingjing Meng, Yaa F. Abu, Yue Zhang, Yuyin Zhou, Yun Xie, Yan Yan, Junyi Tao, Sundaram Ramakrishnan, Chi Chen, Sabita Roy
Summary: This study found that co-administration of opioids exacerbates chemotherapy-induced gastrointestinal toxicity, possibly due to gut microbial dysbiosis caused by opioids leading to increased production of beta-glucuronidase, which worsens the toxicity of the chemotherapy drug.
BRITISH JOURNAL OF PHARMACOLOGY
(2023)
Article
Plant Sciences
Yihan Wu, Yanfen Cheng, Yuhan Yang, Di Wang, Xiaoqin Yang, Chaomei Fu, Jinming Zhang, Yichen Hu
Summary: This study investigates the beneficial effects of Gegen Qinlian Pill (GQP) in treating irinotecan (CPT-11)-induced gut toxicity and diarrhea. Through identifying 19 GQP-derived chemical compounds in murine serum samples and establishing an interaction network, it is found that GQP exerts curative effects on diarrhea through regulating inflammation, oxidative stress, and proliferation processes via different targets. This provides insights into the pharmacological effects and mechanisms underlying GQP's treatment of CPT-11-induced gut toxicity.
JOURNAL OF ETHNOPHARMACOLOGY
(2021)
Review
Immunology
Bei Yue, Ruiyang Gao, Zhengtao Wang, Wei Dou
Summary: Irinotecan (CPT11) and its active metabolite SN38 are broad-spectrum cytotoxic anticancer agents that can cause gastrointestinal toxicity. The gut microbiota plays a crucial role in modulating the efficacy and toxicity of CPT11 chemotherapy through mechanisms such as microbial ecocline, enzyme catalysis, and immunoregulation. Targeting the gut microbiota with specific inhibitors, dietary interventions, probiotics, and strain-engineered interventions can potentially improve CPT11 chemotherapy efficiency and alleviate toxicity.
FRONTIERS IN CELLULAR AND INFECTION MICROBIOLOGY
(2021)
Article
Integrative & Complementary Medicine
Jiamei Chen, Min Li, Rong Chen, Ziyi Xu, Xiaoqin Yang, Huan Gu, Lele Zhang, Chaomei Fu, Jinming Zhang, Yihan Wu
Summary: This study investigated the active ingredients and mechanisms of a traditional Chinese medicine decoction, Gegen Qinlian formula, for the treatment of CPT-11-induced chemotherapy-induced diarrhea. The study identified 37 active compounds in the decoction and found that they exert their effects through the PI3K-AKT signaling pathway, protecting intestinal barrier function and alleviating diarrhea.
Article
Emergency Medicine
David Cunningham, Kacie Clark, Kito Lord
Summary: Valproic acid (VPA) and derivatives are effective anticonvulsants, but overdose can lead to central nervous system depression and hepatotoxicity. Traditional treatments include L-carnitine, activated charcoal, and hemodialysis, but the interaction with carbapenem class antibiotics may offer an alternative approach.
AMERICAN JOURNAL OF EMERGENCY MEDICINE
(2022)
Review
Oncology
Dorte Lisbet Nielsen, Carsten Bogh Juhl, Inna Markovna Chen, Lauge Kellermann, Ole Haagen Nielsen
Summary: ICIs, either alone or in combination with chemotherapy or TKIs, have shown improved cancer outcomes. However, they also carry the risk of immune-related adverse effects, such as diarrhea and colitis. A tailored approach is needed for the management of these adverse effects.
CANCER TREATMENT REVIEWS
(2022)
Article
Multidisciplinary Sciences
Risako Kon, Nobutomo Ikarashi, Arisa Yamaguchi, Yuka Teshima, Tamami Yamaguchi, Kanako Miyaoka, Moeno Fukuda, Hinata Noguchi, Rei Tomimoto, Hiroyasu Sakai, Junzo Kamei, Tomoo Hosoe
Summary: Green tea extract (GTE) can ameliorate CPT-11-induced diarrhea by reducing the abundance of beta-glucuronidase-producing bacteria and increasing the levels of colon UGT1A1, thereby decreasing the production of the active metabolite SN-38 in the intestinal tract.
SCIENTIFIC REPORTS
(2023)
Article
Plant Sciences
Caiyan Wang, Xiaojun Teng, Chuang Wang, Binjie Liu, Runze Zhou, Huawei Qiu, Yu Fu, Rongjin Sun, Zuhui Liang, Rong Zhang, Zhongqiu Liu, Lin Zhang, Lijun Zhu
Summary: In this study, it was demonstrated that Xiao-Chai-Hu-Tang (XCHT) can alleviate CPT-11-induced diarrhea by improving the abundance of beneficial gut microbiota and reducing inflammation.
Article
Biochemistry & Molecular Biology
Dawei Zhao, Di Wu, Gengyue Zhang, Yongqi Li, Weiguo Shi, Bohua Zhong, Hong Yu
Summary: This study evaluates the cytotoxic mechanism of ZBH-1207, a novel CPT-11 derivative, in CRC cells. The results demonstrate that ZBH-1207 has significant inhibitory effects on tumor cell proliferation and induces more cell cycle arrests and apoptosis compared to CPT-11 and SN38. Thus, ZBH-1207 may have higher anti-tumor activity in CRC treatment.
MOLECULAR BIOLOGY REPORTS
(2022)
Article
Biochemistry & Molecular Biology
Larasati Martha, Akane Nakata, Shinnosuke Furuya, Wangyang Liu, Xieyi Zhang, Kenta Mizoi, Takuo Ogihara
Summary: SN-38, an active metabolite of irinotecan (CPT-11), circulates between enterocytes and intestinal lumen via transporters such as OATP2B1, UGTs, MRP2, and BCRP. This intra-enteric circulation mechanism involves the absorption of SN-38 by enterocytes via OATP2B1, conversion to SN-38G by UGTs, and excretion into the digestive tract lumen by MRP2 and BCRP. This newly proposed concept may contribute to the development of delayed diarrhea, a serious side effect of CPT-11.
BIOCHEMICAL AND BIOPHYSICAL RESEARCH COMMUNICATIONS
(2023)
Article
Pharmacology & Pharmacy
Donald P. Alexander, Nancy A. Nickman, Anindit Chhibber, Gregory J. Stoddard, Joseph E. Biskupiak, Mark A. Munger
Summary: ACEi use in neurologically impaired population may reduce the risk of pneumonia and mortality.
Article
Oncology
Gisele F. P. Rangel, Marcio Ramos, Luana D. do Carmo, Liviane M. A. Rabelo, Alfredo A. Silva, Tamiris F. G. de Sousa, Roberto C. P. Lima Junior, Deysi V. T. Wong, Renata F. C. Leitao, Pedro J. C. Magalhaes, Brandon F. Sousa, Marisa J. S. Frederico, Nylane M. N. Alencar
Summary: This study investigates the effects of LP-PII-IAA derived from the latex of Calotropis procera on irinotecan-induced intestinal mucositis. The results show that animals treated with LP-PII-IAA had reduced mortality, absence of diarrhea, and normalized intestinal functions. These effects were accompanied by decreased inflammation and oxidative stress markers. The findings suggest that the peptidases from C. procera are instrumental in suppressing the adverse effects of irinotecan.
ANTI-CANCER AGENTS IN MEDICINAL CHEMISTRY
(2022)
Article
Biochemistry & Molecular Biology
Sevgi Gencosman, Deniz Ceylanli, Ahmet Ozer Sehirli, Kerem Terali, Furkan Bolukbasi, Sule Cetinel, Serkan Sayiner
Summary: This study aimed to investigate whether NAC can provide protection against hepatorenal and gastrointestinal tissue damage induced by CPT-11. The results showed that NAC had significant biochemical and histological improvements in reducing CPT-11 toxicity in rats.
Article
Plant Sciences
Jia-Wen Shi, Zhuang-Zhuang Li, Jia-Shuo Wu, Wei-Yi Jin, Xiao-Yan Chang, Hong Sun, Li Dong, Zhi-Ping Jiang, Yue Shi
Summary: The study identified specific herbal components in Banxia Xiexin Decoction (BXD) that were associated with reduced intestinal SN-38 levels in mice treated with CPT-11, including chrysin, berberine, and baicalin. These compounds were proposed as the primary bioactive components of BXD, offering protection against chemotherapy-induced diarrhea. This spectrum-effect analysis provides valuable insights into the pharmacological activity of traditional Chinese medicine preparations.
JOURNAL OF ETHNOPHARMACOLOGY
(2021)
Editorial Material
Oncology
Spinel Karas, Federico Innocenti
Summary: This article provides essential knowledge on UGT1A1 polymorphisms and their impact on the efficacy and toxicity of irinotecan-based regimens. It offers dosing adjustments based on UGT1A1 genotypes and summarizes recommendations from US and international scientific consortia and major oncology societies.
JCO ONCOLOGY PRACTICE
(2022)