Role of ranibizumab in management of macular degeneration.

Age-related macular degeneration (AMD) is one of the most common causes of severe vision loss in the western world. Both animal and human studies have established that vascular endothelial growth factor (VEGF) plays an important role in the pathogenesis of this process. Ranibizumab (Lucentis(TM) Genentech, South San Francisco, CA) is a monoclonal antibody fragment (Fab) directed toward all isoforms of VEGF-A that was specifically designed to target wet AMD. The human antibody fragment is produced by an E. coli expression system and has a molecular weight of 48kD allowing for excellent retinal penetration. The most common ocular complaints of patients receiving ranibizumab injections in randomized clinical trials were transient conjunctival hemorrhage, vitreous floaters, intraocular inflammation, increased intraocular pressure and eye pain. The rates of serious adverse events such as retinal detachment, cataract and endophthalmitis were similar to those that have been reported with other intravitreal injections and patients should always be treated under strict aseptic conditions to reduce this risk. There were no significant non-ocular events found during any study so far and the risk of thromboembolic events was less than 4% and not different than sham. The MARINA, ANCHOR and PIER studies validated the safety and efficacy of ranibizumab amongst a large population with different choroidal neovascular membrane lesion types against sham or standard of care treatment. These studies recommended monthly intravitreal ranibizumab for patients. However, the PIER study reported that an alternative dosing of every three months is acceptable but less effective than monthly injections.

The Long-term Clinical Results of a Platelet Glycoprotein IIb/IIIa Receptor Blocker (Abciximab: ReoPro (R) ) Coated Stent in Patients with Coronary Artery Disease

BACKGROUND: Previously, the inhibition of coronary restenosis with Abciximab (ReoPro (R) ) -coated stent in a porcine model was reported. ReoPro (R) inhibits platelet aggregation, the proliferation of vascular smooth muscle cells and the inflammatory reaction. METHODS: A prospective randomized trial was performed to compare two types of stent for revascularization in the native coronary artery. The primary effective end points were major adverse coronary events (MACE) : cardiac death, acute myocardial infarction, target vessel revascularization (TVR) and restenosis at the 6-month clinical and angiographic follow-ups. RESULTS: One hundred and fifty-five patients were enrolled between August 2001 and June 2003. The mean ages (56.0 +/- 10.0 vs. 56.9 +/- 10.8 years), baseline diameter of stenosis and minimal luminal diameter were no different between the two groups. There was one myocardial infarction and revascularization during the hospital stay in control stent group. During the clinical follow-up there were two myocardial infarctions in control group. Follow-up coronary angiograms were performed in 62.3% (48/77) and 65.4% (51/78) of the coated and control groups, respectively. The diameter of stenosis and late loss were significantly less in the ReoPro (R) -coated stent group compared with the controls (16.4 +/- 5.8% vs. 34.3 +/- 6.1%, p=0.009; and 0.33 +/- 0.28 mm vs. 0.88 +/- 0.41 mm; p=0.002). The restenosis and TVR rates of the ReoPro (R) -coated stent were relatively lower compared with the control stent [14.6% (7/48) vs. 29.4% (15/51), p=0.062; and 9.2% (7/76) vs. 14.7% (11/75) ; p=0.327]. CONCLUSION: A ReoPro (R) -coated stent is safe, and may be effective in the prevention of coronary restenosis.

Marcación de un anticuerpo monoclonal con 99mTc por medio del grupo 99cTcN: evaluación de un modelo biológico / 99mTC labeling of a monoclonal antibody via a 99mTcN group: a biological model evaluation

El anticuerpo monoclonal (AcMo) anti-CEA B2C114 fue marcado con 99mTc utilizando uno de los métodos directos de marcación, en el cual la proteína (AcMo IgG1) se reuce utilizando una solución de Ditiotreitol (DTT) para generar grupos sulfhidrilos, uniendo el 99mTc a los mismos a través del anión [99mTcNCl4]- preparado por calentamiento a reflujo de pertecneciato en presencia de azida sódica y HCl conc. El exceso de DTT se eliminó pasando el AcMo reducido por Sephadex G-25 y del mismo modo se realizó la purificación del anticuerpo marcado. Las cromatografías en TLC y Whatman Nº1 usando Metanol 85 por ciento y solución fisiológica como solventes, mostraron una actividad unida a proteínas entre 55-60 por ciento, obteniéndose luego de la purificación por Sephadex G-25 un producto con 90-95 por ciento de pureza radioquímica. Se realizó la biodistribución en ratones Balb/c a las 21 h post inyección obteniéndose una relación de 2:1 de la dosis inyectada por gramo de tejido, con respecto al tumor reactivo:no reactivo. El ensayo de unión realizado demostró que el AcMo conservó su actividad biológica después de marcado