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医师主导的新型血管生成肽 AG30/5C 用于治疗严重肢体溃疡患者的首次人体临床研究。

Physician-initiated first-in-human clinical study using a novel angiogenic peptide, AG30/5C, for patients with severe limb ulcers.

机构信息

Department of Health Development and Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan.

Department of Dermatology, Graduate School of Medicine, Osaka University, Osaka, Japan.

出版信息

Geriatr Gerontol Int. 2017 Nov;17(11):2150-2156. doi: 10.1111/ggi.13051. Epub 2017 May 10.

Abstract

AIM

In patients with diabetes or ischemia, angiogenesis and infection control are required for chronic leg ulcers, which substantially impair patients' quality of life. We developed a novel functional peptide, named AG30/5C, with angiogenic and anti-microbial properties. Treatment with AG30/5C significantly accelerated the wound healing of full-thickness defects in mice. To evaluate the safety of AG30/5C in the treatment of leg ulcers, a physician-initiated clinical study was carried out.

METHODS

The first-in-human trial was designed as an open-label treatment with AG30/5C (0.1 mg/mL) given twice per day for 11 days, and with a follow-up period of 17 days. The inclusion criteria for severe skin ulcers were: (i) diabetes or critical limb ischemia; (ii) resistance to standard therapy for 1 month; and (iii) detection of methicillin-resistant Staphylococcus aureus in the skin ulcer.

RESULTS

Four patients were enrolled in this study, and two patients met these criteria. For the evaluation of safety, three adverse effects were reported as possibly related to AG30/5C treatment; however, these adverse effects were not severe and resolved during or after treatment. Thus, there were no safety concerns. In both patients, the size of the ulcer decreased after treatment (44.62% and 10.23% decrease), and further decreased after the follow-up period (73.85% and 10.23% decrease). The former patient was diagnosed as Werner syndrome and the skin ulcer was resistant to standard therapy; however, it was sensitive to AG30/5C treatment.

CONCLUSIONS

Topical treatment with AG30/5C for severe leg ulcers was safe, well tolerated and effective. Geriatr Gerontol Int 2017; 17: 2150-2156.

摘要

目的

糖尿病或缺血患者的慢性腿部溃疡需要进行血管生成和感染控制,这会极大地降低患者的生活质量。我们开发了一种具有血管生成和抗菌特性的新型功能肽,命名为 AG30/5C。AG30/5C 治疗可显著加速小鼠全层缺陷创面的愈合。为评估 AG30/5C 在治疗腿部溃疡中的安全性,进行了一项医生发起的临床研究。

方法

首次人体试验设计为开放性标签治疗,AG30/5C(0.1mg/mL)每天两次,共 11 天,随访期为 17 天。严重皮肤溃疡的纳入标准为:(i)糖尿病或严重肢体缺血;(ii)对标准治疗方案抵抗 1 个月;(iii)皮肤溃疡中检出耐甲氧西林金黄色葡萄球菌。

结果

本研究纳入了 4 名患者,其中 2 名患者符合这些标准。为了评估安全性,报告了 3 种可能与 AG30/5C 治疗相关的不良反应;然而,这些不良反应不严重,且在治疗期间或治疗后得到缓解。因此,不存在安全性问题。在这 2 名患者中,治疗后溃疡面积减小(分别减少 44.62%和 10.23%),随访期后进一步减小(分别减少 73.85%和 10.23%)。其中一名患者被诊断为 Werner 综合征,皮肤溃疡对标准治疗方案抵抗,但对 AG30/5C 治疗敏感。

结论

AG30/5C 治疗严重腿部溃疡安全、耐受良好且有效。老年医学与老年病学杂志 2017;17:2150-2156。

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