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Background: Alport syndrome is one of the most common inherited kidney diseases worldwide. A genetic test or kidney biopsy is necessary for a definite diagnosis of this disease, and an accurate diagnosis system for this disease is highly desired in each country. However, the current situation in Asian countries is not clear. Therefore, the tubular and inherited disease working group of the Asian Pediatric Nephrology Association (AsPNA) aimed to assess the current situation of diagnosis and treatment for Alport syndrome in Asia. Methods: The group conducted an online survey among the members of AsPNA in 2021–2022. Collected data included the number of patients for each inheritance mode, availability of gene tests or kidney biopsy, and treatment strategies for Alport syndrome. Results: A total of 165 pediatric nephrologists from 22 countries in Asia participated. Gene test was available in 129 institutes (78%), but the cost was still expensive in most countries. Kidney biopsy was available in 87 institutes (53%); however, only 70 can access electron microscopy, and 42 can conduct type IV collagen α5 chain staining. Regarding treatment, 140 centers use renin-angiotensin system (RAS) inhibitors (85%) for Alport syndrome patients. Conclusions: This study result might suggest that the system is underdeveloped enough to diagnose all Alport syndrome patients in most Asian countries. However, once diagnosed with Alport syndrome, most of them were treated with RAS inhibitors. These survey results can be used to address knowledge, diagnostic system, and treatment strategy gaps and improve the Alport patients' outcomes in Asian countries. [ABSTRACT FROM AUTHOR]

Andrographolide is a labdane diterpenoid from Andrographis paniculata and has been used in the clinic for several decades to treat a variety of diseases in east Asia. In the present study, modification of 12-thioether andrographolide was carried out to seek compounds with better antitumor activity and drug-like properties. A series of novel 3,19-modified thioether andrographolide derivatives were synthesized and evaluated for their in vitro anticancer activities against human breast cancer cells. The results are promising and important in the further development of anticancer agents. [ABSTRACT FROM AUTHOR]