High‐dose Cepharanthin for pediatric chronic immune thrombocytopenia in Japan

Yamazaki, Taro; Shibuya, Akira; Ishii, Saori; Miura, Nobuyuki; Ohtake, Akira; Sasaki, Nozomu; Araki, Ryuichiro; Ota, Yatio; Fujiwara, M.; Miyajima, Yuji; Uetake, Kimiaki; Hamahata, Keigo; Katô, Kôji; Kawakami, Kiyoshi; Toyoda, Hidemi; Moriguchi, Naohiko; Okada, Masahiko; Nishi, Masanori; Ogata, Yoshiyasu; Takimoto, Tetsuya; Ohga, Shouichi; Ohta, Shigeru; Amemiya, Shin

doi:10.1111/ped.13151

Cited by 14 publications

(15 citation statements)

References 14 publications

(22 reference statements)

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“…This is coherent with early studies showing that inhibition of platelet aggregation by CEP is accomplished during the early, membrane-related activation process. A recent study conducted in a pediatric population also underlined the useful effect of CEP for the management of chronic immune thrombocytopenia (Yamazaki et al, 2017).…”

Section: Immuno-modulation -Treatment Of Sepsis Chronic Immune Thrommentioning

confidence: 99%

Cepharanthine: An update of its mode of action, pharmacological properties and medical applications

2019

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A B S T R A C TBackground: Cepharanthine (CEP) is a drug used in Japan since the 1950s to treat a number of acute and chronic diseases, including treatment of leukopenia, snake bites, xerostomia and alopecia. It is the only approved drug for Human use in the large class of bisbenzylisoquinoline alkaloids. This natural product, mainly isolated from the plant Stephania cephalantha Hayata, exhibits multiple pharmacological properties including anti-oxidative, anti-inflammatory, immuno-regulatory, anti-cancer, anti-viral and anti-parasitic properties. Purpose: The mechanism of action of CEP is multifactorial. The drug exerts membrane effects (modulation of efflux pumps, membrane rigidification) as well as different intracellular and nuclear effects. CEP interferes with several metabolic axes, primarily with the AMP-activated protein kinase (AMPK) and NFκB signaling pathways. In particular, the anti-inflammatory effects of CEP rely on AMPK activation and NFκB inhibition. Conclusion: In this review, the historical discovery and development of CEP are retraced, and the key mediators involved in its mode of action are presented. The past, present, and future of CEP are recapitulated. This review also suggests new opportunities to extend the clinical applications of this well-tolerated old Japanese drug.

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Section: Immuno-modulation -Treatment Of Sepsis Chronic Immune Thrommentioning

confidence: 99%

Cepharanthine: An update of its mode of action, pharmacological properties and medical applications

2019

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“…In Japan, Cepharanthine has a history of more than 70 years in treating radiation‐related leukopenia (Kanamori et al ., 2016), venomous snakebites (Hifumi et al ., 2013), alopecia areata (Hon and Leung, 2011) and other pathologies. In addition, Cepharanthine displays various bioactivities, including anti‐inflammation (Huang et al ., 2014), anti‐tumour (Shahriyar et al ., 2018) and immune‐modulation (Yamazaki et al ., 2017). The anti‐inflammatory potential of Cepharanthine can be exploited to treat an array of diseases, such as mastitis (Ershun et al ., 2014), acute lung injury (Kao et al ., 2015) and cerebral ischaemia/reperfusion injury (Zhao et al ., 2020).…”

Section: Introductionmentioning

confidence: 99%

Cepharanthine ameliorates dextran sulphate sodium‐induced colitis through modulating gut microbiota

Zhang

Wen

et al. 2022

Microbial Biotechnology

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Cepharanthine (CEP) is an active alkaloid isolated from Stephania Cepharantha Hayata. It is reported that the anti-inflammatory properties of CEP could be employed to treat a variety of diseases. In this study, we first found that CEP ameliorates ulcerative colitis (UC) induced by DSS. The effect of CEP on gut microbiota was further evaluated by 16S rRNA gene sequencing, antibiotic pretreatment and faecal microbiota transplantation (FMT). Results showed that the abundances of gut microbiota, such as Romboutsia, Turicibacter and Escherichia-Shigella (especially Romboutsia), were significantly reduced after CEP treatment. Additionally, we explored the mechanisms of CEP by a strategy integrating transcriptomics with network pharmacology. The transcriptome data confirmed that CEP functioned through cytokine and cytokine receptor pathways. The expression levels of 10 pro-inflammatory hub genes (such as CXCL1, CXCL9, CCL7) were positively correlated with the abundance of Romboutsia. Our data identified Romboutsia as a potential pathobiont in UC. Collectively, we confirmed that CEP relieved colon inflammation by modulating gut microbiota and pro-inflammatory cytokine expression. CEP can be adopted to design novel effective therapeutic strategies for UC.

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“…(28) Yamazaki et al were use this drug on 46 chronic-resistant, <16 years Japanese ITP patients. (29) In this study shown cepharantine has used a safe and effective alternative corticosteroidsparing drug. Currently, in refractory cases, successful results have been reported for TPO receptor agonist, romiplostim (30) and eltrombopag (31,32) as a second-line therapy option.…”

Section: Discussionmentioning

confidence: 86%

The Outcome of Immune thrombocytopenic purpura in childhood and the risk factors for chronicity

Yılmaz

Koc

Doğru

et al. 2020

Preprint

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Immune thrombocytopenic purpura (ITP) is an autoimmune disease presents with isolated thrombocytopenia (thrombocyte count < 100.000/mm3) and develops due to increased thrombocyte destruction by autoantibodies. ITP is the most common cause of pediatric thrombocytopenia. Usually a self-limiting disease with an acute course of 70% -80%. However, 20% -25% cases are chronical. These cases are follow-up and management difficult and expensive. It is important to distinguish events that may become chronic at the time of initial diagnosis. In this study, we sought clues to be able to choose, which the patient will be chronicle?

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High‐dose Cepharanthin for pediatric chronic immune thrombocytopenia in Japan

Abstract: CEP alone or combined with CS was useful for the management of pediatric chronic ITPs.

Cited by 14 publications

References 14 publications

Cepharanthine: An update of its mode of action, pharmacological properties and medical applications

Cepharanthine: An update of its mode of action, pharmacological properties and medical applications

Cepharanthine ameliorates dextran sulphate sodium‐induced colitis through modulating gut microbiota

The Outcome of Immune thrombocytopenic purpura in childhood and the risk factors for chronicity

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