ABSTRACT
La amiloidosis cardíaca es una entidad con creciente reconocimiento, la variedad por transtiretina es la que más se diagnostica en la tercera edad de la vida. Hay reciente disponibilidad de fármacos que mejoran el pronóstico y la calidad de vida de los pacientes. Presentamos un caso de amiloidosis por transtiretina donde se usó por primera vez en nuestro país el fármaco tafamidis aprobado para el tratamiento de esta enfermedad.
Cardiac amyloidosis is an entity on increasing recognition, transthyretin variety is the most diagnosed in the third age. There is a recent availability of drugs that can improve the prognosis and quality of life of these patients. We present a case of transthyretin amyloidosis and the first use of tafamidis in our country.
A amiloidose cardíaca é uma entidade em crescente reconhecimento, a variedade transtiretina é a mais diagnosticada em idosos. Há disponibilidade recente de medicamentos que melhoram o prognóstico e a qualidade de vida dos pacientes. Apresentamos um caso de amiloidosis transteretina onde o medicamento tafamidis aprovado para esta doença foi utilizado pela primeira vez em nosso país.
Subject(s)
Humans , Male , Aged , Benzoxazoles/administration & dosage , Amyloidosis/diagnostic imaging , Cardiomyopathies , Amyloidosis/drug therapyABSTRACT
ABSTRACT Transthyretin familial amyloid polyneuropathy is an autosomal dominant inherited sensorimotor and autonomic polyneuropathy, which if untreated, leads to death in approximately 10 years. In Brazil, liver transplant and tafamidis are the only disease-modifying treatments available. This review consists of a consensus for the diagnosis, management and treatment for transthyretin familial amyloid polyneuropathy from the Peripheral Neuropathy Scientific Department of the Brazilian Academy of Neurology. The first and last authors produced a draft summarizing the main views on the subject and emailed the text to 10 other specialists. Relevant literature on this subject was reviewed by each participant and used for the individual review of the whole text. Each participant was expected to review the text and send a feedback review by e-mail. Thereafter, the 12 panelists got together at the city of Fortaleza, discussed the controversial points, and reached a consensus for the final text.
RESUMO Polineuropatia amiloidótica familiar é uma polineuropatia sensitivo-motora e autonômica de herança autossômica dominante, que caso não seja tratada leva a morte em aproximadamente 10 anos. O transplante de fígado e o tafamidis são os únicos tratamentos disponíveis no Brasil. Essa revisão consiste em um consenso do Departamento Científico de Neuropatias Periféricas da Academia Brasileira de Neurologia. O primeiro e último autores produziram um texto resumindo os principais aspectos sobre o tema e enviaram para os outros 10 especialistas por email. A literatura relevante sobre o assunto foi revisada por cada participante e utilizada para revisão individual do texto. Foi esperado que cada participante revisasse o texto e enviasse suas sugestões por e-mail. Finalmente, os 12 panelistas se encontraram na cidade de Fortaleza para discutir os pontos controversos e chegar a um consenso sobre texto final.
Subject(s)
Humans , Animals , Amyloid Neuropathies, Familial/diagnosis , Amyloid Neuropathies, Familial/therapy , Oligonucleotides/therapeutic use , Benzoxazoles/therapeutic use , Brazil , Randomized Controlled Trials as Topic , Amyloid Neuropathies, Familial/pathology , Amyloid Neuropathies, Familial/drug therapy , RNA, Small Interfering/therapeutic use , Diagnosis, Differential , Cardiomyopathies/complicationsABSTRACT
ABSTRACT The neuropeptide orexin-A and its receptors are widely distributed in both hippocampal circuitry and pain transmission pathways. Objective: Involvement of the CA1 orexin 1 receptor (OX1R) on the modulation of orofacial pain and pain-induced changes in hippocampal expression of cyclooxygenase-2 (COX-2) and brain-derived neurotrophic factor (BDNF) was investigated. Methods: Orofacial pain was induced by an intra-lip injection of capsaicin (100 μg). Reverse transcription polymerase chain reaction and immunoblot analysis were used to indicate changes in hippocampal BDNF and COX-2 expression, respectively. Results: Capsaicin induces a significant pain response, which is not affected by either orexin-A or SB-334867-A, an OX1R antagonist. However, an increased expression of COX-2 and decreased expression of BDNF was observed in the hippocampus of animals that received capsaicin or SB-334867-A (80 nM) plus capsaicin. Meanwhile, orexin-A (40 pM) attenuated the effects of capsaicin on the expression of COX-2 and BDNF. Conclusions: CA1 OX1R activation moderates capsaicin-induced neuronal inflammation and neurotrophic deficiency.
RESUMO O neuropeptídeo orexina-A e seus receptores estão amplamente distribuídos nos circuitos do hipocampo e nas vias de transmissão da dor. Objetivo: O envolvimento do receptor de orexina 1 CA1 (OX1R) na modulação da dor orofacial e alterações induzidas pela dor na expressão do hipocampo de ciclooxigenase-2 (COX-2) e fator neurotrófico derivado do cérebro (BDNF) foi investigado. Métodos: A dor orofacial foi induzida por injeção intra-labial de capsaicina (100 μg). A reação em cadeia da polimerase de transcrição reversa e a análise de imunotransferência foram utilizadas para indicar alterações na expressão de BDNF e COX-2 no hipocampo, respectivamente. Resultados: A capsaicina induz uma resposta significativa à dor, que não é afetada pela orexina-A ou pelo SB-334867-A, um antagonista do OX1R. No entanto, uma expressão aumentada de COX-2 e uma expressão diminuída de BDNF foi observada no hipocampo de animais que receberam capsaicina ou SB-334867-A (80 nM) mais capsaicina. Enquanto isso, a orexina A (40 pM) atenuou os efeitos da capsaicina na expressão de COX-2 e BDNF. Conclusões: A ativação de CA1 OX1R modera a inflamação neuronal induzida por capsaicina e a deficiência neurotrófica.
Subject(s)
Animals , Male , Rats , Facial Pain/metabolism , Brain-Derived Neurotrophic Factor/metabolism , Cyclooxygenase 2/metabolism , Orexin Receptors/metabolism , Orexins/pharmacology , Hippocampus/metabolism , Urea/analogs & derivatives , Urea/pharmacology , Benzoxazoles/pharmacology , Capsaicin , Rats, Wistar , Reverse Transcriptase Polymerase Chain Reaction , Disease Models, Animal , Hippocampus/drug effects , Naphthyridines , Neurons/drug effects , Neurons/metabolismABSTRACT
La polineuropatía amiloidótica familiar asociada a transtiretina (PAF-TTR) es una enfermedad hereditaria con distribución geográfica variable. El objetivo de este trabajo fue presentar nuestra experiencia con pacientes con PAF-TTR. Se evaluaron retrospectivamente 9 casos pertenecientes a diferentes familias. Los criterios diagnósticos utilizados se basaron en la combinación de un cuadro clínico compatible, hallazgos histopatológicos y confirmación genética. Cinco casos mostraron la presentación clásica y 4 la variante de inicio tardío. La mutación p.Val30Met en el gen TTR fue hallada en 6 casos y p.Ala36Pro, p.Thr60Ala y p.Tyr114Cys en los 3 los restantes, respectivamente. La edad media de inicio fue 35 años (rango 26-60). El tiempo medio al diagnóstico fue de 4.2 ± 1.5 años. Siete pacientes recibieron diagnóstico erróneo inicial, 3 de la variante clásica y 4 de la tardía. Nuestra serie de pacientes mostró marcada heterogeneidad en la presentación clínica del grupo de PAF-TTR de inicio tardío, en una región no endémica de Sudamérica.
Transthyretin-related familial amyloid polyneuropathy (TTR-FAP) is a hereditary disease with variable geographical distribution. The aim of this study was to present our experience with TTR-FAP patients. We retrospectively analyzed nine cases belonging to different families. Diagnostic criteria were based on the combination of compatible clinical picture, histopathological findings and genetic confirmation. Five cases showed the classic presentation and other 4 the late onset variant. The p.Val30Met mutation in the TTR gene was found in 6 cases and p.Ala36Pro, p.Thr60Ala and p.Tyr114Cys in the remaining 3, respectively. The median age of symptom onset was 35 years (26-60 range). Mean time to diagnosis was 4.2 ± 1.5 years. Our patient series showed the heterogeneity in clinical presentation of TTR-FAP in a non-endemic region of South America.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Prealbumin/genetics , Amyloid Neuropathies, Familial/genetics , Argentina , Benzoxazoles/therapeutic use , Retrospective Studies , Liver Transplantation/statistics & numerical data , Fatal Outcome , Amyloid Neuropathies, Familial/therapy , MutationABSTRACT
The present study was aimed to investigate the effects of orexin-A and orexin-1 receptor (OX1R) antagonist injected into the fourth ventricle of rats on food-intake and spontaneous physical activity (SPA). Obese rat model was induced by high fat diet. Different doses of orexin-A or SB334867, an OX1R antagonist, were injected into the fourth ventricle of obese and normal rats respectively. SPA and food intake were monitored for 4 h after injection in both light and dark environment. In the light measurement cycle, different doses of orexin-A significantly stimulated feeding and SPA in all injected rats, and the animals' responses showed a dose-dependent manner (P < 0.05-0.01), and compared with those of normal rats, the orexin-A induced food intake and SPA were more pronounced in obese rats. In the dark measurement cycle, different doses of orexin-A had no obvious effect on food intake and SPA in both normal and obese rats (P > 0.05). In the light cycle, different doses of SB334867 significantly decreased food intake and SPA in all rats during 0-2 h and 2-4 h after injection (P < 0.05), but the food intake and SPA in obese rats were significantly greater than those of normal rats. In the dark cycle, different doses of SB334867 showed no obvious effect on food intake and SPA of normal and obese rats (P > 0.05). These results suggest that fourth cerebral ventricle nuclei may be one target for orexin-A and light condition may play an important role in orexin-A and OX1R physiological functional processes.
Subject(s)
Animals , Rats , Benzoxazoles , Pharmacology , Diet, High-Fat , Eating , Fourth Ventricle , Motor Activity , Obesity , Orexin Receptor Antagonists , Pharmacology , Orexin Receptors , Orexins , Pharmacology , Urea , PharmacologyABSTRACT
BACKGROUND/AIMS: The unique role of enzyme 5-lipoxygenase (5-LO) in the production of leukotrienes makes it a therapeutic target for inflammatory bowel disease (IBD). The aim of this study was to evaluate the effects of B-98, a newly synthesized benzoxazole derivatives and a novel 5-LO inhibitor, in a mouse model of IBD induced by dextran sulfate sodium (DSS). METHODS: C57BL/6 mice were randomly assigned to four groups: normal control, DSS colitis (DSS+saline), low dose B-98 (DSS+B-98 20 mg/kg) and high dose B-98 (DSS+B-98 100 mg/kg). B-98 was administered with 3% DSS intraperitoneally. The severity of the colitis was assessed via the disease activity index (DAI), colon length, and histopathologic grading. The production of inflammatory cytokines interleukin (IL)-6 was determined by RT-PCR. Th cells were examined for the proportion of Th1 cell, Th2 cell, Th9 cell, Th17 cell and Treg cell using intracellular cytometry. RESULTS: The B-98 group showed lower DAI, less shortening of the colon length and lower histopathologic grading compared with the DSS colitis group (p<0.01). The expression of IL-6 in colonic tissue was significantly lower in the B-98 groups than the DSS colitis group (p<0.05). The cellular profiles revealed that the Th1, Th9 and Th17 cells were increased in the DSS colitis group compared to the B-98 group (p<0.05). CONCLUSIONS: Our results suggest that acute intestinal inflammation is reduced in the group treated with B-98 by Th1, Th9 and Th17 involved cellular immunity.
Subject(s)
Animals , Male , Mice , Acute Disease , Arachidonate 5-Lipoxygenase/chemistry , Benzoxazoles/chemistry , Colitis/chemically induced , Colon/drug effects , Dextran Sulfate/toxicity , Disease Models, Animal , Forkhead Transcription Factors/metabolism , Injections, Intraperitoneal , Interleukin-6/genetics , Lipoxygenase Inhibitors/chemistry , Mice, Inbred C57BL , Severity of Illness Index , T-Lymphocytes/classificationABSTRACT
A series of pyridazinone derivatives carrying benzoheterocycles, such as benzoxazole and benzoxazine, was synthesized and tested as inhibitors of cAMP phosphodiesterase enzyme [PDE]. The most promising compound in this series was 6-[2,4-dioxo-3,4-dihydro- l,3[2H]-benzoxazin-6-yl]-4,5 dihydropyridazin-3[2H]-one [3], which showed potent inhibiting activity on cAMP PDE and was ten times more potent than milrinone [a commercially available cardiotonic agent]
Subject(s)
Benzoxazoles/chemical synthesis , Cardiotonic Agents/chemical synthesis , Benzoxazoles/analogs & derivativesABSTRACT
The prototropic tautomerism of compounds I, II and III was studied as a mean of distinguishing thiones from thiols. Several 2-mercaptobenzothiazole, 2-mercaptobenzimidazole and 2-mercaptobenzoxazole derivatives were studied in solution by PMR and 13C-NMR and, in the solid state, by IR spectra
Subject(s)
Thiazoles/analysis , Benzimidazoles/analysis , Benzoxazoles/analysisABSTRACT
Bogert [1] claimed that'2-ethoxycarbonyl-4H-3, l-benzoxazin-4-one [1] reacted with excess aniline to yield the quinazolinone [III], [R=C[6]H[5]]. However, in our previous publications [2, 3]. We reported that the reaction of [1] with amines gave anthranilamides, while its reaction with hydrazines afforded amidrazone type of compounds. Errede and coworkers [4,5]reported that benzoxazinones react with amines in general to give amidines and/or anthranilamides via the nucleophilic attack of the amine on the electrophilic carbon-2 and/or carbon-4 of the benzoxazinone respectively, and only the amidines can undergo facile cyclodehydration to give quinazolinones. In the present study, we decided to reinvestigate the reaction of [I] with amino compounds, aiming at the synthesis of quinazolinone esters of pharmacological interest