• 한국임상약학회지
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• 제34권1호
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• pp.71-78
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• 2024

Background: Oral cancer drugs, particularly tyrosine kinase inhibitors (TKIs), are increasingly popular due to their convenience. However, they pose challenges like drug interactions, especially with medications like azole antifungals. While the FDA provides some guidance, more detailed information is needed to manage these interactions effectively. A meta-analysis was conducted to understand the impact of interactions between TKIs and azole antifungals on adverse events during clinical studies. Methods: A meta-analysis followed PRISMA guidelines. Data from PubMed, EMBASE, and references were searched until November 30, 2021. Inclusion criteria encompassed studies on TKI-antifungal interactions in English. Study selection and quality assessment were conducted by two independent investigators. Results: Out of 158 articles, 11 were selected for analysis. Combination therapy showed a slight increase in adverse events but was not statistically significant (OR 1.02, 95% CI 0.49-2.13, p=0.95). AUC and Cmax fold changes did not significantly impact adverse event development. Both itraconazole and ketoconazole showed no significant difference in adverse event development compared to TKI alone. Conclusions: Study finds TKI-DDI not significantly linked to AE increase; azole antifungal types not related to AE. Future DDI research crucial for drug development.

• 약학회지
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• 제35권4호
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• pp.308-313
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• 1991

The synthesis of 1-[(2-phenyl-1, 3-benzodioxol-2-yl)methyl]-1H-imidazole derivatives is described starting with 2-bromoacetophenones and catechols. 1-[(2-Phenyl-1, 3-benzodioxol-2-yl)methyl]-1H-imidazole (9-$_{12}$) showed potent broad-spectrum activity, not only against Candida species but also Cr. neofortnans, S. cerevisiae and T. mentagrophytes.

• 한국생물정보학회:학술대회논문집
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• 한국생물정보시스템생물학회 2005년도 BIOINFO 2005
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• pp.139-143
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• 2005

Cytochrome P450 14${\alpha}$-sterol demethylase enzyme (CYP51) is the target a of azole type antifungals. The azole blocks the ergosterol synthesis and thereby inhibits fungal growth. A three-dimensional (3D) homology model of CYP51 from Candida albicans was constructed based on the X-ray crystal structure of CYP51 from Mycobacterium tuberculosis. Using this model, the binding modes for the substrate (24-methylene-24, 25-dihydrolanosterol) and the known inhibitors (fluconazole, voriconazole, oxiconazole, miconazole) were predicted from docking. Virtual screening was performed employing Structure Based Focusing (SBF). In this procedure, the pharmacophore models for database search were generated from the protein-ligands interactions each other. The initial structure-based virtual screening selected 15 compounds from a commercial available 3D database of approximately 50,000 molecule library, Being evaluated by a cell-based assay, 5 compounds were further identified as the potent inhibitors of Candida albicans CYP51 (CACYP51) with low minimal inhibitory concentration (MIC) range. BMD-09-01${\sim}$BMD-09-04 MIC range was 0.5 ${\mu}$g/ml and BMD-09-05 was 1 ${\mu}$g/ml. These new inhibitors provide a basis for some non-azole antifungal rational design of new, and more efficacious antifungal agents.

• Archives of Pharmacal Research
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• 제27권3호
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• pp.295-299
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• 2004

The antifungal activities of the essential oil from Agastache rugosa and its main component, estragole, combined with ketoconazole, one of the azole antibiotics commonly used to treat infections caused by Trichophyton species, were evaluated in this study. The combined effects were measured by the checkerboard microtiter and the disk diffusion tests, against T. erinacei, T. mentagrophytes, T. rubrum, T. schoenleinii and T. soudanense. Susceptibility of the five Trichophyton species to the oil alone, or ketoconazole alone, differed distinctly. The fractional inhibitory concentration indices (FICI) of ketoconazole combined with estragole or A. rugosa essential oil, against the tested Trichophyton species, were between 0.05 and 0.27, indicating synergistic effects. These drug combinations exhibited the most significant synergism against T. mentagrophytes, with FICIs of 0.05 and 0.09 for estragole and the essential oil fraction from A. rugosa, respectively. Isobolograms based on the data from checkerboard titer tests also indicated significant synergism between ketoconazole and the Agastache oil fraction or estragole, against the Trichophyton species evaluated. Trichophyton susceptibility to ketoconazole was significantly improved by combination with the Agastache rugosa oil fraction or its main component, estragole.

• Animal cells and systems
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• 제10권4호
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• pp.203-209
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• 2006

Azoles are widely used antifungal agents, which inhibit the biosynthesis of fungal cell-membrane ergosterol. In this study, using an amphibian follicle culture system, the effects of azoles on follicular steroidogenesis in frogs were examined. Itraconazole (ICZ), clotrimazole (CTZ) and ketoconazole (KCZ) suppressed pregnenolone ($P_5$) production by the follicles ($ED_{50};\;0.04_{\mu}M,\;0.33_{\mu} M,\;and\;0.91_{\mu}M$, respectively) in response to frog pituitary homogenates (FPH). However, fluconazole (FCZ), miconazole (MCZ) and econazole (ECZ) were not effective in the suppression of $P_5$ production. Not all the azoles examined suppressed the conversion of exogenous $P_5$ to progesterone ($P_4$) (by $3{\beta}$- HSD) or $P_4$ to $17{\alpha}$-hydroxyprogesterone ($17{\alpha}$-OHP) (by $17{\alpha}$-hydroxylase), or androstenedione (AD) to testosterone (T) (by $17{\beta}$-HSD). In contrast, CTZ, MCZ and ECZ in medium partially suppressed the conversion of $17{\alpha}$-OHP to AD (by C17-20 lyase) ($ED_{50};\;0.25{\mu} M,\;4.5{\mu}M,\;and\;0.7{mu}M$, respectively) and CTZ, KCZ, ECZ and MCZ strongly suppressed the conversion of exogenous T to estradiol ($E_2$) (by aromatase) ($ED_{50};\;0.02{\mu}M,\;8{\mu}M,\;0.07{\mu}M,\;0.8{\mu}M$, respectively). These results demonstrated that some azole agents strongly suppress amphibian follicular steroidogenesis and particularly, P450scc and aromatase are more sensitive to azoles than other steroidogenic enzymes.

• KSBB Journal
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• 제18권1호
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• pp.1-7
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• 2003

항진균제로 잘 알려진 아졸계 화합물인 이트라코나졸 전구체에 대한 광학선택성 lipase 생산균주 탐색을 수행하였다. 본 라세믹 기질을 선택적으로 가수분해하는 lipase 생산균주 인 Acinetobacter sp. SY-01 를 분리하였고, 효소 가수분해반응을 수행한 결과 본 라세믹 기질은 전환율이 74.8%에 도달하였을 때 95.6%의 ee값을 가지는 S-ester로 분할되었다. 전환율은 온도 $50^{\circ}C$, pH 7.0에서 가장 높게 나타났고, 광학선택성은 온도, pH에 의해 영향을 받지 않았다. 용매의 첨가에 의해 전환율은 감소하였으나 광학선택성은 약간 증가하였다. 기질농도가 증가함에 따라 광학선택성은 감소하였고, 이것은 가수분해반응 생성물에 의한 영향으로 확인되어 반응 생성물을 제거함으로써 광학선택성을 증가시킬 수 있었다.

• Pediatric Infection and Vaccine
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• 제12권1호
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• pp.75-85
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• 2005

목 적 : 혈액종양 환아의 항암요법 후 발생한 호중구감소증 상태에서, 진균 감염은 높은 치명률을 가지는 것으로 알려져 있다. 진균 감염에 대한 경험적 항진균제로 주로 사용되는 ABV는 염증성 사이토카인인 IL-$1{\beta}$, TNF-${\alpha}$의 증가에 의해 발생하는 것으로 알려져 있는 발열, 오한, 발진, 신독성과 같은 부작용이 있다. Azole 계열의 ITZA도 광범위한 항진균 효과를 나타내고 있어 경험적 항진균제로의 사용이 고려되고 있는데 본 연구는 ABV와 ITZA의 정맥 주입에 따른 부작용의 발생 및 효능과 염증성 사이토카인 및 항염증성 사이토카인의 변화를 관찰하고자 한다. 방 법: 2004년 3월부터 2005년 2월까지 호중구감소증 상태에서 발열이 있어 치료한 급성 백혈병 환자를 대상으로 하였다. 대상으로 선정된 환자는 30명으로 ABV, ITZA 각각의 치료군은 15명이었다. 항진균제는 총 14일간 투여하였으며, 투여 후 혈청에 포함된 염증성 사이토카인(IL-$1{\beta}$, TNF-${\alpha}$)과 항염증성 사이토카인(IL-1Ra, IL-4)을 ELIZA를 통하여 측정하고, 치료 종료 시 치료 효과를 평가하였다. 결 과 : 두 치료군의 성별, 나이, 진단명, 항암치료의 단계, 마지막 항암요법의 시기 특성은 유의한 차이가 없었다. ABV 치료군에 비해 ITZA 치료군에서 정맥 주입 시 발생하는 이상 반응의 빈도가 적었다. 또한, ABV 치료군에서 ITZA 치료군에 비해 염증성 사이토카인인 IL-$1{\beta}$가 정맥주입 시 증가함을 보였고, IL-1Ra/IL-$1{\beta}$는 ABV 치료군에서는 감소하는 반면 ITZA 치료군에서는 증가함을 보였다. 결 론: 급성백혈병 소아에서 발열을 동반한 호중구감소증시 경험적 항진균제로 ABV와 ITZA를 사용하여 최종 치료 효과의 유의한 차이는 없었으나 정맥 투여와 연관된 이상 반응은 ABV 군에서 많았으며 호중구의 회복은 ITZA 군에서 빠른 것을 알 수 있었다. 이는 ABV나 ITZA 투여 시 시간에 따른 IL-Ra/IL-$1{\beta}$의 변화와 연관이 있을 것으로 생각된다.