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estradiol (Vagifem)

✓ Approved

Novo Nordisk A/S · ESR1 · 小分子

什么是 estradiol？

estradiol 是一种小分子，由Novo Nordisk A/S研发。该药已获批，用于治疗相关适应症，给药途径：Intravaginal。

药物档案

商品名Vagifem
公司Novo Nordisk A/S
药物类别小分子
分子靶点ESR1
给药途径Intravaginal
状态Approved
来源： ClinicalTrials.gov, Novo Nordisk A/S

作用机制

分子靶点

estradiol 作用于 1 个分子靶点：

ESR1estrogen receptor 1 (ER, ESR)
需要更深入的分析？Noah AI 可解释复杂机制并与同类药物比较。

治疗适应症

estradiol 针对 1 个适应症，涉及 1 个治疗领域。

治疗领域疾病/病症分期
Reproductive system and breast disordersAtrophic vulvovaginitis✓ Approved

相关研究文献

PubMedActa obstetricia et gynecologica Scandinavica2026-09-10

Planned cesarean section or attempted vaginal delivery: Which is more environmentally friendly? An observational life cycle assessment study in France.

Jaafar Sherazade S, Gillani Sayed S, Cordier Sophie S, Garabedian Charles C

While the health sector is known to contribute significantly to environmental degradation, little is known about the specific ecological footprint of childbirth. We thus aimed to compare the environmental impacts of attempted vaginal delivery and planned cesarean section (c-section), and to identify opportunities for improvement. We performed a life cycle assessment to quantify 16 environmental impact indicators from vaginal and c-section deliveries. Data were collected at Lille University Hospital in 2024. Hotspot analyses were undertaken to identify the most impactful stages within each scenario. Attempted vaginal delivery consistently had a lower environmental impact compared with planned c-section, the carbon footprints of which were 23.2 kg carbon dioxide equivalent (CO2e) versus 42.9 kg CO2e, respectively. Compared with planned c-section, attempted vaginal delivery reduced greenhouse gas emissions by 46%, water consumption by 26%, fossil resource use by 44%, and mineral and metal resource use by 30%. Attempted vaginal delivery is more environmentally sustainable compared with planned c-section. Perinatal health professionals should incorporate environmental considerations into clinical and public health decision-making, and should engage in other efforts to reduce this sector's contributions to climate change.

PMID 42720092
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PubMedPregnancy (Hoboken, N.J.)2026-09-10

Interventions following routine hemoglobin assessment after vaginal delivery.

Fujiwara Sarah S, Siu Andrea A, Yamasato Kelly K

To assess the utility of routine postpartum hemoglobin (Hgb) testing after vaginal delivery with normal blood loss by evaluating the frequency of blood transfusion and intravenous (IV) iron administration. This retrospective cohort study included vaginal deliveries with blood loss <500 mL at a tertiary hospital between January 2020 and May 2025. Patients with missing blood loss data, preeclampsia/eclampsia, or a hemorrhage diagnosis were excluded. Predelivery and postpartum Hgb values, as well as blood transfusion and IV iron administration, were collected. The primary outcomes were postpartum blood transfusion and IV iron administration. Univariate logistic regression was used to identify variables associated with blood transfusion and IV iron administration. Multivariable logistic regression was then performed to evaluate independent predictors of each outcome. Manual chart review was performed for those who received a blood transfusion or IV iron to identify signs of anemia and relevant comorbidities. Of 21,719 vaginal deliveries, 11,180 were included. Of these, 10,075 (90.1%) underwent postpartum Hgb testing with a mean Hgb decrease of 1.3 g/dL (SD, 0.9) pre- to postdelivery. Among the 11,180 deliveries, 19 (0.2%) received blood transfusion, and 82 (0.7%) received IV iron. Higher predelivery Hgb was associated with lower odds of blood transfusion (odds ratio [OR], 0.27; 95% confidence interval [CI], 0.19-0.38) and IV iron administration (OR, 0.25; 95% CI, 0.20-0.30). Among the 10,954 deliveries with predelivery Hgb ≥9 g/dL, six (0.05%) received blood transfusion. Of these six patients, five had anemia symptoms (n = 1) or comorbidities, including sepsis (n = 2) and vaginal hematoma (n = 2). Thirty-nine patients with a predelivery Hgb ≥9 g/dL received IV iron, of whom 13 (33.3%) had anemia symptoms and/or comorbidities. Among patients with predelivery Hgb ≥9 g/dL, normal blood loss, and no symptoms or comorbidities, the probability of receiving a blood transfusion or IV iron was 0.23% (one blood transfusion and 26 IV iron infusions). Applying a predelivery Hgb threshold of ≥9 g/dL to guide selective postpartum testing would have avoided 98% of routine assessments while maintaining 99.8% sensitivity for identifying patients who received a blood transfusion or IV iron. In this large cohort of vaginal deliveries with normal blood loss, blood transfusion and IV iron administration were rare. Selective postpartum Hgb testing based on predelivery Hgb and symptoms or comorbidities can be considered.

PMID 42719658
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PubMedBiophotonics discovery2026-09-10

Raman spectroscopy for nondestructive detection of vaginal tissue alterations in the fibulin-5 murine model of pelvic organ prolapse.

Vanoven Triniti N TN, Zaman Fatemeh Vahidi FV, Pan Evelyn T ET, Baas Jessica K JK et al.

Pelvic organ prolapse (POP) is a gynecologic condition where one or more pelvic organs herniate into the vaginal canal that is characterized by suboptimal treatment options, a poorly understood pathophysiology, and a 50% lifetime risk of symptomatic manifestation. The main modality to assess severity is the pelvic organ prolapse quantification (POP-Q) system; however, the POP-Q system, in addition to clinical imaging methods such as MRI and ultrasound, is blind to extracellular matrix (ECM) changes that may relate to loss of tissue compliance. We aimed to establish a nondestructive approach to measure optical biomarkers of POP using Raman spectroscopy as well as complementary assays for tissue compliance and remodeling. Twenty-four nulliparous fibulin-5 sufficient (wildtype) and deficient (knockout) mice were sacrificed at estrus (20 to 26 weeks old; n = 12 / genotype ) and full thickness vaginal samples ( 5 × 5    mm ) from the ventral wall were collected. Raman spectra were acquired and averaged from the vaginal epithelium for compositional analysis. Samples were then speckle-coated and tested using planar biaxial protocols to elucidate biomechanical properties. Finally, samples were subjected to histological sectioning and staining for validation. Spectral modeling and statistical analyses were performed, investigating associations between optical and histological composition with biomechanical measures of tissue compliance. Optical biomarkers of mature, functional elastic fibers significantly decreased in the knockout mice when compared with their wildtype littermates and correlated to histological quantification. In addition, the knockout vagina had direction-dependent alterations in tissue biomechanical response. Nondestructive imaging further identified dysregulated metabolism wherein optical and histological glycogen content significantly decreased when compared with the wildtype controls. Herein, we have established and verified a workflow for non-destructive compositional analysis with future implications in noninvasive clinical POP evaluation and treatment monitoring. Further, we have established potential optical biomarkers related to dysregulated elastogenesis with POP, such as the I 1101 / I 1654 mature, functional elastic fiber to ECM protein ratio.

PMID 42719896
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PubMedCatheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions2026-09-10

Prognostic Value of Angiography-Derived Fractional Flow Reserve Following Drug-Coated Balloon Angioplasty.

Rubio Pablo M PM, Bossard Matthias M, Amurrio Oscar J OJ, Franch Laura L et al.

The role of post-procedural physiological assessment after drug-coated balloon (DCB) percutaneous coronary intervention (PCI) remains poorly defined. Angiography-derived indices such as μQFR provide a non-wire-based alternative to traditional physiological measurements, yet their prognostic value following DCB-PCI has not been established. To explore the association between post-procedural μQFR and target lesion revascularization (TLR) in patients undergoing DCB angioplasty for de novo coronary lesions. This analysis included consecutive patients from the prospective SIROOP registry undergoing DCB-PCI for de novo coronary lesions. Post-procedural μQFR was assessed offline using a dedicated angiography-derived physiology software (AngioPlus, Pulse Medical Imaging Technology, Shanghai, China). Patients were stratified according to a post-procedural μQFR cutoff of 0.80 (≤ 0.80 vs. > 0.80). The primary endpoint was clinically driven TLR at 2-year follow-up. A total of 205 patients were analyzed, of whom 51 (24.9%) had a post-procedural μQFR ≤ 0.80 and 154 (75.1%) had a μQFR > 0.80. Baseline clinical characteristics were similar between groups. During 2-year follow-up, TLR occurred in nine patients (4.4%). Kaplan-Meier analysis demonstrated no significant difference in TLR according to post-procedural μQFR groups (log-rank p = 0.488). In patients undergoing DCB-PCI for de novo coronary lesions, post-procedural angiography-derived physiological assessment using μQFR was not associated with clinically driven TLR at 2-year follow-up when applying a cutoff of 0.80. These findings underscore the need for prospective studies to clarify the role of angiography-derived physiology after DCB-PCI.

PMID 42717411
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PubMedInternational journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics2026-09-10

Trends of induction of labor with success rates: Experience of a tertiary care center.

Alkharouf Feras F, Alqudaibi Nada F NF, Alhamdan Aminah A AA, Alomar Majd A MA et al.

Induction of labor (IOL) is a common obstetric procedure performed when continuation of pregnancy poses maternal or fetal risks. Prostaglandin E2 (PGE2) is widely used for cervical ripening and induction. This study assessed the success rate of PGE2-induced labor and identified obstetric predictors of failed induction and cesarean delivery at a tertiary center in Riyadh. This retrospective cross-sectional study included 1303 women who underwent IOL with PGE2 (tablet or pessary) at the Women's Health Hospital, National Guard Health Affairs, Riyadh, during 2023. Maternal characteristics, obstetric factors, and induction-related variables were analyzed using descriptive and inferential statistics. Logistic regression was applied to determine independent predictors of failed induction and cesarean section, with statistical significance set at P < 0.05. The overall success rate of PGE2 induction was 74.2%, consistent with global benchmarks. The vaginal tablet demonstrated higher effectiveness (80.6%) compared with the pessary (59.4%). Advanced maternal age, pre-eclampsia, and type 1 diabetes significantly increased the likelihood of failed induction and cesarean delivery. Intrapartum factors, particularly nonreassuring cardiotocography and inadequate cervical response, were strong determinants of cesarean section. PGE2 was effective for induction of labor in this cohort. The vaginal tablet was associated with a higher observed vaginal delivery rate than the pessary; however, this finding should be interpreted cautiously because formulation selection was not randomized and was based on availability. Individualized assessment, method selection, and fetal monitoring remain important. Women with relevant medical comorbidities should be counseled regarding their increased risk of cesarean delivery. Further prospective multicenter studies comparing efficacy, maternal safety, and neonatal outcomes are warranted.

PMID 42717831
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PubMedNature biomedical engineering2026-09-10

Sequence and structural determinants of efficacious de novo chimaeric antigen receptors.

Chow Arthur A, Chu Hoyin H, Li Ruofan R, Nalbant Benan N BN et al.

Advances in generative protein design using artificial intelligence (AI) have enabled the rapid development of binders against heterogeneous targets, including tumour-associated antigens. Despite extensive biochemical characterization, these novel protein binders have had limited evaluation in candidate therapeutics, including chimaeric antigen receptor (CAR) T cells. Here we synthesize generative protein design workflows to screen 1,758 newly designed protein binders targeting BCMA, CD19 and CD22 for efficacy in scalable protein-binding, T-cell activation and in vivo killing assays. We characterize three main challenges that hinder the utility of de novo protein binders as CARs, including tonic signalling, occluded epitope engagement and off-target activity. We develop computational and experimental heuristics to overcome these limitations, including screens of sequence variants of individual parental structures, that retain on-target CAR activation while mitigating liabilities. Together, our framework accelerates the development of AI-designed proteins for future preclinical therapeutic screening, helping enable a new generation of cellular therapies.

PMID 42716964
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