The aryl hydrocarbon receptor (AhR) plays a crucial role in regulating many physiological processes. Activating the AhR-CYP1A1 axis has emerged as a novel therapeutic strategy against various inflammatory diseases. Here, a practical in situ cell-based fluorometric assay was constructed to screen AhR-CYP1A1 axis modulators, via functional sensing of CYP1A1 activities in live cells. Firstly, a cell-permeable, isoform-specific enzyme-activable fluorogenic substrate for CYP1A1 was rationally constructed for in-situ visualizing the dynamic changes of CYP1A1 function in living systems, which was subsequently used for discovering the efficacious modulators of the AhR-CYP1A1 axis. Following screening of a compound library, LAC-7 was identified as an efficacious activator of the AhR-CYP1A1 axis, which dose-dependently up-regulated the expression levels of both CYP1A1 and AhR in multiple cell lines. LAC-7 also suppressed macrophage M1 polarization and reduced the levels of inflammatory factors in LPS-induced bone marrow-derived macrophages. Animal tests showed that LAC-7 could significantly mitigate DSS-induced ulcerative colitis and LPS-induced acute lung injury in mice, and markedly reduced the levels of multiple inflammatory factors. Collectively, an optimized fluorometric cell-based assay was devised for in situ functional imaging of CYP1A1 activities in living systems, which strongly facilitated the discovery of efficacious modulators of the AhR-CYP1A1 axis as novel anti-inflammatory agents.

Human carboxylesterase 2A (hCES2A) plays pivotal roles in prodrug activation and hydrolytic metabolism of ester-bearing chemicals. Targeted inhibition of intestinal hCES2A represents a feasible strategy to mitigate irinotecan-triggered gut toxicity (ITGT), but the orally active, selective, and efficacious hCES2A inhibitors are rarely reported. Here, a novel drug-like hCES2A inhibitor was developed via three rounds of structure-based drug design (SBDD) and structural optimization. Initially, donepezil was identified as a moderate hCES2A inhibitor from 2000 US Food and Drug Administration (FDA)-approved drugs. Following two rounds of SBDD and structural optimization, a donepezil derivative (B7) was identified as a strong reversible hCES2A inhibitor. Subsequently, nine B7 carbamates were rationally designed, synthesized and biologically assayed. Among all synthesized carbamates, C3 showed the most potent time-dependent inhibition on hCES2A (IC₅₀ = 0.56 nmol/L), excellent specificity and favorable drug-like properties. C3 could covalently modify the catalytic serine of hCES2A with high selectivity, while this agent also showed favorable safety profiles, high intestinal exposure, and impressive effects for ameliorating ITGT in both human intestinal organoids and tumor-bearing mice. Collectively, this study showcases a rational strategy for developing drug-like and serine-targeting covalent inhibitors against target serine hydrolase(s), while C3 emerges as a promising orally active drug candidate for ameliorating ITGT.

Objective To evaluate five types of DIC scoring systems based on sepsis patients,to explore the values of different DIC scoring systems in the occurrence and prognosis of DIC in sepsis patients,and to compare the applicability of different DIC scoring systems for sepsis complicated with DIC.Methods Laboratory indexes and clinical data from sepsis patients who had been hospitalized in Gansu Provincial People's Hospital from December 1,2019 to December 31,2021 were retrospectively analyzed within 24 hours.Five types of DIC scoring systems were used to score,and the difference of diagnostic rate and discharge outcome in sepsis patients with different severity was compared.The ROC curves of five DIC scoring systems were established to evaluate the accu-racy of DIC in sepsis patients.Results The fatality rate of sepsis increased with the severity of sepsis(P<0.05).There were statistically significant differences in discharge outcomes between DIC and non-DIC in the five scoring systems(P<0.05).JMHW,CDSS and part of ISTH were detected in JAAM cases,while ISTH was detected in non-dominant ISTH cases.ISTH,JAAM,JMHW,CDSS,and non-dominant ISTH5 scoring systems were used to diagnose DIC,and absence of full health restoration and death were 3.0,3.8,4.2,3.9,and 3.0 times higher than non-DIC cases,respectively.Conclusion JAAM scoring system has higher diagnostic rate and sensitivity for adult sepsis.CDSS and JMHW scoring systems are more accurate in predicting the prognosis of sepsis patients.

BACKGROUND:We aimed to observe the dynamic changes in glucose metabolic reprogramming-related parameters and their ability to predict neurological prognosis and all-cause mortality in cardiac arrest patients after the restoration of spontaneous circulation(ROSC). METHODS:Adult cardiac arrest patients after ROSC who were admitted to the emergency or cardiac intensive care unit of the First Affiliated Hospital of Dalian Medical University from August 1,2017,to May 30,2021,were enrolled.According to 28-day survival,the patients were divided into a non-survival group(n=82)and a survival group(n=38).Healthy adult volunteers(n=40)of similar ages and sexes were selected as controls.The serum levels of glucose metabolic reprogramming-related parameters(lactate dehydrogenase[LDH],lactate and pyruvate),neuron-specific enolase(NSE)and interleukin 6(IL-6)were measured on days 1,3,and 7 after ROSC.The Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ)score and Sequential Organ Failure Assessment(SOFA)score were calculated.The Cerebral Performance Category(CPC)score was recorded on day 28 after ROSC. RESULTS:Following ROSC,the serum LDH(607.0 U/L vs.286.5 U/L),lactate(5.0 mmol/L vs.2.0 mmol/L),pyruvate(178.0 μmol/L vs.70.9 μmol/L),and lactate/pyruvate ratio(34.1 vs.22.1)significantly increased and were higher in the non-survivors than in the survivors on admission(all P＜0.05).Moreover,the serum LDH,pyruvate,IL-6,APACHE Ⅱ score,and SOFA score on days 1,3 and 7 after ROSC were significantly associated with 28-day poor neurological prognosis and 28-day all-cause mortality(all P＜0.05).The serum LDH concentration on day 1 after ROSC had an area under the receiver operating characteristic curve(AUC)of 0.904[95％confidence interval[95％CI]:0.851-0.957])with 96.8％specificity for predicting 28-day neurological prognosis and an AUC of 0.950(95％CI:0.911-0.989)with 94.7％specificity for predicting 28-day all-cause mortality,which was the highest among the glucose metabolic reprogramming-related parameters tested. CONCLUSION:Serum parameters related to glucose metabolic reprogramming were significantly increased after ROSC.Increased serum LDH and pyruvate levels,and lactate/pyruvate ratio may be associated with 28-day poor neurological prognosis and all-cause mortality after ROSC,and the predictive efficacy of LDH during the first week was superior to others.

BACKGROUND:We aimed to observe the dynamic changes in glucose metabolic reprogramming-related parameters and their ability to predict neurological prognosis and all-cause mortality in cardiac arrest patients after the restoration of spontaneous circulation(ROSC). METHODS:Adult cardiac arrest patients after ROSC who were admitted to the emergency or cardiac intensive care unit of the First Affiliated Hospital of Dalian Medical University from August 1,2017,to May 30,2021,were enrolled.According to 28-day survival,the patients were divided into a non-survival group(n=82)and a survival group(n=38).Healthy adult volunteers(n=40)of similar ages and sexes were selected as controls.The serum levels of glucose metabolic reprogramming-related parameters(lactate dehydrogenase[LDH],lactate and pyruvate),neuron-specific enolase(NSE)and interleukin 6(IL-6)were measured on days 1,3,and 7 after ROSC.The Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ)score and Sequential Organ Failure Assessment(SOFA)score were calculated.The Cerebral Performance Category(CPC)score was recorded on day 28 after ROSC. RESULTS:Following ROSC,the serum LDH(607.0 U/L vs.286.5 U/L),lactate(5.0 mmol/L vs.2.0 mmol/L),pyruvate(178.0 μmol/L vs.70.9 μmol/L),and lactate/pyruvate ratio(34.1 vs.22.1)significantly increased and were higher in the non-survivors than in the survivors on admission(all P＜0.05).Moreover,the serum LDH,pyruvate,IL-6,APACHE Ⅱ score,and SOFA score on days 1,3 and 7 after ROSC were significantly associated with 28-day poor neurological prognosis and 28-day all-cause mortality(all P＜0.05).The serum LDH concentration on day 1 after ROSC had an area under the receiver operating characteristic curve(AUC)of 0.904[95％confidence interval[95％CI]:0.851-0.957])with 96.8％specificity for predicting 28-day neurological prognosis and an AUC of 0.950(95％CI:0.911-0.989)with 94.7％specificity for predicting 28-day all-cause mortality,which was the highest among the glucose metabolic reprogramming-related parameters tested. CONCLUSION:Serum parameters related to glucose metabolic reprogramming were significantly increased after ROSC.Increased serum LDH and pyruvate levels,and lactate/pyruvate ratio may be associated with 28-day poor neurological prognosis and all-cause mortality after ROSC,and the predictive efficacy of LDH during the first week was superior to others.

BACKGROUND:We aimed to observe the dynamic changes in glucose metabolic reprogramming-related parameters and their ability to predict neurological prognosis and all-cause mortality in cardiac arrest patients after the restoration of spontaneous circulation(ROSC). METHODS:Adult cardiac arrest patients after ROSC who were admitted to the emergency or cardiac intensive care unit of the First Affiliated Hospital of Dalian Medical University from August 1,2017,to May 30,2021,were enrolled.According to 28-day survival,the patients were divided into a non-survival group(n=82)and a survival group(n=38).Healthy adult volunteers(n=40)of similar ages and sexes were selected as controls.The serum levels of glucose metabolic reprogramming-related parameters(lactate dehydrogenase[LDH],lactate and pyruvate),neuron-specific enolase(NSE)and interleukin 6(IL-6)were measured on days 1,3,and 7 after ROSC.The Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ)score and Sequential Organ Failure Assessment(SOFA)score were calculated.The Cerebral Performance Category(CPC)score was recorded on day 28 after ROSC. RESULTS:Following ROSC,the serum LDH(607.0 U/L vs.286.5 U/L),lactate(5.0 mmol/L vs.2.0 mmol/L),pyruvate(178.0 μmol/L vs.70.9 μmol/L),and lactate/pyruvate ratio(34.1 vs.22.1)significantly increased and were higher in the non-survivors than in the survivors on admission(all P＜0.05).Moreover,the serum LDH,pyruvate,IL-6,APACHE Ⅱ score,and SOFA score on days 1,3 and 7 after ROSC were significantly associated with 28-day poor neurological prognosis and 28-day all-cause mortality(all P＜0.05).The serum LDH concentration on day 1 after ROSC had an area under the receiver operating characteristic curve(AUC)of 0.904[95％confidence interval[95％CI]:0.851-0.957])with 96.8％specificity for predicting 28-day neurological prognosis and an AUC of 0.950(95％CI:0.911-0.989)with 94.7％specificity for predicting 28-day all-cause mortality,which was the highest among the glucose metabolic reprogramming-related parameters tested. CONCLUSION:Serum parameters related to glucose metabolic reprogramming were significantly increased after ROSC.Increased serum LDH and pyruvate levels,and lactate/pyruvate ratio may be associated with 28-day poor neurological prognosis and all-cause mortality after ROSC,and the predictive efficacy of LDH during the first week was superior to others.

BACKGROUND:We aimed to observe the dynamic changes in glucose metabolic reprogramming-related parameters and their ability to predict neurological prognosis and all-cause mortality in cardiac arrest patients after the restoration of spontaneous circulation(ROSC). METHODS:Adult cardiac arrest patients after ROSC who were admitted to the emergency or cardiac intensive care unit of the First Affiliated Hospital of Dalian Medical University from August 1,2017,to May 30,2021,were enrolled.According to 28-day survival,the patients were divided into a non-survival group(n=82)and a survival group(n=38).Healthy adult volunteers(n=40)of similar ages and sexes were selected as controls.The serum levels of glucose metabolic reprogramming-related parameters(lactate dehydrogenase[LDH],lactate and pyruvate),neuron-specific enolase(NSE)and interleukin 6(IL-6)were measured on days 1,3,and 7 after ROSC.The Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ)score and Sequential Organ Failure Assessment(SOFA)score were calculated.The Cerebral Performance Category(CPC)score was recorded on day 28 after ROSC. RESULTS:Following ROSC,the serum LDH(607.0 U/L vs.286.5 U/L),lactate(5.0 mmol/L vs.2.0 mmol/L),pyruvate(178.0 μmol/L vs.70.9 μmol/L),and lactate/pyruvate ratio(34.1 vs.22.1)significantly increased and were higher in the non-survivors than in the survivors on admission(all P＜0.05).Moreover,the serum LDH,pyruvate,IL-6,APACHE Ⅱ score,and SOFA score on days 1,3 and 7 after ROSC were significantly associated with 28-day poor neurological prognosis and 28-day all-cause mortality(all P＜0.05).The serum LDH concentration on day 1 after ROSC had an area under the receiver operating characteristic curve(AUC)of 0.904[95％confidence interval[95％CI]:0.851-0.957])with 96.8％specificity for predicting 28-day neurological prognosis and an AUC of 0.950(95％CI:0.911-0.989)with 94.7％specificity for predicting 28-day all-cause mortality,which was the highest among the glucose metabolic reprogramming-related parameters tested. CONCLUSION:Serum parameters related to glucose metabolic reprogramming were significantly increased after ROSC.Increased serum LDH and pyruvate levels,and lactate/pyruvate ratio may be associated with 28-day poor neurological prognosis and all-cause mortality after ROSC,and the predictive efficacy of LDH during the first week was superior to others.

BACKGROUND:We aimed to observe the dynamic changes in glucose metabolic reprogramming-related parameters and their ability to predict neurological prognosis and all-cause mortality in cardiac arrest patients after the restoration of spontaneous circulation(ROSC). METHODS:Adult cardiac arrest patients after ROSC who were admitted to the emergency or cardiac intensive care unit of the First Affiliated Hospital of Dalian Medical University from August 1,2017,to May 30,2021,were enrolled.According to 28-day survival,the patients were divided into a non-survival group(n=82)and a survival group(n=38).Healthy adult volunteers(n=40)of similar ages and sexes were selected as controls.The serum levels of glucose metabolic reprogramming-related parameters(lactate dehydrogenase[LDH],lactate and pyruvate),neuron-specific enolase(NSE)and interleukin 6(IL-6)were measured on days 1,3,and 7 after ROSC.The Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ)score and Sequential Organ Failure Assessment(SOFA)score were calculated.The Cerebral Performance Category(CPC)score was recorded on day 28 after ROSC. RESULTS:Following ROSC,the serum LDH(607.0 U/L vs.286.5 U/L),lactate(5.0 mmol/L vs.2.0 mmol/L),pyruvate(178.0 μmol/L vs.70.9 μmol/L),and lactate/pyruvate ratio(34.1 vs.22.1)significantly increased and were higher in the non-survivors than in the survivors on admission(all P＜0.05).Moreover,the serum LDH,pyruvate,IL-6,APACHE Ⅱ score,and SOFA score on days 1,3 and 7 after ROSC were significantly associated with 28-day poor neurological prognosis and 28-day all-cause mortality(all P＜0.05).The serum LDH concentration on day 1 after ROSC had an area under the receiver operating characteristic curve(AUC)of 0.904[95％confidence interval[95％CI]:0.851-0.957])with 96.8％specificity for predicting 28-day neurological prognosis and an AUC of 0.950(95％CI:0.911-0.989)with 94.7％specificity for predicting 28-day all-cause mortality,which was the highest among the glucose metabolic reprogramming-related parameters tested. CONCLUSION:Serum parameters related to glucose metabolic reprogramming were significantly increased after ROSC.Increased serum LDH and pyruvate levels,and lactate/pyruvate ratio may be associated with 28-day poor neurological prognosis and all-cause mortality after ROSC,and the predictive efficacy of LDH during the first week was superior to others.

BACKGROUND:We aimed to observe the dynamic changes in glucose metabolic reprogramming-related parameters and their ability to predict neurological prognosis and all-cause mortality in cardiac arrest patients after the restoration of spontaneous circulation(ROSC). METHODS:Adult cardiac arrest patients after ROSC who were admitted to the emergency or cardiac intensive care unit of the First Affiliated Hospital of Dalian Medical University from August 1,2017,to May 30,2021,were enrolled.According to 28-day survival,the patients were divided into a non-survival group(n=82)and a survival group(n=38).Healthy adult volunteers(n=40)of similar ages and sexes were selected as controls.The serum levels of glucose metabolic reprogramming-related parameters(lactate dehydrogenase[LDH],lactate and pyruvate),neuron-specific enolase(NSE)and interleukin 6(IL-6)were measured on days 1,3,and 7 after ROSC.The Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ)score and Sequential Organ Failure Assessment(SOFA)score were calculated.The Cerebral Performance Category(CPC)score was recorded on day 28 after ROSC. RESULTS:Following ROSC,the serum LDH(607.0 U/L vs.286.5 U/L),lactate(5.0 mmol/L vs.2.0 mmol/L),pyruvate(178.0 μmol/L vs.70.9 μmol/L),and lactate/pyruvate ratio(34.1 vs.22.1)significantly increased and were higher in the non-survivors than in the survivors on admission(all P＜0.05).Moreover,the serum LDH,pyruvate,IL-6,APACHE Ⅱ score,and SOFA score on days 1,3 and 7 after ROSC were significantly associated with 28-day poor neurological prognosis and 28-day all-cause mortality(all P＜0.05).The serum LDH concentration on day 1 after ROSC had an area under the receiver operating characteristic curve(AUC)of 0.904[95％confidence interval[95％CI]:0.851-0.957])with 96.8％specificity for predicting 28-day neurological prognosis and an AUC of 0.950(95％CI:0.911-0.989)with 94.7％specificity for predicting 28-day all-cause mortality,which was the highest among the glucose metabolic reprogramming-related parameters tested. CONCLUSION:Serum parameters related to glucose metabolic reprogramming were significantly increased after ROSC.Increased serum LDH and pyruvate levels,and lactate/pyruvate ratio may be associated with 28-day poor neurological prognosis and all-cause mortality after ROSC,and the predictive efficacy of LDH during the first week was superior to others.

BACKGROUND:We aimed to observe the dynamic changes in glucose metabolic reprogramming-related parameters and their ability to predict neurological prognosis and all-cause mortality in cardiac arrest patients after the restoration of spontaneous circulation(ROSC). METHODS:Adult cardiac arrest patients after ROSC who were admitted to the emergency or cardiac intensive care unit of the First Affiliated Hospital of Dalian Medical University from August 1,2017,to May 30,2021,were enrolled.According to 28-day survival,the patients were divided into a non-survival group(n=82)and a survival group(n=38).Healthy adult volunteers(n=40)of similar ages and sexes were selected as controls.The serum levels of glucose metabolic reprogramming-related parameters(lactate dehydrogenase[LDH],lactate and pyruvate),neuron-specific enolase(NSE)and interleukin 6(IL-6)were measured on days 1,3,and 7 after ROSC.The Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ)score and Sequential Organ Failure Assessment(SOFA)score were calculated.The Cerebral Performance Category(CPC)score was recorded on day 28 after ROSC. RESULTS:Following ROSC,the serum LDH(607.0 U/L vs.286.5 U/L),lactate(5.0 mmol/L vs.2.0 mmol/L),pyruvate(178.0 μmol/L vs.70.9 μmol/L),and lactate/pyruvate ratio(34.1 vs.22.1)significantly increased and were higher in the non-survivors than in the survivors on admission(all P＜0.05).Moreover,the serum LDH,pyruvate,IL-6,APACHE Ⅱ score,and SOFA score on days 1,3 and 7 after ROSC were significantly associated with 28-day poor neurological prognosis and 28-day all-cause mortality(all P＜0.05).The serum LDH concentration on day 1 after ROSC had an area under the receiver operating characteristic curve(AUC)of 0.904[95％confidence interval[95％CI]:0.851-0.957])with 96.8％specificity for predicting 28-day neurological prognosis and an AUC of 0.950(95％CI:0.911-0.989)with 94.7％specificity for predicting 28-day all-cause mortality,which was the highest among the glucose metabolic reprogramming-related parameters tested. CONCLUSION:Serum parameters related to glucose metabolic reprogramming were significantly increased after ROSC.Increased serum LDH and pyruvate levels,and lactate/pyruvate ratio may be associated with 28-day poor neurological prognosis and all-cause mortality after ROSC,and the predictive efficacy of LDH during the first week was superior to others.