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2.
ACR Open Rheumatol ; 5(8): 407-418, 2023 Aug.
Article in English | MEDLINE | ID: mdl-37385296

ABSTRACT

OBJECTIVE: To assess 12-month safety and efficacy of pegloticase + methotrexate (MTX) versus pegloticase + placebo (PBO) cotherapy in a PBO-controlled, double-blind trial (A randomized, double-blind, placebo-controlled, multicenter, efficacy and safety study of methotrexate to increase response rates in patients with uncontrolled gout receiving pegloticase [MIRROR RCT]). METHODS: Patients with uncontrolled gout (serum urate level [SU] ≥7 mg/dl, oral urate-lowering therapy failure or intolerance, and presence of one or more gout symptoms [one or more tophi, two or more flares in 12 months, gouty arthropathy]) were randomized 2:1 to receive pegloticase (8-mg infusion every 2 weeks) with blinded MTX (oral 15 mg/week) or PBO for 52 weeks. Efficacy end points included proportion of responders (SU level <6 mg/dl for ≥80% of examined month) in the intent-to-treat population (ITT) (all randomized patients) during month 6 (primary end point), month 9, and month 12; proportion with resolution of one or more tophi (ITT); mean SU reduction (ITT); and time to SU-monitoring pegloticase discontinuation. Safety was evaluated via adverse event reporting and laboratory values. RESULTS: Month 12 response rate was significantly higher in patients cotreated with MTX (60.0% [60 of 100] vs. 30.8% [16 of 52]; difference: 29.1% [95% confidence interval (CI): 13.2%-44.9%], P = 0.0003), with fewer SU discontinuations (22.9% [22 of 96] vs. 63.3% [31 of 49]). Complete resolution of one or more tophi occurred in 53.8% (28 of 52) versus 31.0% (9 of 29) of MTX versus PBO patients at week 52 (difference: 22.8% [95% CI: 1.2%-44.4%], P = 0.048), more than at week 24 (34.6% [18 of 52] vs. 13.8% [4 of 29]). Consistent with observations through month 6, pharmacokinetic and immunogenicity findings showed increased exposure and lower immunogenicity of pegloticase when administered with MTX, with an otherwise similar safety profile. No infusion reactions occurred after 24 weeks. CONCLUSION: Twelve-month MIRROR RCT data further support MTX cotherapy with pegloticase. Tophi resolution continued to increase through week 52, suggesting continued therapeutic benefit beyond month 6 for a favorable treatment effect.

3.
Mol Pharm ; 20(3): 1643-1656, 2023 03 06.
Article in English | MEDLINE | ID: mdl-36795985

ABSTRACT

Interfacial adsorption is a molecular process occurring during the production, purification, transport, and storage of antibodies, with a direct impact on their structural stability and subsequent implications on their bioactivities. While the average conformational orientation of an adsorbed protein can be readily determined, its associated structures are more complex to characterize. Neutron reflection has been used in this work to investigate the conformational orientations of the monoclonal antibody COE-3 and its Fab and Fc fragments at the oil/water and air/water interfaces. Rigid body rotation modeling was found to be suitable for globular and relatively rigid proteins such as the Fab and Fc fragments but less so for relatively flexible proteins such as full COE-3. Fab and Fc fragments adopted a 'flat-on' orientation at the air/water interface, minimizing the thickness of the protein layer, but they adopted a substantially tilted orientation at the oil/water interface with increased layer thickness. In contrast, COE-3 was found to adsorb in tilted orientations at both interfaces, with one fragment protruding into the solution. This work demonstrates that rigid-body modeling can provide additional insights into protein layers at various interfaces relevant to bioprocess engineering.


Subject(s)
Antibodies, Monoclonal , Neutrons , Antibodies, Monoclonal/chemistry , Molecular Conformation , Adsorption , Immunoglobulin Fc Fragments
4.
Arthritis Rheumatol ; 75(2): 293-304, 2023 02.
Article in English | MEDLINE | ID: mdl-36099211

ABSTRACT

OBJECTIVE: To assess efficacy, safety, pharmacokinetics, and immunogenicity of pegloticase plus methotrexate (MTX) versus pegloticase plus placebo cotreatment for uncontrolled gout in a randomized, placebo-controlled, double-blind trial. METHODS: This study included adults with uncontrolled gout, defined as serum urate ≥7 mg/dl, oral urate-lowering therapy failure or intolerance, and presence of ongoing gout symptoms including ≥1 tophus, ≥2 flares in the past 12 months, or gouty arthritis. Key exclusion criteria included MTX contraindication, current immunosuppressant use, G6PDH deficiency, and estimated glomerular filtration rate <40 ml/minute/1.73 m2 . Patients were randomized 2:1 to 52 weeks of pegloticase (8 mg biweekly) with either oral MTX (15 mg/week) or placebo. The primary end point was the proportion of treatment responders during month 6 (defined as serum urate <6 mg/dl for ≥80% of visits during weeks 20-24). Efficacy was evaluated in all randomized patients (intent-to-treat population), and safety was evaluated in all patients receiving ≥1 blinded MTX or placebo dose. RESULTS: A total of 152 patients were randomized, 100 to receive pegloticase plus MTX, 52 to receive pegloticase plus placebo. Significantly higher treatment response occurred during month 6 in the MTX group versus the placebo group (71.0% [71 of 100 patients] versus 38.5% [20 of 52 patients], respectively; between-group difference 32.3% [95% confidence interval 16.3%, 48.3%]) (P < 0.0001 for between-group difference). During the first 6 months of pegloticase plus MTX or pegloticase plus placebo treatment, 78 (81.3%) of 96 MTX patients versus 47 (95.9%) of 49 placebo patients experienced ≥1 adverse event (AE), most commonly gout flare (64 [66.7%] of 96 MTX patients and 34 [69.4%] of 49 placebo patients). Reports of AEs and serious AEs were comparable between groups, but the infusion reaction rate was considerably lower with MTX cotherapy (4.2% [4 of 96 MTX patients, including 1 patient who had anaphylaxis]) than with placebo cotherapy (30.6% [15 of 49 placebo patients, 0 who had anaphylaxis]) (P < 0.001). Antidrug antibody positivity was also lower in the MTX group. CONCLUSION: MTX cotherapy markedly increased pegloticase response rate over placebo (71.0% versus 38.5%) during month 6 with no new safety signals. These findings verify higher treatment response rate, lower infusion reaction incidence, and lower immunogenicity when pegloticase is coadministered with MTX.


Subject(s)
Anaphylaxis , Arthritis, Gouty , Gout , Adult , Humans , Gout/drug therapy , Methotrexate/therapeutic use , Uric Acid , Anaphylaxis/chemically induced , Anaphylaxis/drug therapy , Treatment Outcome , Symptom Flare Up , Gout Suppressants/adverse effects , Polyethylene Glycols/therapeutic use , Double-Blind Method
5.
Arthritis Res Ther ; 24(1): 208, 2022 08 25.
Article in English | MEDLINE | ID: mdl-36008814

ABSTRACT

BACKGROUND: Publications suggest immunomodulation co-therapy improves responder rates in uncontrolled/refractory gout patients undergoing pegloticase treatment. The MIRROR open-label trial showed a 6-month pegloticase + methotrexate co-therapy responder rate of 79%, compared to an established 42% pegloticase monotherapy responder rate. Longer-term efficacy/safety data are presented here. METHODS: Uncontrolled gout patients (serum urate [SU] ≥ 6 mg/dL and SU ≥ 6 mg/dL despite urate-lowering therapy [ULT], ULT intolerance, or functionally-limiting tophi) were included. Patients with immunocompromised status, G6PD deficiency, severe kidney disease, or methotrexate contraindication were excluded. Oral methotrexate (15 mg/week) and folic acid (1 mg/day) were administered 4 weeks before and during pegloticase therapy. Twelve-month responder rate (SU < 6 mg/dL for ≥ 80% during month 12), 52-week change from baseline in SU, and extended safety were examined. Efficacy analyses were performed for patients receiving ≥ 1 pegloticase infusion. Pharmacokinetics (PK)/anti-drug antibodies (ADAs) were examined and related to efficacy/safety findings. RESULTS: Fourteen patients were included (all male, 49.3 ± 8.7 years, 13.8 ± 7.4-year gout history, pre-therapy SU 9.2 ± 2.5 mg/dL). Three patients were non-responders and discontinued study treatment before 24 weeks, one patient exited the study per protocol at 24 weeks (enrolled prior to treatment extension amendment), and 10 remained in the study through week 52. Of the 10, 8 completed 52 weeks of pegloticase + methotrexate and were 12-month responders. The remaining two discontinued pegloticase + methotrexate at week 24 (met treatment goals) and stayed in the study under observation (allopurinol prescribed at physicians' discretion); one remained a responder at 12 months. At 52 weeks, change from baseline in SU was - 8.2 ± 4.1 mg/dL (SU 1.1 ± 2.4 mg/dL, n = 10). Gout flares were common early in treatment but progressively decreased while on therapy (weeks 1-12, 13/14 [92.9%]; weeks 36-52, 2/8 [25.0%]). One patient recovered from sepsis (serious AE). Two non-responders developed high ADA titers; fewer patients had trough concentrations (Cmin) below the quantitation limit (BQL), and the median Cmin was higher (1.03 µg/mL vs. BQL) than pegloticase monotherapy trials. CONCLUSIONS: Pegloticase + methotrexate co-therapy was well-tolerated over 12 months, with sustained SU lowering, progressive gout flare reduction, and no new safety concerns. Antibody/PK findings suggest methotrexate attenuates ADA formation, coincident with higher treatment response rates. TRIAL REGISTRATION: ClinicalTrials.gov, NCT03635957 . Registered on 17 August 2018.


Subject(s)
Gout , Gout/drug therapy , Gout Suppressants/adverse effects , Humans , Male , Methotrexate/therapeutic use , Polyethylene Glycols/therapeutic use , Symptom Flare Up , Treatment Outcome , Urate Oxidase/adverse effects , Uric Acid
7.
J Colloid Interface Sci ; 623: 368-377, 2022 Oct.
Article in English | MEDLINE | ID: mdl-35594595

ABSTRACT

HYPOTHESIS: Acyl-l-carnitines (CnLCs) are potentially important as biosurfactants in drug delivery and tissue engineering due to their good biocompatibility. However, little is currently known about the basic interfacial behavior underlying their technological applications. Following our previous characterization of their solution aggregation and adsorption at the air/water interface, this work examines how they adsorb at the hydrophilic solid/liquid interface. EXPERIMENTS: As the SiO2/water interface has served as the model substrate for many interfacial adsorption studies, so it has been used in this work as the solid substrate to facilitate dynamic adsorption by spectroscopic ellipsometry (SE) and structural determination of the adsorbed layers by neutron reflection (NR) under different conditions at the SiO2/water interface from a group of CnLC (n = 12, 14, and 16). FINDINGS: CnLC surfactants are zwitterionic at neutral pH. They reached saturated adsorption above their critical micellar concentrations (CMCs) and formed a sandwich bilayer with a head-tail-head structure at the hydrophilic SiO2/water interface. The total thicknesses of the adsorbed layers at CMC were found to be 33 ± 2, 35 ± 2, and 37 ± 2 Å for C12LC, C14LC, and C16LC, respectively, with their inner and outer head layers remaining similar but the thickness of the interdigitated middle layer increasing with acyl chain length. As the solution becomes acidic, the carboxyl groups become protonated and the l-carnitine heads are net positively charged, resulting in increased repulsion between the head groups. In this situation, the CnLC surfactants are adsorbed as distinct aggregates to reduce repulsive interaction, resulting in reduced surfactant volume fraction and layer thickness. However, a high ionic strength can screen the repulsive interaction and enhance the adsorbed amount, effectively diminishing the impact of pH. This information provides a useful basis for exploring the technological applications of CnLCs involving a solid substrate.


Subject(s)
Silicon Dioxide , Surface-Active Agents , Adsorption , Carnitine , Silicon Dioxide/chemistry , Surface-Active Agents/chemistry , Water/chemistry
8.
J Colloid Interface Sci ; 609: 491-502, 2022 Mar.
Article in English | MEDLINE | ID: mdl-34863541

ABSTRACT

HYPOTHESIS: l-carnitines in our body systems can be readily converted into acyl-l-carnitines which have a prominent place in cellular energy generation by supporting the transport of long-chain fatty acids into mitochondria. As biocompatible surfactants, acyl-l-carnitines have potential to be useful in technical, personal care and healthcare applications. However, the lack of understanding of the effects of their molecular structures on their physical properties has constrained their potential use. EXPERIMENTS: This work reports the study of the influence of the acyl chain lengths of acyl-l-carnitines (CnLC) on solubility, surface adsorption and aggregation. Critical micellar concentrations (CMCs) of CnLC were determined by surface tension measurements. Neutron reflection (NR) was used to further examine the structure and composition of the adsorbed CnLC layer. The structural changes of the micellar aggregates under different concentrations of CnLC, pH and ionic strength were determined by dynamic light scattering (DLS) and small angle neutron scattering (SANS). FINDINGS: C12LC is fully soluble over a wide temperature and concentration range. There is however a strong decline of solubility with increasing acyl chain length. The adsorption and aggregation behavior of C14LC was therefore studied at 30 °C and C16LC at 45 °C. The solubility boundaries displayed distinct hysteresis with respect to heating and cooling. The CMCs of C12LC, C14LC and C16LC at pH 7 were 1.1 ± 0.1, 0.10 ± 0.02 and 0.010 ± 0.005 mM, respectively, with the limiting values of the area per molecule at the CMC being 45.4 ± 2, 47.5 ± 2 and 48.8 ± 2 Å2 and the thicknesses of the adsorbed CnLC layers at the air/water interface increasing from 21.5 ± 2 to 22.6 ± 2 to 24.2 ± 2 Å, respectively. All three surfactants formed core-shell spherical micelles with comparable dimensional parameters apart from an increase in core radius with acyl chain length. This study outlines the effects of acyl chain length on the physicochemical properties of CnLCs under different environmental conditions, serving as a useful basis for developing their potential applications.


Subject(s)
Micelles , Surface-Active Agents , Adsorption , Scattering, Small Angle , Surface Tension
9.
Mol Cell Oncol ; 8(2): 1884034, 2021 Feb 22.
Article in English | MEDLINE | ID: mdl-33855169

ABSTRACT

~50% of colorectal cancers have an activating mutation in KRAS (encoding the KRAS proto-oncogene) and remain difficult to target in the clinic. We have recently shown that activation of KRAS protein alters the regulation of mRNA translation, increasing total protein synthesis, and maintaining elevated c-MYC (MYC proto-oncogene) expression. Targeting these pathways downstream of KRAS reveals a striking dependency that has potential for clinical translation.

10.
J Colloid Interface Sci ; 597: 223-232, 2021 Sep.
Article in English | MEDLINE | ID: mdl-33872879

ABSTRACT

The formation of surface multilayer structures, induced by the addition of multivalent counterions in dilute surfactant solutions, has been widely observed in a range of anionic surfactants. The phenomenon is associated with the ability to manipulate surface properties, especially in the promotion of enhanced surface wetting, and in the presence of an extensive near surface reservoir for rapid surface delivery of surfactant and other active components. HYPOTHESIS: In the single alkyl chain anionic surfactants, such as sodium dodecysulfate, SDS, sodium alkylethoxylsulfate, SAES, and alkylestersulfonate, AES, surface multilayer formation is promoted by trivalent counterions such as Al3+, and is generally not observed with divalent counterions, such as Ca2+ or with monovalent counterions. In the di-alkyl chain anionic surfactant, dodecylbenzenesulfonate, LAS, surface multilayer formation now occurs in the presence of divalent counterions. It is attributed to the closer proximity of a bulk lamellar phase, resulting in a greater tendency for surface multilayer formation, and hence should occur in other di-alkyl chain anionic surfactants. EXPERIMENTS: Aerosol-OT, AOT, is one of the most commonly used di-alkyl chain anionic surfactants, and is extensively used as an emulsifying, wetting and dispersing agent. This paper reports on predominantly neutron reflectivity, NR, measurements which explore the nature of surface multilayer formation of the sodium salt of AOT at the air-solution interface with the separate addition of Ca2+ and Al3+ counterions. FINDINGS: In the AOT concentration range 0.5 to 2.0 mM surface multilayer formation occurs at the air-solution interface with the addition of Ca2+ or Al3+ counterions. Although the evolution in the surface structure with surfactant and counterion concentration is broadly similar to those reported for SDS, SAES and AES, some notable differences occur. In particular the surfactant and counterion concentration thresholds for surface multilayer formation are higher for Ca2+ than for Al3+. The differences encountered reflect the greater affinity of the di-alkyl chain structure for lamellar formation, and how the surface packing is controlled in part by the headgroup structure and the associated counterion binding affinity.

11.
J Colloid Interface Sci ; 591: 106-114, 2021 Jun.
Article in English | MEDLINE | ID: mdl-33592522

ABSTRACT

HYPOTHESIS: l-carnitine plays a crucial role in the cellular production of energy by transporting fatty acids into mitochondria. Acylated l-carnitines are amphiphilic and if appropriate physical properties were demonstrated, they could replace many currently used surfactants with improved biocompatibility and health benefits. EXPERIMENTS: This work evaluated the surface adsorption of lauroyl-l-carnitine (C12LC) and its aggregation behavior. The size and shape of the aggregates of C12LC surfactant were studied at different temperatures, concentrations, pH and ionic strength by dynamic light scattering (DLS) and small-angle neutron scattering (SANS). Surface tension measurements were carried out to determine the critical micellar concentration (CMC) of C12LC. Combining with the Gibbs equation, the surface excess at different concentrations could be determined. Neutron reflection (NR) was used to determine the structure of the adsorbed layer at the air/water interface with the help of isotopic contrast variations. FINDINGS: At pH 7, the limiting area per molecule (ACMC) of the zwitterionic C12LC adsorbed layer at the air/water interface was found to be 46 Å2 from surface tension and neutron reflection, smaller than the values of C12PC, C12E5, DTAB, C12C4betaine and C12C8betaine but close to that of SDS. A pronounced surface tension minimum at pH 2 at the low ionic strength was linked to a minimum value of area per molecule of about 30 Å2, indicating the competitive adsorption from traces of lauric acid produced by hydrolysis of C12LC. As the concentration increased, area per molecule reached a plateau of 37-39 Å2, indicating the dissolution of the more surface-active lauric acid into the micelles of C12LC. DLS and SANS showed that the size and shape of micelles had little response to temperature, concentration, ionic strength or pH. The SANS profiles measured under 3 isotopic contrasts could be well fitted by the core-shell model, giving a spherical core radius of 15.7 Å and a shell thickness of 10.5 Å. The decrease of pH led to more protonated carboxyl groups and more positively charged micelles, but the micellar structures remained unchanged, in spite of their stronger interaction. These features make C12LC potentially attractive as a solubilizing agent.


Subject(s)
Carnitine , Surface-Active Agents , Adsorption , Carnitine/analogs & derivatives , Laurates , Micelles , Surface Tension
12.
Langmuir ; 37(5): 1970-1982, 2021 Feb 09.
Article in English | MEDLINE | ID: mdl-33492974

ABSTRACT

The nature of an interfacial structure buried within a device assembly is often critical to its function. For example, the dye/TiO2 interfacial structure that comprises the working electrode of a dye-sensitized solar cell (DSC) governs its photovoltaic output. These structures have been determined outside of the DSC device, using ex situ characterization methods; yet, they really should be probed while held within a DSC since they are modulated by the device environment. Dye/TiO2 structures will be particularly influenced by a layer of electrolyte ions that lies above the dye self-assembly. We show that electrolyte/dye/TiO2 interfacial structures can be resolved using in situ neutron reflectometry with contrast matching. We find that electrolyte constituents ingress into the self-assembled monolayer of dye molecules that anchor onto TiO2. Some dye/TiO2 anchoring configurations are modulated by the formation of electrolyte/dye intermolecular interactions. These electrolyte-influencing structural changes will affect dye-regeneration and electron-injection DSC operational processes. This underpins the importance of this in situ structural determination of electrolyte/dye/TiO2 interfaces within representative DSC device environments.

13.
Nat Genet ; 53(1): 16-26, 2021 01.
Article in English | MEDLINE | ID: mdl-33414552

ABSTRACT

Oncogenic KRAS mutations and inactivation of the APC tumor suppressor co-occur in colorectal cancer (CRC). Despite efforts to target mutant KRAS directly, most therapeutic approaches focus on downstream pathways, albeit with limited efficacy. Moreover, mutant KRAS alters the basal metabolism of cancer cells, increasing glutamine utilization to support proliferation. We show that concomitant mutation of Apc and Kras in the mouse intestinal epithelium profoundly rewires metabolism, increasing glutamine consumption. Furthermore, SLC7A5, a glutamine antiporter, is critical for colorectal tumorigenesis in models of both early- and late-stage metastatic disease. Mechanistically, SLC7A5 maintains intracellular amino acid levels following KRAS activation through transcriptional and metabolic reprogramming. This supports the increased demand for bulk protein synthesis that underpins the enhanced proliferation of KRAS-mutant cells. Moreover, targeting protein synthesis, via inhibition of the mTORC1 regulator, together with Slc7a5 deletion abrogates the growth of established Kras-mutant tumors. Together, these data suggest SLC7A5 as an attractive target for therapy-resistant KRAS-mutant CRC.


Subject(s)
Colorectal Neoplasms/genetics , Large Neutral Amino Acid-Transporter 1/metabolism , Mutation/genetics , Proto-Oncogene Proteins p21(ras)/genetics , 5' Untranslated Regions/genetics , Amino Acid Transport System ASC/metabolism , Animals , Carcinogenesis/pathology , Cell Proliferation , Colorectal Neoplasms/pathology , Gene Expression Regulation, Neoplastic , Glutamine/metabolism , Humans , Intestinal Mucosa/metabolism , Intestinal Mucosa/pathology , Kaplan-Meier Estimate , Mechanistic Target of Rapamycin Complex 1/metabolism , Mice, Inbred C57BL , Minor Histocompatibility Antigens/metabolism , Neoplasm Metastasis , Oncogenes , RNA, Messenger/genetics , RNA, Messenger/metabolism , Signal Transduction , TOR Serine-Threonine Kinases/metabolism
14.
J Cell Sci ; 134(1)2021 01 13.
Article in English | MEDLINE | ID: mdl-33441326

ABSTRACT

Cell division, differentiation and function are largely dependent on accurate proteome composition and regulated gene expression. To control this, protein synthesis is an intricate process governed by upstream signalling pathways. Eukaryotic translation is a multistep process and can be separated into four distinct phases: initiation, elongation, termination and recycling of ribosomal subunits. Translation initiation, the focus of this article, is highly regulated to control the activity and/or function of eukaryotic initiation factors (eIFs) and permit recruitment of mRNAs to the ribosomes. In this Cell Science at a Glance and accompanying poster, we outline the mechanisms by which tumour cells alter the process of translation initiation and discuss how this benefits tumour formation, proliferation and metastasis.


Subject(s)
Neoplasms , Ribosomes , Eukaryotic Initiation Factors/metabolism , Humans , Neoplasms/genetics , Neoplasms/metabolism , Peptide Chain Initiation, Translational , Protein Biosynthesis , RNA, Messenger/metabolism , Ribosomes/genetics , Ribosomes/metabolism
15.
Cancer Discov ; 11(5): 1228-1247, 2021 05.
Article in English | MEDLINE | ID: mdl-33328217

ABSTRACT

KRAS-mutant colorectal cancers are resistant to therapeutics, presenting a significant problem for ∼40% of cases. Rapalogs, which inhibit mTORC1 and thus protein synthesis, are significantly less potent in KRAS-mutant colorectal cancer. Using Kras-mutant mouse models and mouse- and patient-derived organoids, we demonstrate that KRAS with G12D mutation fundamentally rewires translation to increase both bulk and mRNA-specific translation initiation. This occurs via the MNK/eIF4E pathway culminating in sustained expression of c-MYC. By genetic and small-molecule targeting of this pathway, we acutely sensitize KRASG12D models to rapamycin via suppression of c-MYC. We show that 45% of colorectal cancers have high signaling through mTORC1 and the MNKs, with this signature correlating with a 3.5-year shorter cancer-specific survival in a subset of patients. This work provides a c-MYC-dependent cotargeting strategy with remarkable potency in multiple Kras-mutant mouse models and metastatic human organoids and identifies a patient population that may benefit from its clinical application. SIGNIFICANCE: KRAS mutation and elevated c-MYC are widespread in many tumors but remain predominantly untargetable. We find that mutant KRAS modulates translation, culminating in increased expression of c-MYC. We describe an effective strategy targeting mTORC1 and MNK in KRAS-mutant mouse and human models, pathways that are also commonly co-upregulated in colorectal cancer.This article is highlighted in the In This Issue feature, p. 995.


Subject(s)
Colorectal Neoplasms/genetics , Eukaryotic Initiation Factor-4E/drug effects , Intracellular Signaling Peptides and Proteins/drug effects , MTOR Inhibitors/pharmacology , Protein Serine-Threonine Kinases/drug effects , Animals , Colorectal Neoplasms/metabolism , Disease Models, Animal , Eukaryotic Initiation Factor-4E/metabolism , Humans , Intracellular Signaling Peptides and Proteins/metabolism , Mice , Mice, Inbred C57BL , Phosphorylation , Protein Serine-Threonine Kinases/metabolism
16.
J Rheumatol ; 48(5): 767-774, 2021 05.
Article in English | MEDLINE | ID: mdl-32934137

ABSTRACT

OBJECTIVE: To examine the efficacy and safety of pegloticase in combination with methotrexate (MTX) in patients with uncontrolled gout in an exploratory, open-label clinical trial (ClinicalTrials.gov: NCT03635957) prior to a randomized, controlled trial. METHODS: A multicenter, open-label efficacy and safety study of pegloticase with MTX co-treatment was conducted in patients with uncontrolled gout. Patients were administered oral MTX (15 mg/week) and folic acid (1 mg/day) 4 weeks prior to and throughout pegloticase treatment. The primary study outcome was the proportion of responders, defined as serum uric acid (sUA) < 6 mg/dL for ≥ 80% of the time during Month 6 (Weeks 20, 22, and 24). All analyses were performed on a modified intent-to-treat population, defined as patients who received ≥ 1 pegloticase infusion. RESULTS: Seventeen patients were screened and 14 patients (all men, average age 49.3 ± 8.7 years) were enrolled. On Day 1, mean sUA was 9.2 ± 2.5 mg/dL, and 12 of the 14 patients had visible tophi. At the 6-month timepoint, 11/14 (78.6%, 95% CI 49.2-95.3%) met the responder definition, with 3 patients discontinuing after meeting protocol-defined treatment discontinuation rules (preinfusion sUA values > 6 mg/dL at 2 consecutive scheduled visits). All patients tolerated MTX. No new safety concerns were identified. CONCLUSION: In this study, an increased proportion of patients maintained therapeutic response at 6 months when treated concomitantly with MTX and pegloticase as compared to the previously reported 42% using pegloticase alone. These results support the need for a randomized study of MTX or placebo with pegloticase to validate these open-label findings.


Subject(s)
Gout , Methotrexate , Adult , Gout/drug therapy , Gout Suppressants/adverse effects , Humans , Male , Methotrexate/adverse effects , Middle Aged , Polyethylene Glycols/adverse effects , Treatment Outcome , Urate Oxidase , Uric Acid
17.
J Colloid Interface Sci ; 586: 876-890, 2021 Mar 15.
Article in English | MEDLINE | ID: mdl-33309145

ABSTRACT

HYPOTHESIS: The α-sulfo alkyl ester, AES, surfactants are a class of anionic surfactants which have potential for improved sustainable performance in a range of applications, and an important feature is their enhanced tolerance to precipitation in the presence of multivalent counterions. It is proposed that their adsorption properties can be adjusted substantially by changing the length of the shorter alkyl chain, that of the alkanol group in the ester. EXPERIMENTS: Surface tension and neutron reflectivity have been used to investigate the variation in the adsorption properties with the shorter alkyl chain length (methyl, ethyl and propyl), the impact of NaCl on the adsorption, the tendency to form surface multilayer structures in the presence of AlCl3, and the effects of mixing the methyl ester sulfonate with the ethyl and propyl ester sulfonates on the adsorption. FINDINGS: The variations in the critical micelle concentration, CMC, the adsorption isotherms, the saturation adsorption values, and the impact of NaCl illustrate the subtle influence of varying the shorter alkyl chain length of the surfactant. The non-ideal mixing of pairs of AES surfactants with different alkanol group lengths of the ester show that the extent of the non-ideality changes as the difference in the alkanol length increases. The surface multilayer formation observed in the presence of AlCl3 varies in a complex manner with the length of the short chain and for mixtures of surfactants with different chains lengths.

18.
ACS Appl Mater Interfaces ; 12(50): 55675-55687, 2020 Dec 16.
Article in English | MEDLINE | ID: mdl-33259204

ABSTRACT

Antimicrobial peptides are promising alternatives to traditional antibiotics. A group of self-assembling lipopeptides was formed by attaching an acyl chain to the N-terminus of α-helix-forming peptides with the sequence Cx-G(IIKK)yI-NH2 (CxGy, x = 4-12 and y = 2). CxGy self-assemble into nanofibers above their critical aggregation concentrations (CACs). With increasing x, the CACs decrease and the hydrophobic interactions increase, promoting secondary structure transitions within the nanofibers. Antimicrobial activity, determined by the minimum inhibition concentration (MIC), also decreases with increasing x, but the MICs are significantly smaller than the CACs, suggesting effective bacterial membrane-disrupting power. Unlike conventional antibiotics, both C8G2 and C12G2 can kill Staphylococcus aureus and Escherichia coli after only minutes of exposure under the concentrations studied. C12G2 nanofibers have considerably faster killing dynamics and lower cytotoxicity than their nonaggregated monomers. Antimicrobial activity of peptide aggregates has, to date, been underexploited, and it is found to be a very promising mechanism for peptide design. Detailed evidence for the molecular mechanisms involved is provided, based on superresolution fluorescence microscopy, solid-state nuclear magnetic resonance, atomic force microscopy, neutron scattering/reflectivity, circular dichroism, and Brewster angle microscopy.


Subject(s)
Anti-Infective Agents/chemistry , Lipopeptides/chemistry , Amino Acid Sequence , Anti-Infective Agents/metabolism , Anti-Infective Agents/pharmacology , Antimicrobial Cationic Peptides/chemistry , Antimicrobial Cationic Peptides/metabolism , Antimicrobial Cationic Peptides/pharmacology , Drug Design , Escherichia coli/drug effects , Hemolysis/drug effects , Humans , Lipopeptides/metabolism , Lipopeptides/pharmacology , Liposomes/chemistry , Liposomes/metabolism , Microbial Sensitivity Tests , Microscopy, Fluorescence , Nanofibers/chemistry , Protein Conformation, alpha-Helical , Staphylococcus aureus/drug effects , Surface Tension
19.
ACS Appl Mater Interfaces ; 12(40): 44420-44432, 2020 Oct 07.
Article in English | MEDLINE | ID: mdl-32909733

ABSTRACT

Molecular dynamics (MD) simulations, stochastic optical reconstruction microscopy (STORM), and neutron reflection (NR) were combined to explore how antimicrobial peptides (AMPs) can be designed to promote the formation of nanoaggregates in bacterial membranes and impose effective bactericidal actions. Changes in the hydrophobicity of the designed AMPs were found to have a strong influence on their bactericidal potency and cytotoxicity. G(IIKK)3I-NH2 (G3) achieved low minimum inhibition concentrations (MICs) and effective dynamic kills against both antibiotic-resistant and -susceptible bacteria. However, a G3 derivative with weaker hydrophobicity, KI(KKII)2I-NH2 (KI), exhibited considerably lower membrane-lytic activity. In contrast, the more hydrophobic G(ILKK)3L-NH2 (GL) peptide achieved MICs similar to those observed for G3 but with worsened hemolysis. Both the model membranes studied by Brewster angle microscopy, zeta potential measurements, and NR and the real bacterial membranes examined with direct STORM contained membrane-inserted peptide aggregates upon AMP exposure. These structural features were well supported by MD simulations. By revealing how AMPs self-assemble in microbial membranes, this work provides important insights into AMP mechanistic actions and allows further fine-tuning of antimicrobial potency and cytotoxicity.


Subject(s)
Antimicrobial Cationic Peptides/pharmacology , Biocompatible Materials/pharmacology , Escherichia coli/drug effects , Staphylococcus aureus/drug effects , Surface-Active Agents/pharmacology , Antimicrobial Cationic Peptides/chemistry , Biocompatible Materials/chemistry , Microbial Sensitivity Tests , Molecular Dynamics Simulation , Particle Size , Protein Aggregates , Surface Properties , Surface-Active Agents/chemistry
20.
J Colloid Interface Sci ; 575: 245-253, 2020 Sep 01.
Article in English | MEDLINE | ID: mdl-32361410

ABSTRACT

HYPOTHESIS: Surfactants are widely used in agri-sprays to improve pesticide efficiency, but the mechanism underlying their interactions with the surface wax film on plants remains poorly understood. To facilitate physical characterisations, we have reconstituted wheat cuticular wax films onto an optically flat silicon substrate with and without octadecyltrimethoxysilane modification to control surface hydrophobicity. EXPERIMENTS: Imaging techniques including scanning electron microscopy (SEM) unravelled morphological features of the reconstituted wax films similar to those on leaves, showing little impact from the different substrates used. Neutron reflection (NR) established that reconstituted wax films were comprised of an underlying wax film decorated with top surface wax protrusions, a common feature irrespective of substrate hydrophobicity and highly consistent with what was observed from natural wax films. NR measurements, with the help of isotopic H/D substitutions to modify the scattering contributions of the wax and solvent, revealed different wax regimes within the wax films, illustrating the impact of surface hydrophilicity on the nanostructures within the wax films. FINDINGS: It was observed from both spectroscopic ellipsometry and NR measurements that wax films formed on the hydrophobic substrate were more robust and durable against attack by nonionic surfactant C12E6 solubilised with pesticide Cyprodinil (CP) than films coated on the bare hydrophilic silica. Thus, the former could be a more feasible model for studying the wax-surfactant-pesticide interactions.

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