The detailed understanding of the conformational pathway of fluticasone, a widely prescribed medicine for allergic rhinitis, asthma, and chronic obstructive pulmonary disease (COPD), from formulation to its protein-bound state, has been limited due to a lack of access to its high-resolution structures. The three-dimensional (3D) structure of fluticasone furoate remains unpublished, and the deposited structure of fluticasone propionate could be further refined due to refinement against new data. We applied microcrystal electron diffraction (MicroED) to determine the 3D structures of and in their solid states. The preferred geometries in solution were predicted by using density functional theory (DFT) calculations. A comparative analysis of the structures of and across three states (in solid state, in solution, and protein-bound conformation) revealed the course of the conformational changes during the entire transition. Potential energy plots were calculated for the most dynamic bonds, uncovering their rotational barriers. This study underscores the combined use of MicroED and DFT calculations to provide a comprehensive understanding of conformational and energy changes during drug administration. The quantitative comparison also highlights the subtle structural differences that may lead to significant changes in the pharmaceutical properties.
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http://dx.doi.org/10.1021/acs.cgd.4c01683 | DOI Listing |
Indian J Otolaryngol Head Neck Surg
January 2025
Department of Endocrinology, Joshi Clinic, Mumbai, India.
Allergen immunotherapy (AIT), or specific immunotherapy (SIT), is an effective treatment for inducing immune tolerance to specific allergens. It is widely used for allergic rhinitis, conjunctivitis, asthma, and Hymenoptera venom allergies, with recent applications to food allergies and atopic dermatitis. Despite its benefits, the use of SIT in patients with autoimmune diseases is controversial due to concerns about its potential to induce or exacerbate autoimmune conditions.
View Article and Find Full Text PDFCryst Growth Des
March 2025
Department of Biological Chemistry, University of California, Los Angeles, 615 Charles E. Young Drive South, Los Angeles, California 90095, United States.
The detailed understanding of the conformational pathway of fluticasone, a widely prescribed medicine for allergic rhinitis, asthma, and chronic obstructive pulmonary disease (COPD), from formulation to its protein-bound state, has been limited due to a lack of access to its high-resolution structures. The three-dimensional (3D) structure of fluticasone furoate remains unpublished, and the deposited structure of fluticasone propionate could be further refined due to refinement against new data. We applied microcrystal electron diffraction (MicroED) to determine the 3D structures of and in their solid states.
View Article and Find Full Text PDFPulm Ther
March 2025
Global Real-World Evidence & Health Outcomes Research Organization, GSK, Collegeville, PA, US.
Introduction: Long-acting muscarinic antagonist (LAMA) addition to inhaled corticosteroid/long-acting β-agonist (ICS/LABA) dual therapy is recommended for severe asthma, but its real-world effectiveness is not well established.
Methods: A systematic literature review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) to investigate clinical outcomes in US adults with asthma receiving ICS + LABA + LAMA as multiple-/single-inhaler triple therapy (MITT/SITT). Real-world/observational studies published in English in Embase/MEDLINE databases (2014-2024) and conference abstracts presented 2022-2024 were eligible for inclusion.
Int J Chron Obstruct Pulmon Dis
February 2025
National Heart and Lung Institute, Imperial College London, London, UK.
Purpose: Long-acting bronchodilator (LABD) therapy is recommended for maintenance treatment in most patients with chronic obstructive pulmonary disease (COPD). However, triple therapy (TT; dual LABDs + inhaled corticosteroid [ICS]) is often used as first-line maintenance treatment. The benefits of TT versus dual LABDs as first-line treatments are unknown, necessitating an evaluation of its effectiveness and costs versus non-ICS alternatives.
View Article and Find Full Text PDFClin Exp Otorhinolaryngol
February 2025
Department of Otorhinolaryngology-Head and Neck Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Objectives: Balloon eustachian tuboplasty (BET) is an emerging treatment for dilatory eustachian tube (ET) dysfunction. However, its efficacy in patients with both chronic suppurative otitis media (COM) and ET dysfunction remains unclear. The objective of the trial was to assess the efficacy and safety of BET versus medical management (MM) alone in adult patients with COM and chronic dilatory ET dysfunction, which was defined by a failed Valsalva maneuver.
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