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Bacillus cereus: A review of "fried rice syndrome" causative agents

Leong SS, Korel F, King JH

Microb Pathog, 2023 Dec;185:106418.
PMID: 37866551 DOI: 10.1016/j.micpath.2023.106418

"Fried rice syndrome" originated from the first exposure to a fried rice dish contaminated with Bacillus cereus. This review compiles available data on the prevalence of B. cereus outbreak cases that occurred between 1984 and 2019. The outcome of B. cereus illness varies dramatically depending on the pathogenic strain encounter and the host's immune system. B. cereus causes a self-limiting, diarrheal illness caused by heat-resistant enterotoxin proteins, and an emetic illness caused by the deadly toxin named cereulide. The toxins together with their extrinsic factors are discussed. The possibility of more contamination of B. cereus in protein-rich food has also been shown. Therefore, the aim of this review is to summarize the available data, focusing mainly on B. cereus physiology as the causative agent for "fried rice syndrome." This review emphasizes the prevalence of B. cereus in starchy food contamination and outbreak cases reported, the virulence of both enterotoxins and emetic toxins produced, and the possibility of contaminated in protein-rich food. The impact of emetic or enterotoxin-producing B. cereus on public health cannot be neglected. Thus, it is essential to constantly monitor for B. cereus contamination during food handling and hygiene practices for food product preparation.

Matched MeSH terms: Emetics/metabolism
Fulltext Docking based screening and molecular dynamics simulations to identify potential selective PDE4B inhibitor

Al-Nema M, Gaurav A, Lee VS

Heliyon, 2020 Sep;6(9):e04856.
PMID: 32984588 DOI: 10.1016/j.heliyon.2020.e04856

Inhibition of phosphodiesterase 4 (PDE4) is a promising therapeutic approach for the treatment of inflammatory pulmonary disorders, i.e. asthma and chronic obstructive pulmonary disease. However, the treatment with non-selective PDE4 inhibitors is associated with side effects such as nausea and vomiting. Among the subtypes of PDE4 inhibited by these inhibitors, PDE4B is expressed in immune, inflammatory and airway smooth muscle cells, whereas, PDE4D is expressed in the area postrema and nucleus of the solitary tract. Thus, PDE4D inhibition is responsible for the emetic response. In this regard, a selective PDE4B inhibitor is expected to be a potential drug candidate for the treatment of inflammatory pulmonary disorders. Therefore, a shared feature pharmacophore model was developed and used as a query for the virtual screening of Maybridge and SPECS databases. A number of filters were applied to ensure only compounds with drug-like properties were selected. Accordingly, nine compounds have been identified as final hits, where HTS04529 showed the highest affinity and selectivity for PDE4B over PDE4D in molecular docking. The docked complexes of HTS04529 with PDE4B and PDE4D were subjected to molecular dynamics simulations for 100ns to assess their binding stability. The results showed that HTS04529 was bound tightly to PDE4B and formed a more stable complex with it than with PDE4D.

Matched MeSH terms: Emetics
Fulltext Isolation of Antidiabetic Withanolides from Withania coagulans Dunal and Their In Vitro and In Silico Validation

Maher S, Choudhary MI, Saleem F, Rasheed S, Waheed I, Halim SA, et al.

Biology (Basel), 2020 Jul 30;9(8).
PMID: 32751610 DOI: 10.3390/biology9080197

Withania coagulans (W. coagulans) is well-known in herbal medicinal systems for its high biological potential. Different parts of the plant are used against insomnia, liver complications, asthma, and biliousness, as well as it is reported to be sedative, emetic, diuretic, antidiabetic antimicrobial, anti-inflammatory, antitumor, hepatoprotective, antihyperglycemic, cardiovascular, immuno-suppressive and central nervous system depressant. Withanolides present in W. coagulans have attracted an immense interest in the scientific field due to their diverse therapeutic applications. The current study deals with chemical and biological evaluation of chloroform, and n-butanol fractions of W. coagulans. The activity-guided fractionation of both extracts via multiple chromatographic steps and structure elucidation of pure isolates using spectroscopies (NMR, mass spectrometry, FTIR and UV-Vis) led to the identification of a new withanolide glycoside, withacogulanoside-B (1) from n-butanol extract and five known withanolides from chloroform extract [withanolid J (2), coagulin E (3), withaperuvin C (4), 27-hydroxywithanolide I (5), and ajugin E (6)]. Among the tested compounds, compound 5 was the most potent α-glucosidase inhibitor with IC50 = 66.7 ± 3.6 µM, followed by compound 4 (IC50: 407 ± 4.5 µM) and compound 2 (IC50: 683 ± 0.94 µM), while no antiglycation activity was observed with the six isolated compounds. Molecular docking was used to predict the binding potential and binding site interactions of these compounds as α-glucosidase inhibitors. Consequently, this study provides basis to discover specific antidiabetic compounds from W. coagulans.

Matched MeSH terms: Emetics
Fulltext Health-related quality of life profile in relation to chemotherapy-induced nausea and vomiting among breast cancer patients

Pei, Lin Lua, Noor Salihah Zakaria, Nik Mazlan Mamat

ASEAN Journal of Psychiatry, 2012;13(1):0-0.
MyJurnal

Objective: Despite the availability of modern anti-emetics, chemotherapy-induced nausea and vomiting (CINV) symptoms remain distressing to a high number of cancer patients. This study intended to (1) describe the incidence of CINV and antiemetic usage; (2) assess the health-related quality of life (HRQoL) and correlate its components with Global Health Status; (3) evaluate HRQoL status in relation to CINV among breast cancer patients receiving chemotherapy. Methods: A cross sectional study was conducted in two government hospitals located in the East Coast of Peninsular Malaysia (Terengganu, Kelantan). The Morrow Assessment of Nausea and Emesis Follow-up (MANE-FU) and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) were administered. Descriptive statistics and non-parametric tests were employed (SPSS 16). Results: Respondents included 41 female patients (age = 49 ± 9.6 years; Malay = 92.7%; no family history of breast cancer = 68.3% and on moderately emetogenic chemotherapy = 97.6%). Majority of patients experienced nausea during or after chemotherapy (90.2%) and rated it as ‘severe’. Most patients had taken anti-emetic
(87.8%) and considered it ‘somewhat useful’. The median score for Global Health Status was 50 (IqR= 16.7). Emotional Functioning, Fatigue and Pain correlated fairly with HRQoL (rs= +0.435; -0.417; -0.387 respectively). Patients with ‘a lot’ and ‘moderate’ nausea displayed significantly more fatigue compared to those with little nausea (p=0.029). Those who experienced vomiting reported worse HRQoL profile compared to those who did not (p=0.011). Conclusion: These findings generally ascertained that CINV remains poorly controlled and significantly interferes with HRQoL, providing rooms for improvements in therapeutic intervention.

Matched MeSH terms: Antiemetics; Emetics
Cost-effectiveness analysis of olanzapine-containing antiemetic therapy for managing highly emetogenic chemotherapy in Southeast Asia: a multinational study

Chanthawong S, Lim YH, Subongkot S, Chan A, Andalusia R, Ahmad Bustamam RS, et al.

Support Care Cancer, 2019 Mar;27(3):1109-1119.
PMID: 30112718 DOI: 10.1007/s00520-018-4400-1

PURPOSE: Recent studies suggested that olanzapine, together with dexamethasone and serotonin-3 receptor antagonist (5HT3RA), is effective in preventing chemotherapy-induced nausea and vomiting (CINV) following highly emetogenic chemotherapy (HEC). This regimen is particularly useful in Southeast Asia (SEA) countries where resources are limited. We aimed to evaluate the cost-effectiveness of incorporating olanzapine into standard antiemetic regimens for the prevention of CINV in patients receiving HEC among SEA countries.
METHODS: Using a decision tree model, clinical and economic outcomes associated with olanzapine-containing regimen and standard antiemetic regimen (doublet antiemetic regimen: dexamethasone+first generation 5HT3RA) in most SEA countries except in Singapore (triplet antiemetic regimen: dexamethasone+first generation 5HT3RA + aprepitant) for CINV prevention following HEC were evaluated. This analysis was performed in Thailand, Malaysia, Indonesia, and Singapore, using societal perspective method with 5-day time horizon. Input parameters were derived from literature, network meta-analysis, government documents, and hospital databases. Outcomes were incremental cost-effectiveness ratio (ICER) in USD/quality-adjusted life year (QALY) gained. A series of sensitivity analyses including probabilistic sensitivity analysis were also performed.
RESULTS: Compared to doublet antiemetic regimen, addition of olanzapine resulted in incremental QALY of 0.0022-0.0026 with cost saving of USD 2.98, USD 27.71, and USD 52.20 in Thailand, Malaysia, and Indonesia, respectively. Compared to triplet antiemetic regimen, switching aprepitant to olanzapine yields additional 0.0005 QALY with cost saving of USD 60.91 in Singapore. The probability of being cost-effective at a cost-effectiveness threshold of 1 GDP/capita varies from 14.7 to 85.2% across countries.
CONCLUSION: The use of olanzapine as part of standard antiemetic regimen is cost-effective for the prevention of CINV in patients receiving HEC in multiple SEA countries.

Matched MeSH terms: Antiemetics/economics*; Antiemetics/therapeutic use; Emetics