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1.
Tijdschr Psychiatr ; 61(10): 692-701, 2019.
Article in Dutch | MEDLINE | ID: mdl-31907913

ABSTRACT

BACKGROUND: The co-occurrence of PTSD and alcohol use disorder (AUD) is common. Therefore, it is important to know which treatments are effective for the group of patients suffering from both disorders.
AIM: To explore the evidence of medical treatment options for PTSD and AUD.
METHOD: We systematically searched the literature using MEDLINE, Embase and psycINFO (PRISMA guideline).
RESULTS: Ten studies were included of which 9 were randomised controlled trials (RCT). Only one or a few RCTs examined several drugs. The combination of sertraline, naltrexone and disulfiram showed the biggest effect, although the results were limited and partly contradictory.
CONCLUSION: At the moment, there is little evidence for a clear pharmacological preference for the treatment of both PTSD and AUD. Based on the current studies there is, although limited, most evidence for the combination of naltrexone and sertraline or monotherapy with disulfiram. Further research is necessary in order to adequately treat this double diagnosis.


Subject(s)
Alcohol-Related Disorders/drug therapy , Stress Disorders, Post-Traumatic/drug therapy , Alcohol-Related Disorders/epidemiology , Disulfiram/therapeutic use , Drug Therapy, Combination , Humans , Naltrexone/therapeutic use , Randomized Controlled Trials as Topic , Sertraline/therapeutic use , Stress Disorders, Post-Traumatic/epidemiology
2.
Environ Sci Pollut Res Int ; 22(19): 14442-54, 2015 Oct.
Article in English | MEDLINE | ID: mdl-26022396

ABSTRACT

A combined chemical and biological analysis of samples from a major obsolete pesticide and persistent organic pollutant (POP) dumpsite in Northern Tajikistan was carried out. The chemical analytical screening focused on a range of prioritized compounds and compounds known to be present locally. Since chemical analytics does not allow measurements of hazards in complex mixtures, we tested the use of a novel effect-based approach using a panel of quantitative high-throughput CALUX reporter assays measuring distinct biological effects relevant in hazard assessment. Assays were included for assessing effects related to estrogen, androgen, and progestin signaling, aryl hydrocarbon receptor-mediated signaling, AP1 signaling, genotoxicity, oxidative stress, chemical hypoxia, and ER stress. With this panel of assays, we first quantified the biological activities of the individual chemicals measured in chemical analytics. Next, we calculated the expected sum activity by these chemicals in the samples of the pesticide dump site and compared the results with the measured CALUX bioactivity of the total extracts of these samples. The results showed that particularly endocrine disruption-related effects were common among the samples. This was consistent with the toxicological profiles of the individual chemicals that dominated these samples. However, large discrepancies between chemical and biological analysis were found in a sample from a burn place present in this site, with biological activities that could not be explained by chemical analysis. This is likely to be caused by toxic combustion products or by spills of compounds that were not targeted in the chemical analysis.


Subject(s)
Complex Mixtures/analysis , Endocrine Disruptors/analysis , Environmental Monitoring/methods , Hazardous Substances/analysis , Pesticides/analysis , Waste Disposal Facilities , Biological Assay/methods , Cell Line, Tumor , Complex Mixtures/chemistry , Complex Mixtures/toxicity , Endocrine Disruptors/toxicity , Genes, Reporter , Hazardous Substances/toxicity , Humans , Luciferases/genetics , Pesticides/toxicity , Receptors, Aryl Hydrocarbon/genetics , Receptors, Aryl Hydrocarbon/metabolism , Receptors, Steroid/genetics , Receptors, Steroid/metabolism , Risk Assessment , Tajikistan , Transcription, Genetic/drug effects
3.
Environ Sci Technol ; 47(20): 11651-9, 2013 Oct 15.
Article in English | MEDLINE | ID: mdl-23987121

ABSTRACT

Polycyclic aromatic hydrocarbons (PAHs) represent a class of ubiquitously occurring environmental compounds that are implicated in a wide range of toxicological effects. Routine measurement of PAH contamination generally involves chemical analytical analysis of a selected group of representatives, for example, EPA-16, which may result in underestimation of the PAH-related toxicity of a sample. Many high molecular weight PAHs are known ligands of the aryl hydrocarbon receptor (AhR), a nuclear receptor that mediates toxic effects related to these compounds. Making use of this property we developed a PAH CALUX assay, a mammalian, H4IIe- cell-based reporter assay for the hazard identification of total PAH mixtures. The PAH CALUX reporter cell line allows for specific, rapid (4 h exposure time) and reliable quantification of AhR-induced luciferase induction relative to benzo[a]pyrene (BaP), which is used as a positive reference PAH congener. Full dose response relationships with inductions over 100-fold were reached within only 2 h of exposure to BaP. The PAH CALUX is highly sensitive, that is, using a 4 h exposure time, a limit of detection (LOD) of 5.2 × 10(-11) M BaP was achieved, and highly accurate, that is, a repeatability of 5.9% and a reproducibility of 6.6% were established. Screening of a selection of PAHs that were prioritized by the European Union and/or the U.S. Environmental Protection Agency showed that the PAH CALUX bioassay has a high predictability, particularly for carcinogenic PAHs. Experiments with synthetic mixtures and reference materials containing complex PAH mixtures show the suitability of the assay for these types of applications. Moreover, the presented results suggest that application of the PAH CALUX will result in a lower risk of underestimation of the toxicity of a sample than chemical analytical approaches that focus on a limited set of prioritized compounds.


Subject(s)
Biological Assay/methods , Complex Mixtures/chemistry , Polycyclic Aromatic Hydrocarbons/analysis , Receptors, Aryl Hydrocarbon/metabolism , Animals , Benzo(a)pyrene/analysis , Cell Line , Environmental Pollutants/analysis , Genes, Reporter , Luciferases/metabolism , Mice , Time Factors
4.
Reprod Toxicol ; 33(2): 213-23, 2012 Apr.
Article in English | MEDLINE | ID: mdl-22120849

ABSTRACT

This study examined the developmental toxicity of the polycyclic aromatic hydrocarbons (PAHs) 11H-benzo(b)fluorene (BBF) and 4-azapyrene (AP) in comparison to the known teratogen retene. Developmental toxicity assays were performed in zebrafish embryos exposed for 120 h. BBF and retene induced a similar dioxin-like phenotype, whereas AP showed distinct effects, particularly craniofacial malformations. Microarray analysis revealed that for BBF and retene, drug metabolism pathways were induced, which were confirmed by subsequent studies of cyp1a gene expression. For AP, microarray analysis revealed the regulation of genes involved in retinoid metabolism and hematological functions. Studies with a panel of CALUX(®) bioassays to screen for endocrine disrupting activity of the compounds also revealed novel antagonistic effects of BBF and retene on androgen and progesterone receptors. Classification analysis revealed distinct gene expression profiles for both individual and combined PAH exposure. This study highlights the potential health risk of non priority PAHs.


Subject(s)
Endocrine Disruptors/toxicity , Polycyclic Aromatic Hydrocarbons/toxicity , Teratogens/toxicity , Animals , Embryo, Nonmammalian/drug effects , Gene Expression Regulation, Developmental/drug effects , Oligonucleotide Array Sequence Analysis , Receptors, Aryl Hydrocarbon/genetics , Receptors, Aryl Hydrocarbon/metabolism , Zebrafish
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