OBJECTIVETo systematically evaluate the clinical effects of cyclosporine A (CsA) and tacrolimus, which are calcineurin inhibitors, on lupus nephritis.

METHODIn this study, the clinical trials on treatment of lupus nephritis with cyclosporine A and tacrolimus published until May 2010 were searched at www.guideline.gov, www.nice.org.uk, mdm.ca/cpgsnew/cpgs/index.asp, www.show.scot.nhs.uk, www.nzgg.org.nz, www.eguid elines.co.uk, www.gin.net, Cochrane library, EMBASE, MEDLINE, Wanfang database, Chinese Journal full-text Database, Chongqing Weipu Database by using the methods of Cochrane systematic review. At the same time the information from related journals, professional data and network were hand-searched. The homogeneous evaluation was performed by meta-analysis.Statistical analysis of clinical data was performed by using RevMan 4.2 software provided by the Cochrane Collaboration.

RESULTA total of 214 reports were found, while only 7 randomized controlled trials met the inclusion criteria, 4 of them were on the treatment with CsA (treatment group) and cyclosporine (CTX) group (control group), and 3 of them were the on treatment with FK506 (treatment group) and CTX group (control group). There were 148 reports in the treatment of CsA and CTX group, while 185 reports in the treatment of FK506 and CTX group. Both CsA and tacrolimus group could decrease daily urinary protein. Tacrolimus group was good at reducing daily urinary protein as compared with CTX group, and the difference was statistically significant (Z = 2.8, P = 0.005), but there was no significant difference between CsA and CTX groups (Z = 1.08, P = 0.28). Tacrolimus group was good at complete remission as compared with CTX group (Z = 3.64, P = 0.0003), partial remission was similar in both groups (Z = 0.53, P = 0.6), and tacrolimus group was good at total remission (Z = 2.2, P = 0.03). There was no significant difference between CsA and CTX group in side effect within a short period, while FK506 had less side-effect than CTX group.

CONCLUSIONCompared with the treatment with CTX, tacrolimus was good at reducing daily urinary protein. CsA and CTX were similar in reducing daily urinary protein in the treatment of lupus nephritis. Tacrolimus resulted in better total remission than CTX and had less side effect. CsA and CTX groups were similar in side effect. On the whole, calcineurin inhibitor could significantly decrease daily urinary protein, and tacrolimus was better in treatment and had less side-effect than CTX. However, large scale, multicenter, well-designed clinical trials should be adopted to further confirm the conclusions.

Calcineurin Inhibitors ; Cyclosporine ; therapeutic use ; Enzyme Inhibitors ; therapeutic use ; Humans ; Lupus Nephritis ; drug therapy ; Tacrolimus ; therapeutic use

Lysine specific demethylase 1 (LSD1), a transcriptional corepressor or coactivator that serves as a demethylase of histone 3 lysine 4 and 9, has become a potential therapeutic target for cancer therapy. LSD1 mediates many cellular signaling pathways and regulates cancer cell proliferation, invasion, migration, and differentiation. Recent research has focused on the exploration of its pharmacological inhibitors. Natural products are a major source of compounds with abundant scaffold diversity and structural complexity, which have made a major contribution to drug discovery, particularly anticancer agents. In this review, we briefly highlight recent advances in natural LSD1 inhibitors over the past decade. We present a comprehensive review on their discovery and identification process, natural plant sources, chemical structures, anticancer effects, and structure-activity relationships, and finally provide our perspective on the development of novel natural LSD1 inhibitors for cancer therapy.
Antineoplastic Agents/therapeutic use* ; Enzyme Inhibitors/therapeutic use* ; Histone Demethylases/metabolism* ; Humans ; Lysine/therapeutic use* ; Neoplasms/drug therapy*

Antiviral drugs on influenza are important in the control program of influenza. Options for influenza treatment are currently limited to using the neuraminidase inhibitors (NAIs). Given limited effectiveness of NAIs and related resistance, there remains an urgent need for the development of influenza antiviral drugs that can improve the efficacy and provide low propensity of viral resistance. Several influenza-related antiviral drugs that are currently under the late-stage clinical trials all appear differently in the mechanism of action. It is hoped that when new antiviral drugs are licensed, care and outcomes of severe influenza cases will be improved.
Antiviral Agents/therapeutic use* ; Drug Resistance, Viral ; Enzyme Inhibitors/therapeutic use* ; Humans ; Influenza, Human/drug therapy* ; Neuraminidase/therapeutic use*

OBJECTIVETo evaluate the response rate and adverse reactions of exemestane (a new aromatase inactivator) in the treatment of postmenopausal women with advanced breast cancer.

METHODSOne hundred and seventy-three patients with advanced breast cancer entered this study with two patients excluded because of postmenopausal time being less than one year. Therefore, 173 patients could be evaluated for adverse events and 171 patients could be evaluated for efficacy. Exemestane, 25 mg orally daily for 4 weeks as one cycle was given.

RESULTSIn the 171 patients evaluated for efficacy, 4 (2.3%) experienced a complete response (CR) and 40 (23.4%) a partial response (PR), with the overall response rate of 25.7%. Ninety patients (52.6%) had stable disease (SD), with 25 having SD for at least 24 weeks. The clinical benefit (CR + PR + SD > or = 24 weeks) was shown in 69 (40.4%) patients. Progressive disease (PD) was shown in 37 (21.6%) patients. The untreated patients had a higher objective response rate (33.8%) than the retreated ones (18.1%) with significant difference (P = 0.019 7). The response rates for soft-tissue, bone involvement and visceral metastasis were 32.8%, 23.9%, and 12.4% (P = 0.002). There was no significant difference in different ages, time of menopause, disease-free interval or receptor status (P > 0.05). Drug-related adverse events were gastric discomfort (17.9%), malaise (17.9%), nausea (13.9%), hot flushes (11.0%) and dysphoria (5.8%). Other side reactions and abnormal laboratory parameters were observed occasionally which were irrelevant.

CONCLUSIONExemestane can be used to treat postmenopausal women with advanced breast cancer giving only mild adverse reactions which are well tolerated.

Adult ; Aged ; Androstadienes ; adverse effects ; therapeutic use ; Antineoplastic Agents ; therapeutic use ; Aromatase Inhibitors ; Breast Neoplasms ; drug therapy ; Enzyme Inhibitors ; therapeutic use ; Female ; Humans ; Middle Aged ; Postmenopause

Angiotensin-Converting Enzyme Inhibitors ; therapeutic use ; Anticoagulants ; therapeutic use ; Cyclophosphamide ; therapeutic use ; Cyclosporine ; therapeutic use ; Fish Oils ; therapeutic use ; Glomerulonephritis, IGA ; therapy ; Glucocorticoids ; therapeutic use ; Humans ; Mycophenolic Acid ; analogs & derivatives ; therapeutic use

Adrenergic beta-Antagonists ; therapeutic use ; Angiotensin-Converting Enzyme Inhibitors ; therapeutic use ; Contraindications ; Heart Failure ; drug therapy ; Humans

Angiotensin-Converting Enzyme Inhibitors ; therapeutic use ; Atrial Fibrillation ; prevention & control ; Humans ; Mineralocorticoid Receptor Antagonists ; therapeutic use ; Renin-Angiotensin System

Angiotensin-Converting Enzyme Inhibitors ; therapeutic use ; Heart Failure ; therapy ; Humans ; Stem Cell Transplantation

Angiotensin-Converting Enzyme Inhibitors ; therapeutic use ; Follow-Up Studies ; Heart Failure ; drug therapy ; Humans ; Retrospective Studies

Angiotensin-Converting Enzyme Inhibitors/therapeutic use* ; COVID-19/drug therapy* ; Humans ; Hypertension ; SARS-CoV-2