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Association of CYP2C19 polymorphism with cyclophosphamide-induced toxicity in systemic lupus erythematosus and lupus nephritis: A systematic review and meta-analysis.

BackgroundCyclophosphamide (CYC) is a key immunosuppressive agent used for the treatment of systemic lupus erythematosus (SLE) and lupus nephritis (LN). However, its use is often limited by variability in efficacy and toxicity, potentially influenced by genetic polymorphisms. This systematic review and meta-analysis aimed to evaluate the association between the CYP2C19 polymorphism and cyclophosphamide-induced toxicity in SLE and LN patients.MethodsLiterature search was performed using PubMed and Web of Science databases in accordance with PRISMA guidelines. Studies were included if they evalu…

Impact of rice wine-steamed Cistanche deserticola polysaccharides on intestinal flora and immunological modulation in immunosuppressive mice induced by cyclophosphamide.

INTRODUCTION: Cistanche deserticola, a valued medicinal and food homologous material in traditional Chinese medicine, is renowned for enhanc … RCP and WCP were characterized using SEM, HPGPC, FT-IR, and GC-MS. Immunosuppressed mice induced by cyclophosphamide (CTX) were used as an in vivo model. Immune function was assessed via body weight, organ indices, serum immunoglobulins (IgA, IgM), cytokines (IL-2, IFN-γ), spleen histopathology, and T cell subsets (CD4+/CD8+). Gut microbiota composition was analyz …

Immunomodulatory effects of Yang He decoction on cyclophosphamide-induced immunosuppression in mice: restoration of immune organ integrity and cytokine balance.

OBJECTIVE: To evaluate the protective effects and potential mechanisms of Yang He decoction (YHD), a classic traditional Chinese medicine formula, against cyclophosphamide (CTX)-induced immunosuppression in mice. METHODS: An immunosuppression model was established in Kunming mice via intraperitoneal injection of CTX (80 mg/kg). The mice were then treated with low, medium, or high doses of YHD (50, 100, or 200 mg/kg) or Astragalus polysaccharide (APS, 24 mg/kg) as a positive control for 15 consecutive day. Body weight changes, immune organ (spleen and thymus) index and histopathology, splenic …

Upregulated Expression of TRPV1 and TRPV4 in the Urethra Following Cyclophosphamide-Induced Cystitis in Rats: A Potential Mechanism of Bladder-Urethral Dysfunction.

PURPOSE: This study aimed to investigate the impact of cyclophosphamide (CYP)-induced cystitis on the expression of transient receptor potential vanilloid 1 (TRPV1) and 4 (TRPV4) in the rat urethra, and to evaluate their potential roles in urethral contribution to bladder dysfunction during inflammation. METHODS: Female rats were divided into the control and CYP-treated groups to induce cystitis. After 72 hours, cystometric analysis was performed to evaluate voiding changes, and urethral TRPV1 and TRPV4 expression was assessed by Western blot and immunofluorescence. RESULTS: Cystitis rats ex…

Comparative Efficacy and Safety of Mycophenolate Mofetil Versus Cyclophosphamide As Induction Therapy for Lupus Nephritis: A Systematic Review and Meta-Analysis.

Lupus nephritis (LN) is a serious and potentially fatal systemic lupus erythematosus complication that causes substantial morbidity and may progress to end-stage kidney disease. Traditionally, cyclophosphamide (CYC) has been prescribed as induction therapy for LN. However, there has been a trend toward using mycophenolate mofetil (MMF) as an alternative treatment due to concerns of toxicity. This systematic review and meta-analysis evaluated the comparative safety and efficacy of MMF to CYC as induction therapy in LN. PubMed, Embase, Scopus, and Cochrane CENTRAL databases were searched compreh…

Comparison of Myeloablative Busulfan/Cyclophosphamide and Busulfan/Fludarabine for Allogeneic Hematopoietic Stem Cell Transplantation: A Systematic Review and Meta-Analysis.

Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a curative treatment for many hematological malignancies. The busulfan plus cyclophosphamide (Bu/Cy) combination is a standard myeloablative conditioning (MAC) regimen, but it is associated with significant regimen-related toxicity and non-relapse mortality (NRM). To mitigate these issues, a regimen combining high-dose busulfan with fludarabine (Bu/Flu) was developed, aiming to reduce toxicity while preserving efficacy. While a previous meta-analysis suggested Bu/Flu may reduce early mortality, it included non-randomized studies…

Effect of estradiol on in vitro maturation of immature oocytes in cyclophosphamide-induced premature ovarian failure in NMRI mice: An experimental study.

BACKGROUND: Premature ovarian failure (POF) is a condition characterized by the loss of ovarian function, leading to infertility. OBJECTIVE: This study aims to examine how estradiol supplementation impacts the in vitro maturation of immature oocytes in NMRI female mice exhibiting cyclophosphamide-induced POF. MATERIALS AND METHODS: In this experimental study, 15 female NMRI mice (8-10 wk, 30 ± 5 gr) were divided into 3 groups: control, sham, and treatment. The treatment group was divided into 3 categories. Treatment group 1, which added 0.5 μg/ml estradiol to the basic culture medium, and tr…

Renal Response Outcomes of the EuroLupus and National Institutes of Health Cyclophosphamide Dosing Regimens in Childhood-Onset Proliferative Lupus Nephritis.

OBJECTIVE: We compared clinical characteristics and renal response in patients with childhood-onset proliferative lupus nephritis (LN) treated with the EuroLupus versus National Institutes of Health (NIH) cyclophosphamide (CYC) regimen. METHODS: A retrospective cohort study was conducted at 11 pediatric centers in North America that reported using both CYC regimens. Data were extracted from the electronic medical record at baseline and 3, 6, and 12 months after treatment initiation with CYC. To evaluate the adjusted association between CYC regimen (EuroLupus vs NIH) and renal response over ti…

The effect of L-carnitine in reactive oxygen species reduction and apoptotic gene expression in mice after cyclophosphamide: An experimental study.

BACKGROUND: Cyclophosphamide (CP), a utilized anticancer drug, is known to cause infertility in women. However, L-carnitine (LC), an antioxidant, has been shown to offer protective benefits against infertility. OBJECTIVE: This study aimed to evaluate the levels of reactive oxygen species (ROS) and apoptotic gene expression in mice treated with CP and LC. MATERIALS AND METHODS: 24 NMRI female mice (6-8 wk, 30 ± 5 gr) were divided into 4 groups: control group: received normal saline intraperitoneal (IP) injection for 10 days; CP group: received 75 mg/kg of CP as a single IP on the 10   th da…

Comparison of large single and small multiple doses of cyclophosphamide exposure in mice during early prepubertal age on fertility outcome.

Cyclophosphamide (CY) exposure is known to affect the ovary and impair fertility. Clinically, treatment is generally given over multiple doses, but research models have generally used single doses. The relative effects of administering multiple small doses of CY in the prepubertal period are not elucidated. Two-week-old early-prepubertal Swiss albino female mice were administered with either large single (200 mg/Kg x 1; CY200X1) or small multiple (75 mg/Kg x 4; CY75X4) CY doses, thus a 50% higher total dose. Surviving females were assessed for estrous cyclicity, ovarian follicle reserve, oocyt…

Severe hyponatremia and diabetes insipidus caused by low-dose cyclophosphamide in breast cancer patients: A case report and literature review.

RATIONALE: Cyclophosphamide (CTX) is widely used in the treatment of malignancies and autoimmune diseases. Although severe hyponatremia caused by low-dose CTX chemotherapy is uncommon, it can lead to serious complications and even death. PATIENT CONCERNS: A 44-year-old woman with left-sided breast cancer suddenly experienced headaches, disorientation and weakness after receiving low-dose neoadjuvant chemotherapy combined with CTX and doxorubicin. DIAGNOSES: The patient pathology showed invasive breast carcinoma. She developed severe hyponatremia and a generalized seizure after completing the…

The effects of berberine and curcumin on cardiac, lipid profile and fibrosis markers in cyclophosphamide-induced cardiac damage: The role of the TRPM2 channel.

Cyclophosphamide (CYP) is widely used to treat various types of cancer. In addition to the therapeutic properties of this drug, unfortunately, its side effects are still not fully understood. This study investigated the protective effect of curcumin (CURC) and berberine (BER) on CYP-induced cardiac damage. Thirty-six male rats were equally divided into the control, dimethyl sulfoxide (DMSO), CYP, CYP + CURC, CYP + BER and CYP + BER + CURC groups. Troponin-I, Creatine kinase-myocardial band (CK-MB), total cholesterol, triglyceride levels in serum samples, and reactive oxygen species (ROS), poly…

Uroprotective and pain-relieving effect of dietary supplementation with micronized palmitoyl-glucosamine and hesperidin in a chronic model of cyclophosphamide-induced cystitis.

INTRODUCTION: Feline idiopathic cystitis is a common, chronic-relapsing disorder of the lower urinary tract. In addition to environmental mo … a novel mechanism-oriented approach to chronic cystitis management. A newly validated rat model of cyclophosphamide (CYP)-induced chronic cystitis was used (40 mg/kg, three intraperitoneal injections every 3rd day). Animals were randomized to orally receive either vehicle or PGA-HSP at a low (72 + 24 mg/kg) or high (doubled) dose for 13 days, starting 3 days befo …

Type I interferon gene expression signature as a marker to predict response to cyclophosphamide based treatment in proliferative lupus nephritis.

OBJECTIVES: To assess the longitudinal effect of cyclophosphamide (CYC) treatment on type-I interferon (IFN) signature in proliferative lupus nephritis (LN) and its role in predicting treatment response. METHODS: Fifty-four biopsy proven proliferative LN patients scheduled to receive high-dose (HD) or low-dose (LD) CYC were recruited and followed up for six months. At six months, patients were classified as clinical responders (CR) or non-responders (NR) to treatment, using the EULAR/EDTA criteria. An IFN-gene based score (IGS) was developed from the mean log-transformed gene expression of MX…

Impact of dosing strategy on clinical outcomes of patients with lupus nephritis initially treated with lower-than-recommended-dose cyclophosphamide.

AIM: Cyclophosphamide is the mainstay treatment for patients with lupus nephritis (LN); it can be prescribed at lower doses than the recommended regimen to avoid side effects. We aimed to investigate the impact of cyclophosphamide dosing strategies on treatment outcomes of patients with LN initially treated with a lower-than-recommended dose. METHODS: We retrospectively reviewed patients with proliferative LN (class III, IV, or mixed) initially treated with lower-than-recommended-dose cyclophosphamide. Patients who received a titrated dose of cyclophosphamide ≥0.5 g/m2 were categorized into t…

PB2324: USE OF COMBINATION OF THALIDOMIDE, CYCLOPHOSPHAMIDE AND DEXAMETHASONE IN PATIENTS WITH REFRACTORY/RELAPSED NON-HODGKIN LYMPHOMA: A PALLIATIVE CHEMOTHERAPY STRATEGY.

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… The cyclophosphamide, thalidomide, dexamethasone (CTD) regimen is widely used in multiple myeloma but experience in lymphoma is limited. Aims: Assess efficacy and toxicity of CTD in R/R NHL. …

Hepatoprotective effect of taxifolin on cyclophosphamide-induced oxidative stress, inflammation, and apoptosis in mice: Involvement of Nrf2/HO-1 signaling.

Taxifolin (TA) is a natural flavonoid found in many foods and medicinal plants with well-documented antioxidant and anti-inflammatory properties. Cyclophosphamide (CP) is an effective antineoplastic and immunosuppressive agent; however, it is associated with numerous adverse events, including hepatotoxicity. Herein, we aimed to investigate the potential protective effects of TA using a mouse model of CP-induced hepatotoxicity. Mice were co-treated with TA (25 and 50 mg/kg, orally) and CP (30 mg/kg, i.p.) for 10 consecutive days and sacrificed 24 hours later. CP induced increased transaminases …

Oral glucocorticoids with intravenous cyclophosphamide or oral glucocorticoids alone in the treatment of IgA nephropathy present with nephrotic syndrome and mesangioproliferative glomerulonephritis.

BACKGROUND: Few studies have evaluated the treatment of immunoglobulin A nephropathy (IgAN) patients with nephrotic syndrome (NS) and mesangioproliferative glomerulonephritis (MPGN). The aim of this study was to compare the therapeutic effects of oral glucocorticoids (GCS) combined with intravenous cyclophosphamide (CTX) and oral GCS alone in the treatment of the MPGN-IgAN patients with NS. METHODS: Biopsy-proven primary IgAN patients who were aged ≥14 years at diagnosis, had coexistent NS and MPGN and estimated glomerular filtration rate (eGFR) ≥15 mL/min/1.73 m2, and were treated by oral GC…

Assessment of thyme honey oral gel for the prevention of adriamycin and cyclophosphamide chemotherapy-induced oral mucositis in patients with breast cancer.

PURPOSE: Oral mucositis (OM) is a common complication of cancer treatment that has an impact on a patient's quality of life and the outcome of cancer therapy. This trial evaluated the effect of thyme honey oral gel for the prevention of chemotherapy-induced OM. METHODS: One hundred ten breast cancer patients who received their first cycle of chemotherapy with adriamycin (60 mg/m2) and cyclophosphamide (600 mg/m2) were randomly recruited into two groups: group A were patients who followed general oral hygiene recommendations and rinsing saline 3 times a day, and group B were patients with simi…

Effectiveness and Adverse Events of Cyclophosphamide, Vincristine, and Prednisolone Chemotherapy in Feline Mediastinal Lymphoma Naturally Infected with Feline Leukemia Virus.

Feline leukemia virus (FeLV) infection is considered a poor prognostic factor for feline lymphoma. This study investigated the prevalence of cats suffering from feline lymphoma with natural infection of the feline leukemia virus, as well as clinical signs, adverse events, and survival time after cyclophosphamide, vincristine and prednisolone (COP) chemotherapy. This retrospective study involved 92 cats diagnosed with mediastinal or mediastinal plus other anatomical sites of lymphoma and treated with COP chemotherapy. FeLV-antigen-positive was observed in all cats. Clinical signs and adverse ev…