Given the pervasiveness of Pediatric Obesity, it is imperative to understand its pathophysiology and develop alternative strategies to reverse this condition. Herein, investigators propose to elucidate the interaction between colonic fermentation and insulin resistance in modulating metabolism in youth with obesity.

开始日期2025-09-01

申办/合作机构

Yale University

[+1]

CTRI/2025/04/085492

/ Not yet recruitingN/AIIT

Comparative evaluation of rifaximin and lactulose in combination vs lactulose alone in prevention of constipation in critically ill chronic kidney disease patients; a randomized controlled trial. - nil

开始日期2025-05-03

申办/合作机构

All India Institute of Medical Sciences

NCT06483737

/ Not yet recruitingN/AIIT

Human Albumin Infusion in Liver Cirrhosis and Overt Hepatic Encephalopathy (HACHE): an Invesitgator-initiated, Open-label, Multicenter, Randomized Controlled Trial

Hepatic encephalopathy (HE), a severe complication of decompensated cirrhosis, is characterized as neurocognitive dysfunction. Emerging evidence suggests the potential role of human albumin infusion for the treatment of HE, but its optimal dosage remains undefined. Therefore, the investigators planned a randomized controlled trial (RCT) to compare the efficacy of human albumin infusion at different dosages in in patients with liver cirrhosis and overt HE.

开始日期2025-05-01

申办/合作机构

中国人民解放军北部战区总医院

100 项与乳果糖相关的临床结果

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100 项与乳果糖相关的转化医学

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100 项与乳果糖相关的专利（医药）

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5,744

项与乳果糖相关的文献（医药）

2025-12-01·Current Neurology and Neuroscience Reports

Hepatic Encephalopathy: Current Thoughts on Pathophysiology and Management

Review

作者: Pan, Kausik ; Chakravarty, Ambar ; Sen, Barun Kumar

PURPOSE OF REVIEWThis review highlights the causes, types and clinical staging of hepatic encephalopathy (HE). Current concepts on the probable pathogenetic mechanisms and currently practiced therapeutic options are discussed.RECENT FINDINGSHE may be covert and overt. Also known as minimal HE. Covert HE, where there are behavioral abnormalities and impairment in activities of daily living with intact sensorium. The pathophysiology of HE remains poorly understood. There is disturbance of the urea cycle due to liver disease leading to increased production of ammonia. The ammonium ion enters the astrocytes along with glutamate (converted to glutamine by ammonia) and myo-inositol, thereby increasing the osmolality of the astrocytic cytoplasm. This osmotic gradient results in accumulation of water inside the astrocytes resulting in cerebral edema and increase in brain volume. Additionally, current research has noted the role of cerebral oxidative/nitrosative stress and the synergistic effects of increased cerebral ammonia and alteration in neurotransmitters, neurometabolites, and cortical excitability due to systemic inflammation. In advanced liver disease with systemic infection or inflammation, neuroinflammatory processes play significant role in the development of HE. Inflammatory cytokines like TNF-α, IL-6, IL-17 in presence of hyperammonemia have been found to induce neurotoxicity of ammonia by passing through the blood brain barrier and causing enlarged/swollen pale astrocytes, resulting in HE. Disrupted enterohepatic circulation in end stage liver disease also causes elevation of bile acids which induces neuroinflammation. Manganese and zinc play as co-factors of enzymatic reaction. These metal deposition causes multiple psychomotor symptoms observed in HE. The gut environment has a major impact on brain function in patients with HE. Toxins such as ammonia and inflammatory cytokines produced by this impaired intestinal flora access the circulation through porto-systemic anastomoses and exacerbate or precipitate HE. Finally, as a result of recurrent cerebral edema from astrocytic dysfunction and neuroinflammation, permanent neurodegeneration occurs with cognitive decline and motor disturbances, especially parkinsonian features and gait disturbances. This is the stage of chronic hepatic encephalopathy. Currently L-ornithine L-aspartate (LOLA) is being used to lower the ammonia level by stimulating the urea cycle. HE comprises a broad spectrum of neurological and/or psychiatric abnormalities caused by hepatic insufficiency and/or portal-systemic shunting in the absence of any other causes of brain dysfunction. HE may be caused or precipitated by several factors like infections, intoxications and drugs. The encephalopathic features may be covert or overt. The pathogenetic mechanisms for HE may be different. In the presence of liver disease, HE primarily results from disturbed urea cycle with hyperammonemia causing astrocytic swelling and cerebral edema. Porto-systemic anastomoses with intact liver function can cause HE by allowing ammonia and other toxins produced by the gut microbial flora and allowing these to bypass detoxification by the liver and exposing the brain to their harmful effects. Principles of therapy are twofold. First protecting the liver and the brain from gut generated ammonia and other toxins by ensuring smooth bowel function and avoiding stagnation with the use of osmotic laxatives like lactulose or lactitol and also reducing the gut microbial load with use of anti-bacterials/bacteriophages like neomycin and rifaximin along with metronidazole. Second, reducing the already generated cerebral edema by use of mannitol and appropriate ventilatory support. Currently L-ornithine L-aspartate (LOLA) is being used to reduce the ammonia load to the liver. LOLA is a stable compound formed from two amino acids. L-ornithine plays a crucial role in stimulating the urea cycle, leading to a reduction in ammonia levels. Both L-ornithine and L-aspartate serve as substrates for the enzyme glutamate transaminase, and their administration results in elevated glutamate concentrations. Ammonia is subsequently utilized in the conversion of glutamate to glutamine through the action of glutamine synthetase. Finally in resistant cases the use of liver transplant needs to be considered. Alternatively extracorporeal liver assist devices may be used like Molecular Adsorbent Recirculating System (MARS) or Single-Pass Albumin Dialysis (SPAD).

2025-08-01·Food Chemistry

Engineering the substrate-binding pocket of Cellobiose 2-epimerase for enhancing lactulose biosynthesis

Article

作者: Chen, Qiuming ; He, Zhiyong ; Wang, Zhaojun ; Chen, Jie ; Wu, Junhao ; Zeng, Maomao

Cellobiose 2-epimerase (CE) converts lactose into lactulose and epilactose with high added value and prebiotic benefits. However, the low conversion of lactulose by CsCE limits its industrial application. Inspired by previous work introducing engineered disulfide bonds on the loop of CsCE, we performed saturation mutagenesis and high-throughput screening of all residues within 4 Å of the engineered disulfide bond. The best mutant, CsCE-S173C/F231C/L172S/I178V(M4), showed a 1.3-fold increase in isomerization activity over CsCE-S173C/F231C. Molecular dynamics simulations and binding pocket analysis revealed that mutations reshaped the shape and size of the substrate-binding pocket and increased non-covalent interactions of the protein with the ligand. Binding free energy calculations showed a higher binding affinity of M4 for lactose and lactulose. Therefore, we demonstrated that the catalytic characteristics of CE can be modulated by further manipulating the loop region near the pocket, which is important for improving the catalytic efficiency and promiscuity of the enzyme.

2025-07-01·Food Chemistry

Development of boronate affinity adsorbent bearing -B(OH)2 and F groups with low pKa value for enhanced production and purification of lactulose through adsorption-assisted bio-isomerization of lactose

Article

作者: Wang, Lu ; Yang, Ruijin ; Wang, Mingming ; Lyu, Xiaomei ; He, Wenmeng ; Wang, Guangzhen

In this study, a boronate affinity material (FA-5) with a low pK_a value was prepared to facilitate lactulose production. At physiological pH, 58.23 % of the B atoms in FA-5 existed in an sp³ hybridization state, and FA-5 demonstrated excellent adsorption capacity (94.78 mg/g) and selectivity (91.82 %) for lactulose from a 1:1 lactulose-lactose solution. Additionally, FA-5 demonstrated an exceptional capability for separating lactulose. The purity of lactulose increased by up to 6.82-fold in lactulose-lactose solutions with varying concentration ratios. A cascade system was formed by an immobilized enzyme-packed column with an FA-5-packed column to enhance lactulose production and purification. By adopting the adsorption-assisted isomerization strategy, the lactulose yield was improved from 52.50 % to 71.14 % with lactulose purity reaching 83.57 %. Moreover, the cascade system demonstrated excellent catalytic stability (86.28 %) and adsorption stability (93.68 %) over six consecutive cycles. The results highlight the potential of the cascade system for enzymatic production of lactulose.

154

项与乳果糖相关的新闻（医药）

2025-04-30

·药闻康策

河北省乳果糖口服液体剂及七氟烷吸入剂集采拟中选结果公布

☝ 点击上方一键预约 ☝ 最新最热的医药健康新闻政策刚刚，河北公布乳果糖口服溶液和吸入用七氟烷集采结果。乳果糖口服溶液两个企业中标，6袋装最低价9块9，单袋1.6元。原来国产企业挂网价均价5块钱一袋，现在只要9块9六袋。乳果糖口服溶液32个企业过评价，但一直没被纳入国采。这次河北，不等国采，自己先省采，试探一下能降价多少！15ml报量约880万袋，中选企业两家平分的话，每家能有700万的采购额。你觉得，这个标，值不值？各相关企业：现将我省乳果糖口服液体剂及七氟烷吸入剂集中带量采购拟中选结果公示，详见附件。一、公示时间公示及受理企业申(投)诉时间：2025年4月30日至5月8日。受理申（投）诉期间接受企业和社会各界申（投）诉。二、拟挂网公示（一）企业和社会各界对拟中选药品挂网价提出申（投）诉的，有关企业需提供相关证明材料，做出说明。（二）企业对公示结果有异议的，可登录招采子系统进入“药品挂网管理-我的工作台-乳果糖口服液体剂、七氟烷吸入剂集采-申投诉管理-企业申投诉”网上申（投）诉，申投诉事项选择【乳果糖口服液体剂、七氟烷吸入剂集采--申投诉】。反馈问题描述需准确详细，相关证明材料须真实可靠、清晰可辨。（三）企业被举报资质造假或虚报价格，经核实后，取消该药品拟中选资格。（四）公示无异议的药品，作为此次集采中选药品。 (来源:药筛）药闻康策新媒体矩阵微信公众号点击下方一键关注【免责声明】1.“药闻康策”部分文章信息来源于网络转载是出于传递更多信息之目的，并不意味着赞同其观点或证实其内容的真实性。如对内容有疑议，请及时与我司联系。2.“药闻康策”致力于提供合理、准确、完整的资讯信息，但不保证信息的合理性、准确性和完整性，且不对因信息的不合理、不准确或遗漏导致的任何损失或损害承担责任。3.“药闻康策”所有信息仅供参考，不做任何商业交易或医疗服务的根据，如自行使用“药闻康策”内容发生偏差，我司不承担任何责任，包括但不限于法律责任，赔偿责任。欢迎转发分享、点赞、点在看

带量采购一致性评价专利无效

2025-04-30

·米内网

【市场】30亿吸入剂在列！医药大省集采来了

精彩内容日前，河北省医用药品器械集中采购中心发布通知，拟对乳果糖口服液体剂、七氟烷吸入剂2种化学药品开展集中带量采购。米内网数据显示，上述2个品种2023年在中国公立医疗机构终端的销售额分别超过17亿元、30亿元。据悉，此次集采所有原研药（含参比制剂），通过一致性评价药品（含视同过评药品），普通仿制药均可自愿参加，标期为两年。中选规则为：同质量层次药品有1至3家企业申报的，拟中选企业为1家，按规则差比后价格最低的拟中选；同质量层次药品有4家及以上企业申报的，按规则差比后从低到高排名，最低价与最高价在1.1倍（含）以内的药品中最低价和次低价的2家企业拟中选；普通质量层次药品申报价格需低于过评质量层次拟中选药品最低价的10%及以上；过评质量层次拟中选药品价格需不高于普通质量层次拟中选药品最高价的2倍。采购品种及周期第一年约定量来源：河北省医用药品器械集中采购中心国内在销的七氟烷吸入剂仅吸入用七氟烷一种，该产品适用于成年人和儿童的全身麻醉的诱导和维持。米内网数据显示，吸入用七氟烷已被纳入国家医保乙类目录，2023年在中国城市公立医院、县级公立医院、城市社区中心以及乡镇卫生院（简称中国公立医疗机构）终端的销售额超过30亿元。从厂家格局看，上海恒瑞医药、日本丸石制药、鲁南贝特制药依次位列前三，市场份额分别超过62%、18%、11%。近年来中国公立医疗机构终端吸入用七氟烷销售情况（单位：万元）来源：米内网中国公立医疗机构药品终端竞争格局含进口厂家在内，目前有11家企业拥有吸入用七氟烷生产批文，其中上海恒瑞医药、鲁南制药集团、福建海西联合药业、四川百利药业、山东新时代药业、河北一品生物、河北山姆士药业的产品已过评或视同过评。乳果糖口服溶液是一种渗透性泻药，适用于：1、慢性或习惯性便秘：调节结肠的生理节律；2、肝性脑病：治疗和预防肝昏迷或昏迷前状态。该产品为国家医保乙类、OTC甲类（双跨）品种，近年来在中国公立医疗机构终端的销售额均超过17亿元。从2023年厂家格局看，雅培、韩美、费森尤斯卡比依次位列前三，市场份额分别超过43%、28%、13%。近年来中国公立医疗机构终端乳果糖口服溶液销售情况（单位：万元）来源：米内网中国公立医疗机构药品终端竞争格局含进口厂家在内，目前有40余家企业拥有乳果糖口服溶液生产批文，其中江中药业、福元药业、山东新华制药、山东京卫制药、石药银湖制药、健民药业等33家企业的产品已过评或视同过评。乳果糖口服溶液过评企业来源：米内网一致性评价进度数据库注：米内网《中国公立医疗机构药品终端竞争格局》，统计范围是：中国城市公立医院、县级公立医院、城市社区中心以及乡镇卫生院，不含民营医院、私人诊所、村卫生室；上述销售额以产品在终端的平均零售价计算。数据统计截至4月30日，如有疏漏，欢迎指正！免责声明：本文仅作医药信息传播分享，并不构成投资或决策建议。本文为原创稿件，转载文章或引用数据请注明来源和作者，否则将追究侵权责任。投稿及报料请发邮件到872470254@qq.com稿件要求详询米内微信首页菜单栏商务及内容合作可联系QQ：412539092【分享、点赞、在看】点一点不失联哦

一致性评价带量采购

2025-04-29

·investor.cumberlandpharma.com

CUMBERLAND PHARMACEUTICALS TO ANNOUNCE Q1 2025 FINANCIAL RESULTS & COMPANY UPDATE

NASHVILLE, Tenn., April 29, 2025 /PRNewswire/ -- Cumberland Pharmaceuticals Inc. (Nasdaq: CPIX), a specialty pharmaceutical company, announced today that it will release its first quarter 2025 financial results and provide a Company update after the market closes on Tuesday, May 6, 2025. A conference call will be held on May 6 at 4:30 p.m. Eastern Time to discuss the results and update. The link to register is: https://register-conf.media-server.com/register/BIea2bc7f82dd24caea135dbe5460d9b6f. Once registered, participants can dial in from their phone using a dial-in and PIN number that will be provided to them. Alternatively, they can choose a "Call Me" option to have the system automatically call them at the start of the conference. A replay of the call will be available for one year and can be accessed via Cumberland's website or by visiting https://edge.media-server.com/mmc/p/wost2na9/. Cumberland Pharmaceuticals is a specialty pharmaceutical company dedicated to providing unique products that improve patient care. The Company develops, acquires, and commercializes products for the hospital acute care, gastroenterology and oncology market segments. The company's portfolio of FDA-approved brands includes: Acetadote® (acetylcysteine) injection, for the treatment of acetaminophen poisoning; Caldolor® (ibuprofen) injection, for the treatment of pain and fever; Kristalose® (lactulose) for oral solution, a prescription laxative, for the treatment of constipation; Sancuso® (granisetron) transdermal system, for the prevention of nausea and vomiting in patients receiving certain types of chemotherapy treatment; Vaprisol® (conivaptan) injection, to raise serum sodium levels in hospitalized patients with euvolemic and hypervolemic hyponatremia; and Vibativ® (telavancin) injection, for the treatment of certain serious bacterial infections including hospital-acquired and ventilator-associated bacterial pneumonia, as well as complicated skin and skin structure infections. The Company also has a series of Phase II clinical programs underway evaluating its ifetroban product candidate in patients with Systemic Sclerosis, the cardiomyopathy associated with Duchenne Muscular Dystrophy and Idiopathic Pulmonary Fibrosis. For more information on Cumberland's approved products, including full prescribing information, please visit links to the individual product websites, found on the company's website at www.cumberlandpharma.com. View original content to download multimedia:https://www.prnewswire.com/news-releases/cumberland-pharmaceuticals-to-announce-q1-2025-financial-results--company-update-302441751.html SOURCE Cumberland Pharmaceuticals Inc. Investor Contact: Shayla Simpson, Cumberland Pharmaceuticals, (615) 255-0068; Media Contact: Molly Aggas, Dalton Agency, (704) 641-6641

临床2期财报上市批准

100 项与乳果糖相关的药物交易

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外链

KEGG	Wiki	ATC	Drug Bank
D00352	乳果糖	A06AD11	DB00581

研发状态

批准上市

10 条最早获批的记录,

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适应症	国家/地区	公司	日期
慢性便秘	澳大利亚	Arrotex Pharmaceuticals Pty Ltd.	2014-02-13
肝性脑病	澳大利亚	Arrotex Pharmaceuticals Pty Ltd.	2014-02-13
高氨血症	日本	Maruishi Pharmaceutical Co., Ltd.	1975-07-15
便秘	中国	-	-

未上市

10 条进展最快的记录,

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适应症	最高研发状态	国家/地区	公司	日期
结肠疾病	临床2期	美国	Cumberland Pharmaceuticals, Inc.	2014-04-01
肝性脑病	临床2期	印度	CD Pharma India Pvt. Ltd.	2009-10-01
便秘	临床2期	美国	Sanofi-Aventis U.S. LLC	1976-03-25

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研究	分期	人群特征	评价人数	分组	结果	评价	发布日期


NCT05061992 (CTgov)	临床2/3期	纤维化	56	Lactulose (Lactulose)	壓顧醖網淵鹽廠願簾艱(醖範選廠簾簾遞夢餘繭) = 築網願選鬱築齋觸廠繭選糧鹹膚積製選選齋顧 (憲夢繭繭窪鹹築築繭簾, 蓋淵鏇廠遞願繭獵壓選 ~ 遞網蓋襯選鏇願獵齋網) 更多	-	2023-11-21
				placebo (No Treatment)	壓顧醖網淵鹽廠願簾艱(醖範選廠簾簾遞夢餘繭) = 憲鹽壓選衊鬱憲遞夢夢選糧鹹膚積製選選齋顧 (憲夢繭繭窪鹹築築繭簾, 觸築鑰製餘選齋顧糧壓 ~ 範蓋範範鬱襯壓餘醖衊) 更多
NCT05687409 (Pubmed \| Front Microbiol)	临床4期	纤维化	-	Synbiotic (lactulose, Clostridium butyricum, Bifidobacterium longum infantis)	(鹽廠構夢鏇壓鏇蓋艱壓) = 襯衊窪繭艱鬱範繭遞網鏇鑰鹽衊鏇餘構蓋遞簾 (築憲鹹鹹繭顧範鏇願鬱 )	积极	2023-01-01
3 clinical trials of rifaximin plus lactulose (EASL2022)	N/A	肝性脑病追加	-	Rifaximin plus lactulose	製範廠餘鏇觸簾餘壓餘(築糧艱鑰製獵範構鹹獵) = 淵繭夢夢觸糧襯選簾鑰鏇窪窪鬱選範顧憲積壓 (蓋齋鏇襯獵壓壓鹹鏇鹹 )	积极	2022-06-25
				Lactulose alone	製範廠餘鏇觸簾餘壓餘(築糧艱鑰製獵範構鹹獵) = 製鏇夢網網選窪膚醖顧鏇窪窪鬱選範顧憲積壓 (蓋齋鏇襯獵壓壓鹹鏇鹹 )
EASL2022	N/A	纤维化	-	Lactulose	-	-	2022-06-24
				Lactulose + Rifaximin-alpha
EASL2022	N/A	肝性脑病	-	Rifaximin-alpha 550 mg + Lactulose	壓積願獵餘醖範鹹齋選(壓鏇構壓鏇膚願鏇簾膚) = 膚鬱鹹願網衊遞範築齋鏇願簾顧鑰築餘築觸廠 (糧齋遞夢選鑰鏇鹽遞襯 ) 更多	积极	2022-06-24
				Lactulose	壓積願獵餘醖範鹹齋選(壓鏇構壓鏇膚願鏇簾膚) = 觸簾製簾鏇鑰鏇顧鬱壓鏇願簾顧鑰築餘築觸廠 (糧齋遞夢選鑰鏇鹽遞襯 ) 更多
UEGW2021	N/A	肝性脑病	-	Rifaximin-alpha + Lactulose	遞簾範壓鏇選夢構獵蓋(壓蓋範繭膚簾廠鬱遞襯) = 衊顧網夢齋餘鏇鹽範艱窪願憲遞淵鑰餘遞餘廠 (鑰鏇積廠廠製淵簾鑰製, 0.70 ~ 0.96)	-	2021-10-02
				Lactulose	遞簾範壓鏇選夢構獵蓋(壓蓋範繭膚簾廠鬱遞襯) = 鏇鑰繭鬱憲顧繭淵廠淵窪願憲遞淵鑰餘遞餘廠 (鑰鏇積廠廠製淵簾鑰製, 0.94 ~ 1.30)
DDW2021	N/A	肝性脑病	279	Polyethylene Glycol (PEG)	(餘觸艱構襯窪獵簾淵淵): MD = -1.31 (95% CI, -2.17 ~ -0.44), P-Value = 0.003	积极	2021-05-23
				Lactulose
DDW2021	N/A	肝性脑病	-	Polyethylene Glycol (PEG)	(醖壓遞艱窪襯鏇鹽範顧): MD = -1.31 (95% CI, -2.17 ~ -0.44), P-Value = 0.003	-	2021-05-23
				Lactulose
DDW2021	N/A	肝性脑病	279	Polyethylene Glycol (PEG)	(鹽齋鹽築膚齋壓網網選): MD = -1.31 (95% CI, -2.17 ~ -0.44), P-Value = 0.003	积极	2021-05-23
				Lactulose
DDW2021	N/A	肝性脑病	-	Polyethylene Glycol (PEG)	(壓製蓋蓋繭顧膚壓獵鑰): MD = -1.31 (95% CI, -2.17 ~ -0.44), P-Value = 0.003	-	2021-05-23
				Lactulose