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1.
FEBS J ; 291(11): 2423-2448, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38451841

ABSTRACT

Oxidation of histone H3 at lysine 4 (H3K4ox) is catalyzed by lysyl oxidase homolog 2 (LOXL2). This histone modification is enriched in heterochromatin in triple-negative breast cancer (TNBC) cells and has been linked to the maintenance of compacted chromatin. However, the molecular mechanism underlying this maintenance is still unknown. Here, we show that LOXL2 interacts with RuvB-Like 1 (RUVBL1), RuvB-Like 2 (RUVBL2), Actin-like protein 6A (ACTL6A), and DNA methyltransferase 1associated protein 1 (DMAP1), a complex involved in the incorporation of the histone variant H2A.Z. Our experiments indicate that this interaction and the active form of RUVBL2 are required to maintain LOXL2-dependent chromatin compaction. Genome-wide experiments showed that H2A.Z, RUVBL2, and H3K4ox colocalize in heterochromatin regions. In the absence of LOXL2 or RUVBL2, global levels of the heterochromatin histone mark H3K9me3 were strongly reduced, and the ATAC-seq signal in the H3K9me3 regions was increased. Finally, we observed that the interplay between these series of events is required to maintain H3K4ox-enriched heterochromatin regions, which in turn is key for maintaining the oncogenic properties of the TNBC cell line tested (MDA-MB-231).


Subject(s)
Amino Acid Oxidoreductases , Heterochromatin , Histones , Triple Negative Breast Neoplasms , Triple Negative Breast Neoplasms/genetics , Triple Negative Breast Neoplasms/pathology , Triple Negative Breast Neoplasms/metabolism , Humans , Amino Acid Oxidoreductases/genetics , Amino Acid Oxidoreductases/metabolism , Histones/metabolism , Histones/genetics , Female , Heterochromatin/metabolism , Heterochromatin/genetics , Cell Line, Tumor , Chromatin/metabolism , Chromatin/genetics , Gene Expression Regulation, Neoplastic , DNA Helicases/genetics , DNA Helicases/metabolism
2.
Antioxidants (Basel) ; 10(8)2021 Aug 10.
Article in English | MEDLINE | ID: mdl-34439518

ABSTRACT

A role of iron as a target to prevent stroke-induced neurodegeneration has been recently revisited due to new evidence showing that ferroptosis inhibitors are protective in experimental ischemic stroke and might be therapeutic in other neurodegenerative brain pathologies. Ferroptosis is a new form of programmed cell death attributed to an overwhelming lipidic peroxidation due to excessive free iron and reactive oxygen species (ROS). This study aims to evaluate the safety and tolerability and to explore the therapeutic efficacy of the iron chelator and antioxidant deferoxamine mesylate (DFO) in ischemic stroke patients. Administration of placebo or a single DFO bolus followed by a 72 h continuous infusion of three escalating doses was initiated during the tPA infusion, and the impact on blood transferrin iron was determined. Primary endpoint was safety and tolerability, and secondary endpoint was good clinical outcome (clinicalTrials.gov NCT00777140). DFO was found safe as adverse effects were not different between placebo and DFO arms. DFO (40-60 mg/Kg/day) reduced the iron saturation of blood transferrin. A trend to efficacy was observed in patients with moderate-severe ischemic stroke (NIHSS > 7) treated with DFO 40-60 mg/Kg/day. A good outcome was observed at day 90 in 31% of placebo vs. 50-58% of the 40-60 mg/Kg/day DFO-treated patients.

3.
Nat Commun ; 9(1): 3420, 2018 08 24.
Article in English | MEDLINE | ID: mdl-30143639

ABSTRACT

Lamins (A/C and B) are major constituents of the nuclear lamina (NL). Structurally conserved lamina-associated domains (LADs) are formed by genomic regions that contact the NL. Lamins are also found in the nucleoplasm, with a yet unknown function. Here we map the genome-wide localization of lamin B1 in an euchromatin-enriched fraction of the mouse genome and follow its dynamics during the epithelial-to-mesenchymal transition (EMT). Lamin B1 associates with actively expressed and open euchromatin regions, forming dynamic euchromatin lamin B1-associated domains (eLADs) of about 0.3 Mb. Hi-C data link eLADs to the 3D organization of the mouse genome during EMT and correlate lamin B1 enrichment at topologically associating domain (TAD) borders with increased border strength. Having reduced levels of lamin B1 alters the EMT transcriptional signature and compromises the acquisition of mesenchymal traits. Thus, during EMT, the process of genome reorganization in mouse involves dynamic changes in eLADs.


Subject(s)
Lamin Type B/metabolism , Animals , Cell Nucleus/metabolism , Chromatin Immunoprecipitation , Epithelial-Mesenchymal Transition/genetics , Epithelial-Mesenchymal Transition/physiology , Euchromatin/chemistry , Euchromatin/genetics , Euchromatin/metabolism , Fluorescence Recovery After Photobleaching , Humans , Lamin Type B/chemistry , Lamin Type B/genetics , Mice
4.
ACS Synth Biol ; 7(4): 1116-1130, 2018 04 20.
Article in English | MEDLINE | ID: mdl-29565577

ABSTRACT

It is generally accepted that chromatin containing the histone H3 variant CENP-A is an epigenetic mark maintaining centromere identity. However, the pathways leading to the formation and maintenance of centromere chromatin remain poorly characterized due to difficulties of analysis of centromeric repeats in native chromosomes. To address this problem, in our previous studies we generated a human artificial chromosome (HAC) whose centromere contains a synthetic alpha-satellite (alphoid) DNA array containing the tetracycline operator, the alphoidtetO-HAC. The presence of tetO sequences allows the specific targeting of the centromeric region in the HAC with different chromatin modifiers fused to the tetracycline repressor. The alphoidtetO-HAC has been extensively used to investigate protein interactions within the kinetochore and to define the epigenetic signature of centromeric chromatin to maintain a functional kinetochore. In this study, we developed a novel synthetic HAC containing two alphoid DNA arrays with different targeting sequences, tetO, lacO and gal4, the alphoidhybrid-HAC. This new HAC can be used for detailed epigenetic engineering studies because its kinetochore can be simultaneously or independently targeted by different chromatin modifiers and other fusion proteins.


Subject(s)
Centromere/genetics , Chromosomes, Artificial, Human/genetics , Epigenesis, Genetic , Bacterial Proteins/genetics , Binding Sites , Carrier Proteins/genetics , Cell Line , Centromere Protein A/genetics , Centromere Protein B/genetics , Chromosome Segregation , Cloning, Molecular , DNA, Satellite , DNA-Binding Proteins/genetics , DNA-Binding Proteins/metabolism , Heterochromatin/genetics , Heterochromatin/metabolism , Humans , Kinetochores/metabolism , Saccharomyces cerevisiae Proteins/genetics , Saccharomyces cerevisiae Proteins/metabolism , Transcription Factors/genetics , Transcription Factors/metabolism , Transfection
5.
Prog Neuropsychopharmacol Biol Psychiatry ; 79(Pt B): 481-492, 2017 10 03.
Article in English | MEDLINE | ID: mdl-28803924

ABSTRACT

Alterations in innate immunity may underlie the pathophysiology of schizophrenia (SZ). Toll-like receptor-4 (TLR4) is a master element of innate immunity. The specificity proteins (SPs), transcription factors recently implicated in SZ, are putative regulatory agents of this. This work was aimed at describing alterations in the TLR4 signalling pathway in postmortem brain prefrontal cortex (PFC) and cerebellum (CB) of 16 chronic SZ patients and 14 controls. The possible association of TLR4 pathway with SP1 and SP4 and SZ negative symptomatology is explored. In PFC, TLR4/myeloid differentiation factor 88 (MyD88)/inhibitory subunit of nuclear factor kappa B alpha (IκBα) protein levels were lower in SZ patients, while nuclear transcription factor-κB (NFκB) activity, cyclooxygenase-2 (COX-2) expression and the lipid peroxidation index malondialdehyde (MDA) appeared increased. The pattern of changes in CB is opposite, except for COX-2 expression that remained augmented and MDA levels unaltered. Network interaction analysis showed that TLR4/MyD88/IκBα/NFκB/COX-2 pathway was coupled in PFC and uncoupled in CB. SP4 co-expressed with TLR4 and NFκB in PFC and both SP1 and SP4 co-expressed with NFκB in CB. In PFC, correlation analysis found an inverse relationship between NFκB and negative symptoms. In summary, we found brain region-specific alterations in the TLR4 signalling pathway in chronic SZ, in which SP transcription factors could participate at different levels. Further studies are required to elucidate the regulatory mechanisms of innate immunity in SZ and its relationship with symptoms.


Subject(s)
Cerebellum/metabolism , Prefrontal Cortex/metabolism , Schizophrenia/metabolism , Toll-Like Receptor 4/metabolism , Aged , Cerebellum/pathology , Chronic Disease , Cyclooxygenase 2/metabolism , Gene Expression Regulation , Humans , Male , Myeloid Differentiation Factor 88/metabolism , NF-KappaB Inhibitor alpha/metabolism , NF-kappa B/metabolism , Prefrontal Cortex/pathology , Psychiatric Status Rating Scales , Schizophrenia/drug therapy , Schizophrenia/pathology , Schizophrenic Psychology , Signal Transduction
6.
Proc Natl Acad Sci U S A ; 114(23): E4686-E4694, 2017 06 06.
Article in English | MEDLINE | ID: mdl-28533418

ABSTRACT

Schizophrenia is a devastating disease that arises on the background of genetic predisposition and environmental risk factors, such as early life stress (ELS). In this study, we show that ELS-induced schizophrenia-like phenotypes in mice correlate with a widespread increase of histone-deacetylase 1 (Hdac1) expression that is linked to altered DNA methylation. Hdac1 overexpression in neurons of the medial prefrontal cortex, but not in the dorsal or ventral hippocampus, mimics schizophrenia-like phenotypes induced by ELS. Systemic administration of an HDAC inhibitor rescues the detrimental effects of ELS when applied after the manifestation of disease phenotypes. In addition to the hippocampus and prefrontal cortex, mice subjected to ELS exhibit increased Hdac1 expression in blood. Moreover, Hdac1 levels are increased in blood samples from patients with schizophrenia who had encountered ELS, compared with patients without ELS experience. Our data suggest that HDAC1 inhibition should be considered as a therapeutic approach to treat schizophrenia.


Subject(s)
Histone Deacetylase 1/metabolism , Schizophrenia/enzymology , Stress, Psychological/enzymology , Adult , Aged , Animals , DNA Methylation , Female , Hippocampus/enzymology , Histone Deacetylase 1/blood , Histone Deacetylase 1/genetics , Histone Deacetylase Inhibitors/pharmacology , Humans , Male , Mice , Mice, Inbred C57BL , Mice, Mutant Strains , Mice, Transgenic , Middle Aged , Phenotype , Prefrontal Cortex/enzymology , RNA, Messenger/genetics , RNA, Messenger/metabolism , Schizophrenia/etiology , Schizophrenia/genetics , Stress, Psychological/complications , Stress, Psychological/genetics , Young Adult
7.
Res Rep Urol ; 8: 105-11, 2016.
Article in English | MEDLINE | ID: mdl-27556017

ABSTRACT

PURPOSE: The ability to test for and detect prostate cancer with minimal invasiveness has the potential to reduce unnecessary prostate biopsies. This study was conducted as part of a clinical investigation for the development of an OligoFISH(®) probe panel for more accurate detection of prostate cancer. MATERIALS AND METHODS: One hundred eligible male patients undergoing transrectal ultrasound biopsies were enrolled in the study. After undergoing digital rectal examination with pressure, voided urine was collected in sufficient volume to prepare at least two slides using ThinPrep. Probe panels were tested on the slides, and 500 cells were scored when possible. From the 100 patients recruited, 85 had more than 300 cells scored and were included in the clinical performance calculations. RESULTS: Chromosomes Y, 7, 10, 20, 6, 8, 16, and 18 were polysomic in most prostate carcinoma cases. Of these eight chromosomes, chromosomes 7, 16, 18, and 20 were identified as having the highest clinical performance as a fluorescence in situ hybridization test and used to manufacture the fluorescence in situ hybridization probe panels. The OligoFISH(®) probes performed with 100% analytical specificity. When the OligoFISH(®) probes were compared with the biopsy results for each individual, the test results highly correlated with positive and negative prostate biopsy pathology findings, supporting their high specificity and accuracy. Probes for chromosomes 7, 16, 18, and 20 showed in the receiver operator characteristics analysis an area under the curve of 0.83, with an accuracy of 81% in predicting the biopsy result. CONCLUSION: This investigation demonstrates the ease of use with high specificity, high predictive value, and accuracy in identifying prostate cancer in voided urine after digital rectal examination with pressure. The test is likely to have positive impact on clinical practice and advance approaches to the detection of prostate cancer. Further evaluation is warranted.

8.
Surg Technol Int ; 29: 53-59, 2016 Oct 26.
Article in English | MEDLINE | ID: mdl-27466867

ABSTRACT

Melanoma is characterized by a high degree of chromosome instability (CIN), the loss or gain of entire chromosomes or pieces of chromosomes. Also, CIN is likely to drive the progression of benign melanocytic lesions to malignant tumors, although very little is known about the acquisition of the mechanisms that promote CIN along this progression. Here, we describe the development of a model system to study the progression of melanomagenesis starting with normal human melanocytes followed by inactivation of the p53 and pRb tumor suppressors by addition of the E6/E7 proteins. The cells were then transduced with a growth-promoting, constitutionally-active mutant NRAS. The addition of E6/E7 and E6/E7 NRAS was found to give a growth advantage to the cells compared to normal melanocytes and a statistically significant gain of aneuploidy; aneuploidy was 24.7% in primary melanocytes, 33.8% in E6/E7 melanocytes, and 70.5% in E6/E7 NRAS melanocytes. Further, we found an increase in tetraploid cells in the cell model which was statistically significant between primary melanocytes and E6/E7, NRAS melanocytes. We also observed an increase in aneuploid cells between three population doublings in primary melanocytes, whereas this increase was not seen in the E6/E7 melanocytes. Together, these data demonstrate that this model system utilizing stepwise addition of genetic mutations driving melanomagenesis is a useful tool to study CIN and could even be used to study the mechanisms responsible for these alterations in genetic makeup.


Subject(s)
Aneuploidy , Cell Transformation, Neoplastic , Melanoma , Skin Neoplasms , Tetraploidy , Humans , Melanocytes , Oncogene Proteins, Viral , Repressor Proteins
9.
Res Rep Urol ; 7: 49-55, 2015.
Article in English | MEDLINE | ID: mdl-25914883

ABSTRACT

BACKGROUND: Previously, we had developed and manufactured an oligonucleotide fluorescence in situ hybridization (OligoFISH) probe panel based on the most clinically sensitive chromosomes found in a reference set of bladder carcinoma cases. The panel was clinically validated for use as a diagnostic and monitoring assay for bladder cancer, reaching 100% correlation with the results of the UroVysion test. After 1 year of using this probe panel, we present here the comparison of cytology, cystoscopy, and pathology findings to the OligoFISH probe panel results to calculate its clinical performance. MATERIALS AND METHODS: In order to calculate clinical performance, we compared the OligoFISH results to the cytology and cystoscopy/pathology findings for 147 initial diagnoses and 399 recurrence monitorings. Finally, we compared clinical performance to published values for the UroVysion test, including both low- and high-grade tumors. RESULTS: Chromosomes 3, 6, 7, and 20 were highly involved in bladder carcinoma aneuploidy. At the initial diagnosis, we obtained 90.5% (95% confidence interval [CI]: 84.5%-94.7%) accuracy, 96.8% sensitivity (95% CI: 91.0%-99.3%), 79.2% specificity (95% CI: 65.9%-87.8%), 89.2% positive predictive value (PPV; 95% CI: 81.5%-94.5%), and 93.3% negative predictive value (NPV; 95% CI: 81.7%-97.3%). When monitoring for recurrence, we obtained 85.2% accuracy (95% CI: 81.3%-88.5%), 82.0% sensitivity (95% CI: 76.0%-87.1%), 88.4% specificity (95% CI: 83.2%-92.5%), 87.7% PPV (95% CI: 82.1%-92.0%), and 83.0% NPV (95% CI: 77.3%-87.8%). When looking at low- and high-grade tumors, the test showed 100% sensitivity for high-grade tumors (95% CI: 92.5%-100%) and 87.5% sensitivity (95% CI: 68.8%-95.5%) for low-grade tumors. All the clinical parameters for the OligoFISH panel were higher than the UroVysion test's published performance. We found significantly higher clinical sensitivity and NPV at initial diagnosis and significantly higher specificity and PPV for recurrence. CONCLUSION: The OligoFISH probe panel is a fast, easy, and reproducible test for bladder cancer diagnosis and monitoring, with excellent clinical performance and utility.

10.
Mar Pollut Bull ; 91(1): 65-72, 2015 Feb 15.
Article in English | MEDLINE | ID: mdl-25561004

ABSTRACT

The sinking of the Don Pedro merchant ship in 2007 near the island of Ibiza is a good example of the extreme sensitivity of the tourism sector to oil spills. Despite the limited scale of the spill (only some 20 tonnes), its minimal ecological impact, and the rapid deployment of personnel and equipment to contain it, the accident nonetheless caused significant economic damage to the island's tourism sector. This particular case demonstrates the importance of the beach as a factor of production in the holiday tourism sector, and the capacity of even small amounts of oil to render it unusable and cause heavy losses to holiday firms.


Subject(s)
Bathing Beaches/economics , Petroleum Pollution/economics , Ships , Travel/economics , Bathing Beaches/history , History, 21st Century , Petroleum Pollution/history , Spain
11.
Mol Cell Oncol ; 1(2): e960770, 2014.
Article in English | MEDLINE | ID: mdl-27308335

ABSTRACT

Constitutive heterochromatin, an essential structure that has been conserved throughout evolution, is required to maintain genome stability. Although heterochromatin is enriched for repressive traits, it can be actively transcribed to generate thousands of noncoding RNAs that are required for correct chromatin assembly. Despite the importance of this structure, how and why heterochromatin transcription is regulated, and the proteins responsible for this regulation, remain poorly understood. Here, we summarize recent findings in heterochromatin transcription regulation during different cellular processes with a focus on the epithelial-mesenchymal transition (EMT), which elicits important changes in cell behavior, has a key role in early development, and is involved in cancer progression.

16.
PLoS One ; 8(1): e48814, 2013.
Article in English | MEDLINE | ID: mdl-23382797

ABSTRACT

Exosomes are cellular secretory vesicles containing microRNAs (miRNAs). Once secreted, exosomes are able to attach to recipient cells and release miRNAs potentially modulating the function of the recipient cell. We hypothesized that exosomal miRNA expression in brains of patients diagnosed with schizophrenia (SZ) and bipolar disorder (BD) might differ from controls, reflecting either disease-specific or common aberrations in SZ and BD patients. The sources of the analyzed samples included McLean 66 Cohort Collection (Harvard Brain Tissue Resource Center), BrainNet Europe II (BNE, a consortium of 18 brain banks across Europe) and Boston Medical Center (BMC). Exosomal miRNAs from frozen postmortem prefrontal cortices with well-preserved RNA were isolated and submitted to profiling by Luminex FLEXMAP 3D microfluidic device. Multiple statistical analyses of microarray data suggested that certain exosomal miRNAs were differentially expressed in SZ and BD subjects in comparison to controls. RT-PCR validation confirmed that two miRNAs, miR-497 in SZ samples and miR-29c in BD samples, have significantly increased expression when compared to control samples. These results warrant future studies to evaluate the potential of exosome-derived miRNAs to serve as biomarkers of SZ and BD.


Subject(s)
Bipolar Disorder/genetics , MicroRNAs/genetics , Prefrontal Cortex/metabolism , Schizophrenia/genetics , Aged , Aged, 80 and over , Biomarkers/metabolism , Bipolar Disorder/metabolism , Exosomes/genetics , Exosomes/metabolism , Gene Expression Regulation , Humans , Male , MicroRNAs/metabolism , Middle Aged , Schizophrenia/metabolism
17.
Phytother Res ; 27(6): 911-5, 2013 Jun.
Article in English | MEDLINE | ID: mdl-22927102

ABSTRACT

The antifungal activity of hexane, dichloromethane, methanol and aqueous extracts from the rhizome and root of Ferula hermonis was assayed in vitro by the agar disk diffusion method against a panel of human opportunistic and pathogenic fungi. Among them, the hexane and dichloromethane extracts showed the highest activity particularly against the dermatophytes Microsporum gypseum and Tricophyton mentagrophytes as well as the yeast Candida lactis-condensi. Activity-guided fractionation of both extracts using an agar overlay bioautographic method led to the isolation of two antifungal compounds which were identified as the daucane aryl esters jaeschkeanadiol p-hydroxybenzoate (ferutinin) and jaeschkeanadiol benzoate (teferidin). Determination of minimal inhibitory concentration (MIC) and minimal fungicidal concentration (MFC) values of both compounds evidenced a stronger antifungal activity for ferutinin than for teferidin. Particularly, T. mentagrophytes was the most sensitive strain with MIC and MFC values ranging from 8 to 256 µg/mL.


Subject(s)
Antifungal Agents/pharmacology , Ferula/chemistry , Plant Extracts/pharmacology , Antifungal Agents/isolation & purification , Arthrodermataceae/drug effects , Benzoates/isolation & purification , Benzoates/pharmacology , Bridged Bicyclo Compounds/isolation & purification , Bridged Bicyclo Compounds/pharmacology , Candida/drug effects , Cycloheptanes/isolation & purification , Cycloheptanes/pharmacology , Microbial Sensitivity Tests , Microsporum/drug effects , Plant Oils/isolation & purification , Plant Oils/pharmacology , Plant Roots/chemistry , Rhizome/chemistry , Sesquiterpenes/isolation & purification , Sesquiterpenes/pharmacology , Trichophyton/drug effects
18.
Phytochemistry ; 72(11-12): 1406-13, 2011 Aug.
Article in English | MEDLINE | ID: mdl-21609848

ABSTRACT

The analysis of the essential oil from rhizome and roots of Ferula hermonis Boiss. (Apiaceae) by GC-FID, GC-MS and ¹³C NMR allowed the identification of 79 constituents, more than 90% of the oil, the major one being α-pinene (43.3%), followed by α-bisabolol (11.1%) and the unusual acetylenic compound 3,5-nonadiyne (4.4%). The antifungal activity of the essential oil before and after fractionation was assayed against several yeasts and filamentous fungi. Purification of the active fractions afforded 3,5-nonadiyne, α-bisabolol, jaeschkeanadiol angelate, α-bisabolol oxide B and trans-verbenol, as well as two purified fractions, one of them (JB73) with 73% of jaeschkeanadiol benzoate and the other with 50% of spathulenol. Determination of MIC and MFC values of all these products evidenced strong antifungal activities for JB73 and 3,5-nonadiyne. Particularly, against the dermatophyte Tricophyton mentagrophytes, MIC and MFC values were 0.25 µg/ml for JB73, and 8 µg/ml for 3,5-nonadiyne, the former being more active than amphotericin B and nystatin.


Subject(s)
Antifungal Agents/pharmacology , Ferula/chemistry , Oils, Volatile/chemistry , Plant Roots/chemistry , Rhizome/chemistry , Alkynes/chemistry , Antifungal Agents/chemistry , Bicyclic Monoterpenes , Chemical Fractionation , Fungi/drug effects , Microbial Sensitivity Tests , Monocyclic Sesquiterpenes , Monoterpenes/chemistry , Monoterpenes/isolation & purification , Monoterpenes/pharmacology , Oils, Volatile/pharmacology , Sesquiterpenes/chemistry , Sesquiterpenes/isolation & purification , Sesquiterpenes/pharmacology
19.
J Clin Psychiatry ; 72(4): 522-8, 2011 Apr.
Article in English | MEDLINE | ID: mdl-21034680

ABSTRACT

BACKGROUND: Depression is one of the main reasons for treatment withdrawal and failure in chronic hepatitis C patients treated with interferon. Antidepressants are useful for its treatment, but whether they can also be used for prevention has yet to be established. METHOD: To evaluate the efficacy and safety of escitalopram for preventing interferon alfa-2a-induced depression, we conducted an investigator-initiated multicenter, randomized, double-blind, placebo-controlled trial in 133 chronic hepatitis C patients without baseline mental disorders who were randomly assigned to receive escitalopram or placebo during the first 12 weeks of treatment. Primary efficacy outcomes were the development of DSM-IV major depression and scores on the Montgomery-Asberg Depression Rating Scale (MADRS) and the Hospital Anxiety and Depression Scale (HADS). Primary safety end points were biochemical and virological responses. Patients were recruited between March 2005 and July 2006. RESULTS: Rates of major depression were low (5.4%) and did not differ between placebo (3.2%) and escitalopram (7.6%). MADRS and HADS scores significantly increased during treatment (P < .001 and P = .028, respectively), but there were no differences between treatment groups. Sustained virological response was achieved by 69.2% of patients, 70.4% in the placebo group and 67.9% in the escitalopram group. CONCLUSIONS: Findings do not support the use of an antidepressant to prevent interferon-induced depression during the first 12 weeks of treatment in chronic hepatitis C patients at low psychiatric risk. Future studies should be directed to subpopulations of patients at high psychiatric risk. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00166296.


Subject(s)
Antiviral Agents/adverse effects , Citalopram/therapeutic use , Depressive Disorder, Major/chemically induced , Hepatitis C/drug therapy , Interferon-alpha/adverse effects , Polyethylene Glycols/adverse effects , Adult , Antiviral Agents/therapeutic use , Depressive Disorder, Major/prevention & control , Double-Blind Method , Female , Hepatitis C/psychology , Humans , Interferon alpha-2 , Interferon-alpha/therapeutic use , Male , Middle Aged , Polyethylene Glycols/therapeutic use , Psychiatric Status Rating Scales , Recombinant Proteins , Ribavirin/adverse effects , Ribavirin/therapeutic use , Treatment Outcome
20.
Eur J Clin Pharmacol ; 66(6): 633-41, 2010 Jun.
Article in English | MEDLINE | ID: mdl-20204337

ABSTRACT

UNLABELLED: Intravenous immunoglobulin (IVIG) use in non-approved indications, the increase in consumption and its high cost recommend rationalisation in its utilisation. AIMS: To assess the use of IVIG in Spanish hospitals. METHODS: An observational, prospective and multicentre drug utilisation study was conducted in 13 tertiary Spanish hospitals. Data were collected for 3 months in patients receiving any IVIG. Patient demographics, indication for IVIG use, dosage regimen and cost of treatment were collected. RESULTS: Five hundred and fifty-four patients (mean age of 52 years) were included in the study. A total of 1,287 prescriptions were administered, and the average number of prescriptions per patient was 2.3. The mean daily dose was 24 g (range 0.6-90 g). Overall, IVIG was prescribed for authorised indications in 335 patients (60%) with 953 prescriptions (74%), for non-authorised indications with scientific evidentiary support in 86 patients (16%) with 137 prescriptions (11%), and non-authorised and non-accepted indications in 133 patients (24%) with 197 prescriptions (15%). The most frequent authorised indications were primary and secondary immunodeficiencies, and the most frequent non-authorised and non-accepted indications were multiple sclerosis and bullous dermatosis. The mean cost of IVIG per patient for authorised indications was 2,636.2 , non-authorised indications with scientific support 5,262.1 and non-accepted indications 3,555.8 . CONCLUSIONS: IVIG is prescribed for a significant number of non-authorised and non-accepted indications with a notable cost. There is an important variability in IVIG prescriptions between hospitals, indicating room for improvement in IVIG use and the need for a consensus of protocol use.


Subject(s)
Drug Costs , Drug Utilization/statistics & numerical data , Hospitals, General/statistics & numerical data , Immunoglobulins, Intravenous/economics , Immunoglobulins, Intravenous/therapeutic use , Immunologic Factors/economics , Immunologic Factors/therapeutic use , Off-Label Use/statistics & numerical data , Adult , Aged , Drug Utilization/standards , Empathy , Female , Humans , Immunoglobulins, Intravenous/administration & dosage , Immunoglobulins, Intravenous/adverse effects , Immunologic Factors/administration & dosage , Immunologic Factors/adverse effects , Male , Middle Aged , Prospective Studies , Spain
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