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脂质体紫杉醇比生物等效剂量的紫杉醇引起的血液学和心血管并发症更少。

Liposomal paclitaxel induces fewer hematopoietic and cardiovascular complications than bioequivalent doses of Taxol.

机构信息

Graduate Institute of Life Sciences, National Defense Medical Center, Taipei 114, Taiwan, R.O.C.

Institute of Cellular and Organismic Biology, Academia Sinica, Taipei 115, Taiwan, R.O.C.

出版信息

Int J Oncol. 2018 Sep;53(3):1105-1117. doi: 10.3892/ijo.2018.4449. Epub 2018 Jun 21.

Abstract

Paclitaxel (PTX) exhibits potent antineoplastic activity against various human malignancies; however, clinical application must overcome the inherent hydrophobicity of this molecule. The commercialized Taxol formulation utilizes Cremophor EL (CrEL)/ethanol as a solvent to stabilize and dispense PTX in an aqueous solution. However, adverse CrEL‑induced hypersensitivity reactions have been reported in ~30% of recipients, and 40% of patients receiving premedication may also experience this adverse effect. Therefore, the development of a CrEL-free delivery system is crucial, in order to fully exploit the therapeutic efficacy of PTX. In the present study, a novel liposomal PTX (lipo‑PTX) formulation was optimized with regards to encapsulation rate and long‑term stability, arriving at a molar constituent ratio of soybean phosphatidylcholine:cholesterol:N-(carbonyl-methoxy-poly-ethylene glycol 2000)‑1,2‑distearoyl‑sn-glycero‑3-phosphoethanolamine, sodium salt:PTX at 95:2:1:2. Comparable doses of lipo‑PTX and Taxol were bioequivalent in terms of therapeutic efficacy in xenograft tumor models. However, the systemic side effects, including hematopoietic toxicity, acute hypersensitivity reactions and cardiac irregularities, were significantly reduced in lipo‑PTX‑treated mice compared with those infused with reference formulations of PTX. In conclusion, the present study reported that lipo‑PTX exhibited a higher therapeutic index than clinical PTX formulations.

摘要

紫杉醇(PTX)对多种人类恶性肿瘤具有强大的抗肿瘤活性;然而,临床应用必须克服该分子固有的疏水性。商业化的 Taxol 制剂利用 Cremophor EL(CrEL)/乙醇作为溶剂,在水溶液中稳定和分配 PTX。然而,约 30%的接受者报告了 CrEL 诱导的过敏反应,即使接受了预先用药,40%的患者也可能会出现这种不良反应。因此,开发无 CrEL 递送系统至关重要,以便充分发挥 PTX 的治疗效果。在本研究中,优化了一种新型的紫杉醇脂质体(lipo-PTX)制剂的包封率和长期稳定性,达到了大豆磷脂酰胆碱:胆固醇:N-(羰基-甲氧基-聚乙二醇 2000)-1,2-二硬脂酰-sn-甘油-3-磷酸乙醇胺,钠盐:PTX 的摩尔组成比为 95:2:1:2。脂质体-PTX 和 Taxol 的等效剂量在异种移植肿瘤模型中的疗效方面具有生物等效性。然而,与输注参考制剂的 PTX 相比,脂质体-PTX 治疗的小鼠的全身副作用,包括血液毒性、急性过敏反应和心律失常,明显减少。总之,本研究表明,脂质体-PTX 的治疗指数高于临床 PTX 制剂。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb8e/6065427/68b385c879b7/IJO-53-03-1105-g00.jpg

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