Mahidol University's Institutional Repository
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Recent Submissions
First molecular confirmations of Anopheles dirus and Anopheles scanloni in Indonesia, with DNA of zoonotic, enzootic and human malarias detected in An. dirus
(2026-03-02) Sebayang B.F.; van de Straat B.; Kurniawan A.; Haq A.M.; Garjito T.A.; Saeung M.; Manguin S.; Lubis I.N.D.; Grigg M.J.; Russell T.L.; Burkot T.R.; Sebayang B.F.; Mahidol University
Fatty acid transporter protein isoform 2 (FATP2) inhibitor lipofermata inhibits Zika virus replication and blocks fatty acid uptake in SH-SY5Y neuroblastoma cell line
(2026-04-07) Thongon S.; Boonarkart C.; Sirihongthong T.; Jitobaom K.; Kongmanas K.; Auewarakul P.; Thongon S.; Mahidol University
Zika virus (ZIKV) infection in adults is typically mild and self-limiting, but infection during pregnancy can cause fetal and neonatal microcephaly. No approved drugs or vaccines currently exist. ZIKV hijacks host lipid homeostasis to facilitate replication, and inhibitors of fatty acid synthesis decrease its production. However, cells obtain lipids from both de novo synthesis and uptake. Neurons, a primary target of ZIKV pathogenesis, have limited capacity for de novo lipid synthesis and rely more on lipid uptake. We previously demonstrated that lipid uptake inhibitors block influenza virus replication, yet their efficacy against ZIKV-particularly in neuronal cells-remains unknown. In the present study, we examined the anti-ZIKV and fatty acid uptake inhibitory activities of lipofermata, a fatty acid transporter protein isoform 2 (FATP2)‒specific inhibitor. Lipofermata effectively inhibited ZIKV production in immortalized hepatocyte (imHC) and SH-SY5Y (neuroblastoma) cell lines, with respective half-maximal inhibitory concentration (IC50) values of 1.41 and 1.11 μM with 50% cytotoxic concentration (CC50) of more than 20.0 μM. FATP2 mRNA and protein expression was significantly elevated in infected SH-SY5Y cells. ZIKV also significantly increased cellular phosphatidylcholine content. Lipofermata inhibited fatty acid uptake with an IC50 of 7.0 μM and significantly decreased phosphatidylcholine level. In addition, FATP2 knockdown by siRNA significantly decreased FATP2 mRNA and protein expression in SH-SY5Y and decreased ZIKV titer. These findings suggest that lipofermata disrupts ZIKV replication via fatty acid uptake inhibition. Furthermore, lipofermata at 2 µM markedly diminished caspase 3/7 and 8 activities, indicating that lipofermata mitigated ZIKV-induced extrinsic apoptosis in SH-SY5Y. Mitigating apoptosis may result in reduced neuropathogenesis. Consequently, FATP2 may serve as a promising target for anti-ZIKV therapies.IMPORTANCEZika virus can infect and cause severe damages to the brain. There is no effective antiviral drug for the treatment of Zika infection. Similar to many viruses, replication of Zika virus requires lipid. We show here that the virus could upregulate the fatty acid transporter FATP2 in neuroblastoma cells, which may increase the lipid supply in the infected cells, and that inhibiting the fatty acid transporter by lipofermata could suppress the viral replication and apoptosis. ZIKV production was also reduced by FATP2 knockdown. These suggest that FATP2 may be a promising target for the development of anti-Zika medication.
Association of pre-endoscopic fresh frozen plasma transfusion with clinical outcomes in patients with acute upper gastrointestinal bleeding and mild coagulopathy: a two-center retrospective cohort study
(2026-02-28) Bunnag K.; Chang A.; Nuyim T.; Sitthinamsuwan N.; Rujipattanapong N.; Chienwichai K.; Rugivarodom M.; Chirapongsathorn S.; Prachayakul V.; Bunnag K.; Mahidol University
The clinical benefit of fresh frozen plasma (FFP) transfusion prior to endoscopy in patients with acute upper gastrointestinal bleeding (AUGIB) and mild coagulopathy remains uncertain. We evaluated the association between pre-endoscopic FFP transfusion and clinical outcomes in patients with AUGIB and an international normalized ratio (INR) of 1.5-2.5. We conducted a retrospective two-center cohort study including adult patients admitted with AUGIB and INR 1.5-2.5 at two tertiary referral hospitals in Thailand between 2016 and 2020. Patients were categorized according to receipt of pre-endoscopic FFP transfusion. Multivariable logistic regression analyses were performed using baseline covariates and bleeding severity scores. An exploratory composite in-hospital major adverse event endpoint was evaluated to improve model stability. Among 244 patients (158 received FFP; 86 did not), those receiving pre-endoscopic FFP had higher crude rates of 30-day all-cause mortality (23.4% vs. 11.6%), in-hospital mortality (24.1% vs. 7.0%), pulmonary edema (23.4% vs. 4.7%), and the composite in-hospital major adverse event endpoint (40.5% vs. 10.5%) (all p < 0.01). After multivariable adjustment, pre-endoscopic FFP transfusion remained associated with the composite endpoint (adjusted odds ratio [aOR] 5.28; 95% confidence interval [CI], 2.17-12.82), in-hospital mortality (aOR 5.36; 95% CI, 1.87-15.37), pulmonary edema (aOR 3.85; 95% CI, 1.21-12.26), and 30-day mortality (aOR 2.69; 95% CI, 1.09-6.66). In subgroup analyses, these associations were more consistent among patients with variceal bleeding. In patients with AUGIB and mildly elevated INR, pre-endoscopic FFP transfusion was associated with higher mortality and pulmonary complications, particularly in those with variceal bleeding. Given the retrospective design and potential for residual confounding, these findings should be interpreted with caution. Nevertheless, these findings support consideration of a more selective, context-based approach to plasma transfusion and highlight the need for prospective studies to inform evidence-based transfusion strategies.
The Trade-Offs that Vietnamese Women Make in Early Detection Services for Breast Cancer: Insights from a Discrete Choice Experiment Using a Latent Class Model
(2026-04-01) Tran V.Q.; Le Dang V.C.; Ta Ngoc P.A.; Phan Nguyen T.V.; Ngo Hoang Y.N.; Phung T.L.; Ho Nguyen A.T.; Vo T.Q.; Tran V.Q.; Mahidol University
INTRODUCTION: Delays in diagnosis and treatment are common among Vietnamese breast cancer (BC) patients. This study analyzed women's preferences regarding breast cancer screening (BCS) programs and mammography screening to support the government in implementing population-based BCS. METHODS: We conducted literature reviews, focus group discussions, and qualitative interviews to develop the attributes and levels of a discrete choice experiment (DCE) involving [breast cancer screening (BCS) programs and mammography screening. The BCS program included] seven attributes (screening test staff's gender, method of invitation, free breast self-exam course, waiting time, combined screening test, screening location, and cost), and mammography screening included five attributes (comfort level, screening test staff's gender, false positives, overdiagnosis, and cost). The choice data were analyzed using a latent class model. Uptake was predicted, and policy scenarios were formulated. RESULTS: A total of 1,023 women, with an average age of 33.4 years, completed the DCE survey. In the BCS scenario, respondents in all classes preferred a combination of screening tests and lower costs, except for the smallest class of participants. Screening location and waiting time were influential components in decision-making for all women. Most participants were sensitive to organizational characteristics and costs. In the mammography screening scenario, respondents' preferences were strongly influenced by the gender of screening test personnel, false positives, and costs across all classes. CONCLUSION: Women in Vietnam exhibit heterogeneous preferences for breast cancer screening (BCS) programs and mammography screening. This study provides supporting evidence related to Vietnamese women's preferences for BCS, which may be valuable for public health authorities.
Phase II randomized controlled trial comparing traditional Thai cannabis-based medicine with lorazepam for insomnia treatment
(2026-12-01) Kamoltham T.; Chokchaisiri S.; Yongram C.; Sripan P.; Im-iam S.; Sanasit P.; Intaravattana V.; Sawasdichai C.; Udompat P.; Chaiphongpachara T.; Kummalue T.; Kamoltham T.; Mahidol University
Background: A traditional Thai cannabis-based multi-herbal formulation is legally recognized in Thailand for therapeutic use and clinical research. However, clinical evidence supporting its use for insomnia remains limited. Methods : This Phase II randomized, double-blind, active-controlled non-inferiority trial compared the efficacy and safety of the Anti-Pom-Leung Fever medicine with lorazepam in patients with chronic insomnia. One hundred participants were randomized to receive either the herbal formulation or lorazepam for 4 weeks. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Non-inferiority was evaluated at week 4 using a predefined margin of 2.1 based on the upper bound of the two-sided 95% confidence interval for the mean PSQI difference (experimental minus comparator). Longitudinal changes were analyzed using repeated-measures analysis of variance, and safety was evaluated through clinical and laboratory assessments. Results : Eighty-two participants completed the study (41 per group). Baseline characteristics were comparable between groups. Both treatments significantly improved sleep quality over 4 weeks. At week 4, mean PSQI scores were 3.44 in the experimental group and 4.78 in the comparator group, with a mean difference of -1.34 (95% CI: -2.99 to 0.31), demonstrating non-inferiority. A significant main effect of time on PSQI scores was observed, with no significant time-by-treatment interaction. Quality of life and stress improved in both groups, and safety profiles were comparable, with no clinically significant adverse effects. Conclusions : The traditional Thai cannabis-based multi-herbal formulation demonstrated non-inferior efficacy to lorazepam and was well tolerated, supporting its use as a short-term alternative for chronic insomnia.