Current Drug Metabolism - Online First
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20 results
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Computational Chemistry Approach in the Assessment of Potential Acyl Glucuronide-Mediated Toxicity
Authors: Nathan D. Ricke, Markus Walles, Russell Jones, John Davis and Mithat GunduzAvailable online: 22 January 2026More LessIntroductionAcyl glucuronides are common phase II metabolites of xenobiotics and can sometimes contribute to idiosyncratic toxicities. Their reactivity is primarily mediated through acyl migration and/or nucleophilic displacement, and shorter acyl glucuronide half-lives are associated with increased reactivity. This reactivity can lead to metabolite-induced toxicity, posing a significant risk during drug development.
MethodsWe developed regression models trained on features derived from Density Functional Theory (DFT) calculations to predict the half-lives of acyl glucuronide metabolites. The aim was to provide a computational tool to guide the design of drug candidates with more stable acyl glucuronide metabolites.
ResultsThe best-performing model achieved a strong correlation between predicted and experimental half-lives, with an R2 of 0.67 on the test set. Predicted half-lives for drugs classified as clinically safe were longer than those for drugs in the warning and withdrawn categories, demonstrating a separation comparable to experimentally measured half-lives.
DiscussionThe model is sufficiently accurate to support the optimization of acyl glucuronides for longer half-lives. Further analysis indicated that acyl glucuronide stability can be modulated by electron-donating and electron-withdrawing groups, effects that are effectively captured by the model.
ConclusionThis modeling approach can be applied during drug discovery to reduce the risk of metabolite-related toxicity by enabling in silico screening of compound modifications and ranking them based on predicted effects on acyl glucuronide half-life.
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Comparative Proteomics Of Hepatocytes And Hepatic Cell Lines Using Swath-MS
Authors: Anitha Saravanakumar, Rohitash Jamwal, Benjamin B Barlock, Xin Bush and Fatemeh AkhlaghiAvailable online: 22 January 2026More LessIntroductionHuman hepatic carcinoma cell lines are widely used in vitro to study lipid and xenobiotic metabolism, as well as glucose regulation in both normal and diseased states. However, their validity is often questioned due to variability in protein expression compared to primary human hepatocytes (cHH). This study aimed to quantify protein abundance in various hepatic cell lines versus cHH and human liver tissue homogenate (HLT) using a data-independent acquisition-based total protein approach (DIA-TPA). We compared the global proteome from the whole cell homogenates of HepaRG, HepG2, and Huh7 cell lines with that of cHH and HLT.
MethodsProteins in whole cell homogenates were digested in solution using pressure-cycling technology (PCT). DIA was performed via sequential window acquisition of theoretical mass spectra (SWATH-MS), and MS2 spectra were quantified using Spectronaut™, followed by analysis with TPA.
ResultsWe identified 2715, 2578, 2874, 2717, and 3083 proteins in HepaRG, HepG2, Huh7, cHH, and HLT, respectively, at a 1% FDR. The global proteome of cHH significantly differed from that of the cancer hepatic cell lines. Among the cell lines, the global and ADME protein profile of HepaRG most closely correlated with cHH, with 89 out of 101 ADME proteins identified. Clinically relevant DMEs from the CYP450 family (CYP2C9, CYP2C19, CYP2D6, and CYP3A4) and the UGT family (UGT1A1, UGT1A3, UGT1A6, UGT2B7, and UGT2B15) were quantifiable in human hepatocytes, human liver tissue, and the HepaRG cell line. The Huh7 cell line exhibited a higher abundance of proteins related to gluconeogenesis and glycolysis compared to other groups.
ConclusionThis study highlights the potential of untargeted global proteomics in detecting differences in protein expression among various hepatic cell lines and provides a comprehensive database to inform the choice of the cell line in future studies.
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Exploring Microbiome-Based Therapy: Bacterial Flavonoid Synthesis as a Novel Approach to PCOS Treatment
Authors: Navjyoti Goyal, Sarita Sharma, Ruby Bhatia and Sumeet GuptaAvailable online: 22 January 2026More LessBackgroundPCOS is a common endocrine disorder characterized by metabolic irregularities, hormonal imbalance, and ovarian dysfunction. Traditional therapies, including dietary changes, herbal remedies, and lifestyle modifications, offer limited efficacy in addressing the complex pathophysiology of PCOS.
MethodA literature review was conducted using PubMed, Google Scholar, and ScienceDirect to identify studies on gut microbiota and microbiome-based management strategies for PCOS.
ResultEmerging evidence highlights the role of gut bacteria in regulating hormonal and metabolic functions, sparking interest in microbiota-targeted therapies. Microbial flavonoid synthesis by species such as Streptomyces and Escherichia coli may positively influence endocrine and metabolic pathways relevant to PCOS.
DiscussionModulating the gut microbiome, particularly through microbial flavonoid production, represents a promising therapeutic avenue. However, most evidence remains preclinical, with limited clinical validation. Key gaps include mechanistic understanding, safety evaluation, and translational research. Integrating microbiome-targeted interventions with conventional therapies could enhance metabolic and hormonal regulation, offering improved outcomes for women with PCOS.
ConclusionMicrobiome-based medicinal approaches, including microbial flavonoid production, may offer novel strategies for PCOS management. Rigorous preclinical studies and well-designed clinical trials are essential to establish their efficacy, safety, and therapeutic potential.
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Shenfu Decoction Extends Survival Time of Seawater-Induced Hypothermia in Rats: The Role of Metabolomics and Gut Microbiota
Authors: Ya-jing Wang, Hong-zhi Chen, Zhi-bo Wang, Chao-yue Sun, Chen-yang Guo, Yi Ruan, Chuan-tao Li, Bin Zou, Zi-fei Yin and Wei GuAvailable online: 20 January 2026More LessIntroductionShenfu decoction (SFD), a Traditional Chinese Medicine formula, is used in clinical emergencies. Its effects on seawater-induced hypothermia remain unclear. This study investigates the therapeutic mechanisms of SFD in improving the survival of hypothermic rats through metabolomics and gut microbiota analysis.
MethodsHypothermia was induced in rats via seawater immersion. The chemical constituents of SFD were analyzed using ultra-performance liquid chromatography quadrupole time-of-flight mass spectrometry (UPLC-Q-TOF-MS). Survival time and rates of low-temperature water-immersed rats were assessed. Rat blood samples were obtained for analysis of hematologic parameters, electrolytes, hepatic and renal function, cardiac injury, and inflammatory cytokines. To investigate the potential mechanism underlying the survival-prolonging effect of SFD on seawater-immersed hypothermic rats, untargeted blood metabolomics and gut microbiota profiling were employed for preliminary screening.
ResultsUPLC-Q-TOF-MS identified almost 50 compounds in SFD, and 1.35 g/kg SFD significantly extended the survival time of seawater-induced hypothermia rats by 6 hours. After hypothermic seawater immersion, the levels of red blood cells, hemoglobin, hematocrit, as well as serum calcium, phosphorus, blood urea nitrogen, alkaline phosphatase, total protein, cardiac troponin T, and interleukin-6 were significantly increased. However, pretreatment with 1.35 g/kg SFD in rats markedly decreased these parameters. The induction of hypothermic seawater immersion elevated blood glucose, and the administration of SFD exacerbated this increase in rats. Metabolomic analysis revealed elevated levels of valerenic acid and benzoylmesaconine in the SFD group, suggesting the restoration of metabolic homeostasis. This recovery was associated with modulation of the gut microbiota, notably an enhancement of beneficial genera, such as Enterococcus.
DiscussionThe findings demonstrated that SFD significantly prolonged survival in a rat model of seawater-immersion hypothermia. The protective mechanism involved a dual action: mitigating hypothermia-induced organ damage and hematological disturbances, coupled with restoring metabolic homeostasis and modulating gut microbiota. SFD has been found to possess specifically enriched beneficial bacterial genera, linked to the activation of brown adipose tissue and non-shivering thermogenesis. This study has provided initial evidence for a gut microbiota-metabolism axis mediating SFD's protective effect.
ConclusionSFD prolonged survival in rats with seawater-induced hypothermia, likely by enhancing thermogenesis and regulating lipid metabolism through gut microbiota changes. The findings highlighted the potential of SFD for hypothermia prevention; however, its exact underlying mechanisms require further validation.
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Development and Characterization of Ricinoleic Acid-Loaded Chitosan Nanoparticles for Targeted Hepatoprotective Drug Delivery
Authors: Soniya Sarthi, Harish Bhardwaj and Rajendra Kumar JangdeAvailable online: 02 January 2026More LessIntroductionRicinoleic acid (RA), a fatty acid derived from castor oil (Ricinus communis), exhibits potent antioxidant activity and hepatoprotective properties, primarily attributed to its ability to mitigate oxidative stress. However, its therapeutic application is limited by poor bioavailability due to high metabolism, low intestinal permeability, poor water solubility, rapid urinary and biliary elimination, frequent dosing requirements, and a short half-life. This study aimed to optimize the formulation of ricinoleic acid-loaded chitosan nanoparticles (RA-CSNPs) for improved delivery and bioavailability using the ionic gelation technique.
MethodThe formulation was developed using chitosan as the polymer and sodium tripolyphosphate (STPP) as the cross-linking agent. The synthesized nanoparticles were characterized for particle size (PS: 164.15 nm), polydispersity index (PDI: 0.259), zeta potential (ZP: +30.25 mV), and entrapment efficiency (EE: 97.07%) and drug release within 24 hours. Structural and thermal properties were assessed using differential scanning calorimetry (DSC), X-ray diffraction (XRD), and Fourier-transform infrared spectroscopy (FTIR).
ResultsThe in vitro drug release profile of the RA-CSNPs showed a cumulative release of 92.12%, demonstrating significant controlled release. Additionally, the antioxidant activity was measured at 84.45%, indicating that RA retained its bioactivity in the nanoparticle formulation.
DiscussionThese results highlight the potential of RA-CSNPs as an effective drug-delivery system to overcome the bioavailability challenges of ricinoleic acid. The controlled release and antioxidant activity of the formulation are promising for therapeutic applications in various oxidative stress-related diseases. However, limitations in scaling up nanoparticle production and conducting long-term pharmacokinetic studies need to be addressed in future research.
ConclusionThis study successfully demonstrates the potential of RA-loaded chitosan nanoparticles as a novel and efficient drug delivery system. The formulation provides controlled release, enhancing the bioavailability of ricinoleic acid and offering a promising strategy for improving its therapeutic efficacy in clinical applications.
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A Systematic Review of Pharmacokinetic Models of Vancomycin in Adult Patients (2020-2024): Trends, Variability, and Key Covariates
Available online: 15 November 2025More LessIntroductionThis systematic review aimed to identify, evaluate, and critically analyze pharmacokinetic models of vancomycin in adult populations published in PubMed and EMBASE between 2020 and 2024.
Materials and MethodsTwenty-two studies were included, describing 24 models characterized by substantial heterogeneity in terms of study populations, methodological design, and covariate selection. Most models were developed in Asia and focused on hospitalized patients, particularly those in intensive care units (ICUs). Data from 2150 patients were analyzed, with an average of 93 patients per model.
ResultsThe models demonstrated high variability in pharmacokinetic parameters, such as vancomycin clearance (Cl) and volume of distribution (Vd), influenced by factors, such as renal function, weight, age, and comorbidities. The meta-analysis conducted on clearance and interindividual variability in clearance (IIV Cl) revealed high heterogeneity among the analyzed studies. The average vancomycin clearance was 4.23 L/h, with higher values observed in neurosurgical, oncohematologic patients, and those with increased renal function. The volume of distribution showed greater variability in obese patients and those undergoing continuous renal replacement therapy. Creatinine clearance (ClCr) was identified as a significant covariate in 66% of the models, while weight was significant in 33%. Other important covariates included age, sex, serum creatinine, serum urea, and the hospital admission unit. The meta-analysis of Cl and IIV Cl showed high heterogeneity among the studies, with I2 values of 0.83 for Cl and 0.98 for IIV Cl, indicating substantial variability.
DiscussionThe limitations of this study included the diversity of the analyzed populations, which made it challenging to assess the model's suitability. While the models showed advances in precision, challenges, such as the lack of external validation and discrepancies in dosing recommendations, remain.
ConclusionThis review paper has highlighted the need to validate models in diverse populations and clinical settings to optimize personalized vancomycin therapy in adults. The findings have highlighted the importance of validating or adapting pharmacokinetic models to the specific characteristics of each hospital population.
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Molecular Pathways Involved in Drug-Induced Hepatotoxicity: A Mini Review
Authors: Annu Bhati, Avijit Mazumder, Priyanka Bansal and SalahuddinAvailable online: 14 November 2025More LessDrug-induced hepatotoxicity (DIH) poses a significant clinical challenge due to its unpredictable nature and diverse manifestations. The liver, with its central role in metabolism and close association with the gastrointestinal tract, is particularly susceptible to drug-induced toxicity. DIH encompasses a spectrum of liver injuries, including hepatocellular, cholestatic, and mixed patterns, which may increase the risk of other liver diseases. This review examines diverse examples and molecular mechanisms underlying DIH, highlighting the influence of genetic predisposition, drug interactions, and pre-existing liver conditions. Given the complexity and variability of hepatotoxic responses to numerous medications, understanding these mechanisms is crucial for improving the diagnosis and management of DIH.
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Lung-Targeting Cepharanthine Polymer Micelles Modified with Mannose: Effectiveness against Acute Lung Injury Evaluated Using in vitro and in vivo Analyses
Authors: Rui Xue, Yi-Ying Chen, Jia-Hua Mei, Pei-Pei Zhang, Wen-Bin Jin, Li-Li Cui, Xiao-Yu Zhao, Hai-Liang Zhang, Li-Qin Luo and Yun-Shu MaAvailable online: 10 November 2025More LessIntroductionThe currently available therapies for acute lung injury (ALI), including glucocorticoids, protease inhibitors, and heparin, have limited clinical efficacy and are often associated with significant side effects. Cepharanthine (CEP) has demonstrated effectiveness in treating pulmonary diseases, but its clinical application is restricted by low solubility and poor bioavailability. This study aimed to develop mannosylated cepharanthine-loaded polymeric micelles (MA-CEP-PMs) to improve CEP bioavailability and enhance lung-targeted delivery for the treatment of ALI.
MethodsThe pharmacokinetics of MA-CEP-PMs in rats were assessed using Ultra-Performance Liquid Chromatography Quadrupole Time-of-Flight Mass Spectrometry (UPLC-Q-TOF-MS). Lung-targeting ability was evaluated through tissue distribution studies and near-infrared imaging. In a rat model of ALI induced by lipopolysaccharide (LPS), anti-ALI effects were assessed via general physiological indicators, Enzyme-Linked Immunosorbent Assay (ELISA), and Western blot analysis. Hematoxylin-eosin (HE) staining was used to examine hepatotoxicity and nephrotoxicity of MA-CEP-PMs in normal rats. Cytotoxicity of the mannosylated polyethylene glycol–poly(lactic-co-glycolic acid) copolymer (MA-PEG-PLGA) on NR8383 cells was evaluated using the Cell Counting Kit-8 (CCK-8) assay. Cellular uptake experiments were performed to determine the targeting ability of MA-PEG-PLGA in NR8383 cells, and the effects of MA-CEP-PMs on inflammatory cytokines were analyzed using ELISA.
ResultsMA-CEP-PMs significantly increased the AUC and exhibited better lung targeting ability compared to the unmodified micelles (p < 0.01). In the ALI model, MA-CEP-PMs improved the thymus and spleen indices, decreased the lung wet-to-dry weight ratio (p < 0.05), alleviated model animal damage, and inhibited inflammatory factor and nuclear factor-κB (NF-κB)–related protein levels (p < 0.05). MA-CEP-PMs exhibited no significant hepatotoxicity or nephrotoxicity. MA-PEG-PLGA exhibited low toxicity against NR8383 cells and greater cell uptake, indicating stronger targeting of the lung. MA-CEP-PMs also exhibited more potent anti-inflammatory effects.
DiscussionThis study focused on the short-term therapeutic effects of ALI, whereas the clinical management of lung injury often requires long-term intervention. Future research should therefore assess the long-term efficacy of this delivery system in chronic lung injury, along with determining its safety profile and potential impacts on extra-pulmonary organs. While the involvement of the NF-κB pathway in the anti-inflammatory effects has been confirmed, it remains to be deciphered whether mannose modification synergistically regulates other signaling pathways and what the specific intracellular targets of CEP are, which would require further exploration through detailed molecular biology experiments.
ConclusionThe MA-CEP-PMs significantly improved CEP bioavailability and increased lung targeting. They exhibited good safety and had a significant effect on ALI management.
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Smart Stimuli-Responsive Drug Delivery Systems for Advanced Diabetes Management
Authors: Km. Preeti Jaiswal, Monika1*, Rupa Mazumder and Avijit MazumderAvailable online: 04 November 2025More LessTraditional treatment methods for the management of diabetes, such as oral hypoglycemic medications and insulin injections, include drawbacks like systemic adverse effects, inconsistent medication levels, and low compliance. To avoid difficulties, glycemic levels in diabetic patients, a long-term metabolic condition, must be precisely and consistently controlled. Smart therapeutic systems allow for precise, on-demand medication release in response to local physiological or environmental cues, such as glucose levels, pH, temperature, or enzyme activity. They provide a possible substitute for conventional diabetic therapies. As these systems only administer medications when and where needed, they reduce side effects while simultaneously increasing therapeutic efficacy and patient compliance. These systems are designed to respond to signals from external sources (such as light, ultrasound, or magnetic fields) or stimuli like temperature, pH, glucose levels, and enzymes. As they use glucose-sensitive substances like phenylboronic acid, glucose oxidase, or polymers to precisely release insulin in hyperglycemic circumstances, glucose-responsive delivery methods are essential for diabetes. This review discusses a stimuli-responsive drug delivery system designed for diabetes treatment, with a focus on the developments in biomaterials, nanotechnology, and engineering that improve its effectiveness and biocompatibility. Along with the possibility of combining a stimuli-responsive drug delivery system with wearable technology for continuous glucose monitoring and intelligent insulin delivery, issues, such as manufacturing complexity, stability, and patient safety, are also addressed. The stimuli-responsive drug delivery system has the potential to revolutionize diabetes management by bridging the gap between physiological needs and therapeutic delivery, providing better glucose control, fewer side effects, and an enhanced standard of living for patients.
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Applications of Proteomics, Glycomics, and Metabolomics Analyses in Systemic Lupus Erythematosus
Authors: Rui Xu, Guosong Zhang, Shifang Wang, Tao Yang and Canjian WangAvailable online: 04 November 2025More LessSystemic Lupus Erythematosus (SLE) is a multifactorial autoimmune disorder influenced by genetic predisposition, immune dysregulation, environmental triggers, and epigenetic modifications. Despite advances in treatment, many patients experience recurrent symptoms and adverse effects. Recent large-scale studies have revealed significant alterations in proteins, glycopeptides, and metabolites in SLE, deepening our understanding of its pathogenesis. Emerging omics technologies, such as proteomics, glycomics, and metabolomics, enable the high-throughput identification of disease-related biomarkers. However, biological processes are typically driven by the interplay among multiple molecular layers. Therefore, integrative multi-omics approaches have become essential for uncovering potential biomarkers and risk factors. This review summarizes the classification of SLE biomarkers and recent advances in diagnostic applications across proteomics, glycomics, and metabolomics, aiming to support the development of more precise diagnostic strategies for SLE.
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A Lack of Studies on the Metabolism and Disposition of Hot Compound Class: Triphenylphosphonium-Conjugated Compounds
Available online: 03 November 2025More Less
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Study on the Mechanism of Anti-Cerebral Ischemia-Reperfusion Injury of Ai Pian Based on Network Pharmacology and Metabolomics
Authors: Jianing Lian, Yilun Ma, Dazhong Lu, Peiru Wang, Mengmeng Zhang and Taiwei DongAvailable online: 31 October 2025More LessObjectiveThe objective of this study was to investigate the mechanism of anti-cerebral ischemia-reperfusion injury (anti-CIRI) of Ai pian by using the network pharmacology approach combined with serum metabolomics technique based on UPLC-MS.
MethodsThe cerebral ischemia-reperfusion injury (CIRI) model was established by middle cerebral artery occlusion (MCAO). The therapeutic effect of Ai pian on CIRI rats was evaluated by behavioral test, 2,3,5-triphenyltetrazolium chloride (TTC) staining, Nissl staining, and hematoxylin-eosin (HE) staining. The active compound–potential target–disease network for Ai Pian in the treatment of CIRI was established using network pharmacology methods. Rat serum was detected by the metabolomics technique based on UPLC-MS. A Western blot was used to validate common targets of the network pharmacology approach combined with serum metabolomics.
ResultsThe process of treating CIRI with Ai Pian involved regulating enzyme, nuclear receptor, and transcription factor activity, managing the inflammatory response, and participating in biofilm composition. Twenty endogenous potential biomarkers were screened and submitted to MetaboAnalyst 6.0 for pathway and enrichment analysis. Four metabolic pathways were identified: butanoate metabolism, fructose and mannose metabolism, alanine, aspartate, and glutamate metabolism, and pyrimidine metabolism. Fructose and mannose metabolism and pyrimidine metabolism were two key pathways. Western blot analysis suggested that DHODH, TYMS, and AKR1B1 may be targets through which therapeutic effects are exerted.
DiscussionThe present study made preliminary predictions on the possible mechanisms of Ai Pian against CIRI. Differential metabolites were screened and identified, and the relevant metabolic pathways potentially affected by Ai Pian were discovered to understand the importance of these markers in health and disease. However, there were also some limitations, further exploration of the molecular mechanisms at the transcriptional level was necessary to make the experimental results more reliable.
ConclusionThis research contributed to the development of Ai pian as an adjunctive drug for treating CIRI and provided a basis for further research on CIRI.
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A Population Pharmacokinetics Model of Busulfan in Pediatric Patients with Thalassemia Major
Authors: Fangyuan Lai, Dongwei Cui, Yue Li, Sixi Liu, Zebin Chen, Qiru Su, Shijian Xiang, Xiaoqin Feng, Fang Yao and Xuejuan LiAvailable online: 15 October 2025More LessPurposeThis research aimed to establish a population pharmacokinetic (PPK) model for busulfan (Bu) in Chinese pediatric patients with thalassemia major. We analyzed pharmacokinetic (PK) parameter variability and explored potential covariates affecting Bu disposition using patient data. These findings are intended to support the optimization and personalization of Bu dosage regimens for children with thalassemia major.
MethodsConcentration-time samples were collected retrospectively from 62 pediatric patients with thalassemia major. These patients had previously received intravenous Bu as a preparatory regimen for allogeneic hematopoietic stem cell transplantation (allo-HSCT). A PPK model of Bu was developed through nonlinear mixed-effects modeling. This modeling process, conducted using NONMEM software, concurrently involved data analysis and examination of the effect of covariates on Bu pharmacokinetics. For validation purposes, the resulting model was evaluated against an external dataset consisting of 20 individuals.
ResultsThe pharmacokinetic results were optimally analyzed using a model that incorporated a one-compartment model with first-order elimination. Body surface area (BSA) was subsequently identified as the most significant factor influencing both Bu clearance (CL) and volume of distribution (V). Diagnostic evaluations, encompassing goodness-of-fit plots, normalized prediction distribution errors, and visual predictive checks, confirmed the satisfactory fit and predictability of the final PPK model. Moreover, prediction-based diagnostic indices (MDPE%, 15.75; MAPE%, 22.26; F20%, 45.71; and F30%, 58.57) from external validation showed that no significant bias was detected when comparing the model's predicted concentrations against the observed data.
ConclusionThe present study developed the first PPK model characterizing the pharmacokinetics of Bu specifically in children with thalassemia major. This study's final PPK model demonstrated that BSA was the key predictive covariate for CL and V.
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Pharmacokinetics of Trelagliptin in Rats after Exposure to Acute and Chronic High Altitude Hypoxia
Authors: Zhilan Huan, Delong Duo, Ni Zhao, Ye Chang, Guiqin Xu, Xue Wu and Yafeng WangAvailable online: 15 October 2025More LessbackgroundAs a long-acting DPP-4 inhibitor administered orally once a week, trelagliptin can address the issues of frequent medication and poor compliance associated with traditional hypoglycemic drugs.
MethodsThe Hypoxia model in rats was constructed at an altitude of approximately 4300 meters. The plasma concentration of trelagliptin was determined by LC-MS/MS. The biochemical indices and the protein expression levels of P-gp and OCT2 in the kidneys of rats were determined to explain the possible reasons for the pharmacokinetic changes of trelagliptin.
ResultsThis study demonstrated that the pharmacokinetic parameters of trelagliptin were significantly changed in high-altitude hypoxic environments. Compared with the control group, the AUC, MRT, t1/2, and Vd were remarkably increased during acute and chronic hypoxia, while the CL and Ke were decreased. Additionally, the biochemical indexes and protein expression of P-gp and OCT2 were significantly altered.
ConclusionThe study demonstrated that high-altitude hypoxia significantly altered trelagliptin's pharmacokinetics, slowing clearance, prolonging elimination half-life and residence time, and increasing bioavailability. These changes suggested that the optimal therapeutic dosage of trelagliptin should be reassessed under hypoxic exposure.
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Mass Balance and Metabolic Profiling of Avacopan, a Selective C5a Receptor 1 Antagonist, in Healthy Humans
Available online: 10 October 2025More LessIntroductionAvacopan (Tavneos®) is approved as an oral adjunctive treatment at a dose of 30 mg twice daily with food for adult patients with severe active granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (MPA) in combination with standard therapy including glucocorticoids.
MethodsIn this pharmacokinetic (PK) study, the absorption, metabolism, and excretion of avacopan were evaluated following a single 100 mg/400 μCi oral 14C-avacopan dose solution in six healthy male participants. The mass balance recovery, plasma concentrations, and metabolite profile in plasma, urine, and feces were determined.
ResultsFecal and renal excretion accounted for 77.2% and 9.5%, respectively, of the total administered radioactivity, with none of the mono- or bis-oxidation metabolites present at greater than 7% of the total radioactive dose. In urine, intact avacopan was present at <1% of the radioactive dose. In feces, intact avacopan was present at 8.7%, which represented 6.7% of the total radioactive dose, suggesting at least 93.3% of the radioactive dose was absorbed. The predominant component in plasma was avacopan, which accounted for 18.0% of the dose. The major circulating metabolite, M1, a monohydroxylation metabolite with similar potency in C5a receptor inhibition as avacopan, accounted for 11.9% of the total radioactivity.
DiscussionThe primary route of elimination of avacopan is phase I metabolism, followed by biliary excretion of the metabolites. CYP3A4 is the primary isozyme involved in the in vitro metabolism of avacopan and formation of metabolite M1.
ConclusionStudy results provide a definitive assessment of the absorption, elimination, and nature of metabolism of avacopan in humans.
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The Intricacies of Polypharmacy and Drug Interactions in Schizophrenia Treatment
Authors: Jyotsana Dwivedi, Mohd Seemab, Pranay Wal, Piyali Dey, Thirumalaikumaran Rathinam, Avula Dhamini and Abida KhanAvailable online: 10 October 2025More LessIntroductionPolypharmacy is frequently practiced in the management of schizophrenia due to its chronic nature, recurrent relapses, and associated comorbidities. While combining psychotropic medications may benefit patients with treatment-resistant symptoms, it poses risks such as drug–drug interactions (DDIs), adverse effects, and reduced medication adherence. The absence of uniform prescribing standards further complicates clinical decision-making.
MethodsThis narrative review was conducted using a scoping methodology. Databases including PubMed, Scopus, and Web of Science were searched for English-language publications from 2000 to 2024. Search terms included “schizophrenia,” “polypharmacy,” “drug–drug interactions,” “clinical outcomes,” and “pharmacogenetics.” Eligible sources included clinical trials, observational studies, systematic reviews, and treatment guidelines. Exclusion criteria were non-English articles, gray literature, and individual case reports.
ResultsPolypharmacy is reported in 30–60% of individuals with schizophrenia, especially in institutionalized or treatment-resistant populations. Treatment regimens often involve multiple antipsychotics along with adjunctive antidepressants or mood stabilizers. This approach is associated with increased risks of metabolic syndrome, cardiovascular events (e.g., QT prolongation), extrapyramidal symptoms, and decreased adherence. Interindividual variability in pharmacogenetics further affects drug efficacy and safety. Innovative approaches like genotype-guided therapy and computerized clinical decision-support systems are promising but not yet widely implemented.
DiscussionAlthough polypharmacy may offer symptomatic relief in specific scenarios, it requires careful management due to its potential to cause harm. Rational prescribing, close monitoring, and attention to individual patient factors such as pharmacogenetic profiles are essential to optimize therapy.
ConclusionEnsuring a balance between therapeutic benefit and adverse effects is crucial when employing polypharmacy in schizophrenia treatment. Integrating personalized medicine strategies, regular monitoring, and deprescribing practices when feasible can enhance clinical outcomes and patient safety.
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Metabolomics and Network Pharmacology Analyses of Yiqi Huazhuo Decoction in Regulating EGFR Signaling and Metabolic Pathways in Type 2 Diabetes with Insulin Resistance: In Vivo Validation
Authors: Sinan Li, Jiaying Liu and Siying WengAvailable online: 24 September 2025More LessIntroductionType 2 diabetes mellitus (T2DM), characterized by insulin resistance (IR) and hepatic ectopic lipid deposition (ELD), poses a complex metabolic challenge. This study aimed to elucidate the mechanisms of Yiqi Huazhuo Decoction (YD) through an integrated approach combining network pharmacology and metabolomics. T2DM is marked by impaired insulin signaling and disrupted hepatic lipid metabolism, resulting in a vicious cycle that accelerates disease progression. While Traditional Chinese Medicine (TCM), such as YD, demonstrates potential in modulating these dysfunctions, its underlying molecular mechanisms remain to be fully clarified.
Materials and MethodsA diabetic fat rat model was used to evaluate the efficacy of YD. UPLC-MS characterized the main metabolites found in YD. After an 8-week intervention, physiological indices and hepatic pathology were assessed. Network pharmacology identified bioactive metabolites and targets, which were validated by molecular docking. Untargeted metabolomics was employed to analyze hepatic metabolic changes.
ResultsYD improved glucose/lipid metabolism, insulin sensitivity, and hepatic function. Network pharmacology revealed that YD acts via the EGFR and PI3K-Akt/IL-17 pathways. Molecular docking confirmed luteolin-EGFR binding. Metabolomics identified 20 altered metabolites in the biosynthesis of unsaturated fatty acids. Multi-omics analysis revealed that YD regulated EGFR and hepatic metabolic networks.
DiscussionThe multi-metabolite, multi-target mechanism of YD distinguishes it apart from single-target drugs, such as metformin. The binding of luteolin to EGFR may potentially reactivate the PI3K-Akt signaling pathway, thereby enhancing insulin sensitivity. Regulation of metabolic pathways, including the biosynthesis of unsaturated fatty acids, contributes to the reduction of hepatic lipid deposition. These findings underscore the capacity of YD to disrupt the IR-ELD cycle in T2DM.
ConclusionYD ameliorates T2DM-IR and hepatic ELD by modulating EGFR signaling and metabolic pathways, providing multi-omics evidence for its clinical application.
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Comprehensive Insights into Licochalcone A: its Distribution, Biosynthesis, Metabolism, and Pharmacological Effects
Authors: Xiaoxiao Wang, Jinrui Liu, Wei Li, Xingjie Tao, Chenxi Yu, Junbo Xie and Yanqing ZhangAvailable online: 25 August 2025More LessLicochalcone A (LCA) is an important secondary metabolite in licorice that has attracted extensive attention due to its unique species-specific distribution characteristics and various pharmacodynamic activities, particularly its anti-inflammatory and anti-cancer effects. LCA was originally considered exclusive to Glycyrrhiza inflata Batal. However, further analyses have shown its distribution in different licorice species, extending its known distribution among licorice species and suggesting a broader role in secondary metabolism. Nevertheless, the complex chemical synthesis of LCA presents challenges in regioselectivity control. The oral bioavailability of LCA is limited due to the intestinal first-pass effect, and its metabolic mechanism has not yet been fully elucidated. These issues restrict the therapeutic effects and practical applications of LCA in vivo. In recent years, advancements in optimizing synthetic pathways and developing new delivery systems have significantly improved the efficacy of LCA while also achieving notable breakthroughs in its safety. This review examines the distribution patterns, synthesis methods, in vivo metabolic processes, pharmacological activities, and current application status of LCA, while also exploring future research directions. However, its metabolic mechanisms and prospects for clinical application still require further investigation in the future. A multi-source database search related literature employed “Licochalcone A”as the anchor term, synergized with species taxonomy (Glycyrrhiza), biogeographic patterns, and phytochemical dynamics (biosynthesis/metabolism).
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Emerging Approaches in Data-Driven Drug Discovery for Rare Diseases
Available online: 25 August 2025More LessRare diseases present unique challenges in drug discovery and development, primarily due to small patient populations, limited clinical data, and significant variability in disease mechanisms. The primary objective of this review is to examine the integration of pharmacokinetics (PK) and drug metabolism data into data-driven drug discovery approaches, particularly in the context of rare diseases. By incorporating advanced computational techniques such as Machine Learning (ML) and Artificial Intelligence (AI), researchers can better predict PK parameters, optimize drug candidates, and identify personalized therapeutic strategies. AI integration with genomic and proteomic data reveals previously unidentifiable pathways, fostering collaboration among researchers, clinicians, and pharmaceutical companies. This interdisciplinary approach reduces development timelines and costs while enhancing the precision and effectiveness of therapies for patients with rare diseases. This review highlights the critical role of absorption, distribution, metabolism, and excretion (ADME) in understanding drug behavior in genetically diverse populations, thereby enabling the development of tailored treatments for patients with rare diseases. Additionally, it evaluates the opportunities and limitations of integrating PK/PD (pharmacodynamics) models with multi-omics data to improve drug discovery efficiency. Key examples of enzyme-drug interactions, metabolic pathway analysis, and AI-based PK simulations are discussed to illustrate advancements in predictive accuracy and drug safety. This review concludes by emphasizing the transformative potential of integrating PK and metabolism studies into the broader framework of data-driven drug discovery, ultimately accelerating therapeutic innovation and addressing unmet medical needs in rare diseases.
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Bioactive Herbs for Liver Disorders: A Phyto-Pharmacological Review
Authors: Poonam Sahu and Trilochan SatapathyAvailable online: 21 August 2025More LessIntroductionThis review aims to explore the therapeutic potential and safety of herbal bioactive compounds in the treatment of various liver disorders. As the liver plays a critical role in digestion, detoxification, energy storage, and protein synthesis, any impairment in its function can lead to significant health complications. The study aims to identify effective herbal agents that may support liver health.
MethodsA comprehensive literature search was conducted using scientific databases and platforms including Web of Science, Scopus, PubMed, HINARI, ScienceDirect, and Google Scholar. The review includes studies that investigate the hepatoprotective potential of herbal bioactives, while research related to hepatic cancers was excluded to maintain a focus on non-malignant liver disorders.
ResultsThe review identifies several medicinal plants and their active constituents that exhibit hepatoprotective properties. These bioactives function through various pharmacological mechanisms at the molecular level. Common liver conditions addressed include fatty liver, hepatitis, fibrosis, steatosis, and cirrhosis. The reviewed compounds demonstrate antioxidant, anti-inflammatory, and antifibrotic activities, supporting their role in liver disease management.
DiscussionThe findings support growing evidence that herbal bioactives can modulate key molecular pathways involved in liver disorders. These results align with existing studies highlighting the benefits of plant-based treatments. However, the limitations include a lack of clinical trial data, poor bioavailability of some compounds, and the need for standardized formulations. Further research is necessary to validate these results in human populations.
ConclusionHerbal bioactives such as flavonoids, polyphenols, alkaloids, glycosides, saponins, vitamins, and essential oils show promising hepatoprotective effects. This review emphasizes the importance of understanding their precise molecular mechanisms and ADME (absorption, distribution, metabolism, and excretion) profiles. These insights are crucial for developing safe, effective, and standardized herbal therapies for liver disease management.
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