Efficacy and safety of polysaccharide iron complex capsules compared with iron sucrose in hemodialysis patients: study protocol for a randomized, open-label, positive control, multicenter trial (IHOPE)

Background Anemia is one of the main complications of chronic kidney disease especially kidney failure, which includes treatment with erythropoiesis-stimulating agents and iron supplementation, including intravenous and oral iron. However, intravenous iron may pose limitations, such as potential infusion reactions. Oral iron is mainly composed of divalent iron, which can excessively stimulate the gastrointestinal tract. Iron polysaccharide complex capsules are a novel oral iron trivalent supplement with higher iron content and lower gastrointestinal irritation. However, since high-quality evidence-based medicinal support is lacking, it is necessary to conduct clinical studies to further evaluate the effectiveness and safety of oral iron polysaccharide complex in chronic kidney disease patients. Methods This randomized controlled trial uses an open-label, parallel group design, where the efficacy and safety of maintenance hemodialysis (MHD) participants is evaluated. The experimental group is assigned erythropoietins and iron polysaccharide complex (two capsules each time, bid), and the control group is assigned erythropoietin and sucrose iron (100mg, 2w) injection. Participants (aged 18–75 years) undergoing maintenance hemodialysis were considered for screening. Inclusion criteria included hemoglobin (Hb) ≥110g/L and < 130g/L, transferrin saturation (TSAT) > 20% and < 50%, and serum ferritin (SF) > 200μg/L and < 500μg/L. Exclusion criteria included acute or chronic bleeding, serum albumin < 35g/L, hypersensitive C-reactive protein (HsCRP) > 10 mg/L, and severe secondary hyperparathyroidism (iPTH ≥ 800 pg/mL). Full inclusion and exclusion criteria are described in the “Methods” section. The primary endpoint is TSAT of the participants at week 12. Secondary endpoints include Hb, SF, hematocrit (Hct), HsCRP, pharmacoeconomic evaluation, drug costs, quality of life, and indicators of oxidative stress. The treatment will last for 24 weeks with a follow-up visit at baseline (within 7 days prior to initial treatment) and weeks 4, 8, 12, 16, 20, and 24 after initial treatment. This clinical research includes 9 hemodialysis centers in mainland China and plans to enroll 186 participants. Discussion It is expected that it will provide strong evidence to reveal the clinical efficacy and safety of oral iron in the treatment of chronic CKD-related anemia in MHD patients through this clinical trial. Trial registration Chinese Clinical Trial Registry ChiCTR2000031166. Registered on March 23, 2020

ISOLATION AND STUDY OF THE POLYSACCHARIDE COMPLEX ISOLATED FROM AESCULUS HIPPOCASTA-NUM L.

This paper presents the results of a study of the polysaccharide complex, first obtained using microwave radiation from the shells of horse chestnut seeds (Aesculus Hippocastanum L.), collected on the territory of the Tashkent region of the Republic of Uzbekistan. It is shown that the use of microwave waves makes it possible to intensify the method of obtaining polysaccharides with an increase in their yield. The yield of the obtained product reaches 13%, compared with the method of obtaining without using microwave radiation (9.85%), which indicates the prospects of using microwave radiation in the isolation of polysaccharides from this type of raw material. The molecular weight characteristics were determined, and using GC/MS analysis of trimethylsilyl derivatives, the monosaccharide composition of the complex isolated from the shells of the Semyon chestnut by alkaline extraction was established. It was found that the isolated polysaccharides consist mainly of arabinose and galactose residues (65–100%), and also, as minor monosaccharides, up to 35% of glucose, xylose, mannose, rhamnose, ribose residues. Signals and absorption bands corresponding to total polysaccharides were observed in 13C NMR and IR spectra. The NMR analysis data are consistent with the results of the analysis of the monosaccharide composition of the polysaccharide complex obtained using GC / MS. The antiradical activity of the polysaccharide complex has been established.

A soil-binding polysaccharide complex released from root hairs functions in rhizosheath formation

SUMMARYTo elucidate factors involved in rhizosheath formation, wild type (WT) barley (Hordeum vulgare L. cv. Pallas) and a root hairless mutant, bald root barley (brb), were investigated with a combination of physiological, biochemical and immunochemical assays. When grown in soil, WT barley roots bound ∼5-fold more soil than brb per unit root length. High molecular weight (HMW) polysaccharide exudates of brb roots had less soil-binding capacity than those of WT root exudates. Carbohydrate and glycan monoclonal antibody analyses of HMW polysaccharide exudates indicated differing glycan profiles. Relative to WT plants, root exudates of brb had reduced signals for arabinogalactan-protein (AGP), extensin and heteroxylan epitopes than brb. In contrast, the brb root exudate contained ∼25-fold more detectable xyloglucan epitope relative to WT. Epitope detection chromatography indicated that the increased detection of xyloglucan in brb exudates was due to enhanced abundance of a neutral polymer. Exudate preparations from brb had decreased amounts of an acidic form of xyloglucan associated with root-hair located glycoprotein and heteroxylan epitopes and with soil-binding properties. Therefore, in addition to physically structuring soil particles, root hairs facilitate rhizosheath formation by releasing a soil-binding polysaccharide complex.One sentence summaryThe root exudate of a root hairless mutant of barley, relative to wild type, has an altered pattern of polysaccharide epitopes and lesser amounts of an acidic soil-binding polysaccharide complex.

DEVELOPMENT OF A SOLID DOSAGE FORM WITH ADSORPTION ACTIVITY

Enterosorbents are produced in various dosage forms – powders, tablets, pastes, etc., some of them are also manufactured in the form of capsules. A water-soluble polysaccharide complex (WSPC) manifesting a pronounced adsorption activity, which determines the prospects for the development of dosage forms of sorbents, was obtained from the cones of European Spruce (Picea abies).The aim of the work is to develop a solid dosage form with an adsorption activity based on a water-soluble polysaccharide complex from the cones of European Spruce (Picea abies).Materials and methods. The samples of European Spruce (Picea abies) cones were collected on the territory of Ilyinsky district of the Perm Krai and used as plant raw materials. A water-soluble polysaccharide complex was obtained from the raw materials. In order to improve the technological properties of the substance, (WSPC) granulates were obtained. The granulates were hand-made by wet granulation. The adsorption activity of the obtained granules was determined by the ability to bind methylene blue.Results. As a result of the experiment it has been established, that the WSPC substance of European Spruce (Picea abies) cones needs to be improved in its technological properties. Granulation of the substance led to an improvement in technological properties and an increase in the adsorption activity in most of the selected compositions. It has also been shown that increased moisture content of granulate decreases its adsorption activity. A direct dependence of the adsorption activity on the concentration of the granulating liquid (with the exception of some granulates) has been revealed, but no significant effect of the size of the granulate particles on the manifestation of the adsorption effect has been reported. According to the results of the study, a dosage form “Capsules” has been proposed for the compositions that showed the best results of the adsorption activity, and their biopharmaceutical evaluation was carried out according to the disintegration test.Conclusion. Thus, a solid dosage form with an adsorption activity has been obtained. The study shows the prospects for further research on the preparation of the drug with an adsorption activity based on the water-soluble polysaccharide complex of European Spruce (Picea abies) cones.

INFLUENCE OF POLYSACCHARIDE COMPLEXES OF PLANTS OF CENTRAL RUSSIA ON THE P-GLYCOPROTEIN ACTIVITY IN VITRO

The purpose of this work was to study the effect of polysaccharide complexes isolated from tansy flowers (Tanacetum vulgare L., fam. Asteraceae) and melilotus herb (Melilotus officinalis L., fam. Fabaceae) on P-glycoprotein (Pgp, ABCB1 protein) activity in vitro. On Caco-2 cell line the effect of polysaccharide complex isolated from tansy flowers and melilotus herb on Pgp activity was studied. In vitro Pgp activity was assessed by the transport of fexofenadine in the transwell system. High performance liquid chromatography with UV detection at wavelength 220 nm was used to determine fexofenadine concentration in the transport medium. It was revealed that when polysaccharide isolated from tansy flowers was added to the transport medium in concentrations 10 and 100 μM the ratio of the apparent permeability coefficients of fexofenadine b-a/a-b decreased by 1.81 and 2.65 times, respectively, compared with the series of isolated transport of fexofenadine, which indicated decreased Pgp functional activity under the polysaccharide action. The polysaccharide complex of the melilotus herb did not change the b-a/a-b ratio in any of the applied concentrations, thus it did not affect the activity of this transporter. It is advisable to continue the study of tansy flower polysaccharide complex as an inhibitor of Pgp transporter protein in order to assess the possibility of its clinical use for the treatment of pharmacoresistant forms of cancer by overcoming the phenomenon of multidrug resistance of cells.