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1.
Food Funct ; 12(17): 7664-7675, 2021 Sep 07.
Article in English | MEDLINE | ID: mdl-34236362

ABSTRACT

The aim of this study was to investigate the immunomodulatory effect and mechanism of the glycopeptides from Paecilomyces sinensis (CPS-II) on ethanol induced ulcers in mice. In this study, histopathological evaluation (H&E staining) and the gastric ulcer score, ulcer index, total acid secretion and gastric pH value were used to determine the anti-ulcer activity. The expression levels of interleukin (IL)-6, interleukin (IL)-10 and tumor necrosis factor-α (TNF-α) were detected by ELISA. The contents of superoxide dismutase (SOD), malondialdehyde (MDA) and epidermal growth factor (PEG2) in serum were measured according to the instructions for the reagents. Western blotting was used to detect the effect of CPS-II on the MEK/ERK pathway. The results showed that CPS-II could inhibit the ulcer score and ulcer index compared with the disease control group. CPS-II could significantly increase gastric pH and decrease gastric acid secretion in mice. The ELISA analysis showed that the expression levels of IL-6 and TNF-α in the CPS-II treatment group were significantly decreased, while the expression levels of IL-10 were significantly increased in the CPS-II treatment group. In the resveratrol treatment group, the content of MDA in serum was decreased, and the level of PEG2 and the activity of SOD in serum were significantly increased, which indicated that CPS-II has immunoregulation and anti-ulcer properties. The CPS-II treatment group could reduce the expression level of miR-9-5p in gastric tissue. pEGFR had been identified as a potential target of miR-9-5p. Western blot analysis showed that CPS-II could up-regulate the relative protein expression of pEGFR/EGFR, pRaf/Raf, pMEK/MEK, pERK/ERK, and ZO-1. The results showed that CPS-II could reduce oxidative stress and inflammatory response by regulating the miR-9-5p-MEK/ERK signaling pathway, thus protecting the gastric mucosa and improving stress gastric ulcers.


Subject(s)
Anti-Inflammatory Agents/administration & dosage , Glycopeptides/administration & dosage , Hypocreales/chemistry , MicroRNAs/immunology , Mitogen-Activated Protein Kinase Kinases/immunology , Stomach Ulcer/drug therapy , Animals , Ethanol/adverse effects , Gastric Mucosa/drug effects , Gastric Mucosa/immunology , Humans , Interleukin-10/genetics , Interleukin-10/immunology , Interleukin-6/genetics , Interleukin-6/immunology , MAP Kinase Signaling System/drug effects , Male , Mice , Mice, Inbred BALB C , MicroRNAs/genetics , Mitogen-Activated Protein Kinase Kinases/genetics , Oxidative Stress/drug effects , Stomach Ulcer/chemically induced , Stomach Ulcer/genetics , Stomach Ulcer/immunology
2.
Clin Pharmacol Ther ; 109(4): 928-941, 2021 04.
Article in English | MEDLINE | ID: mdl-33565627

ABSTRACT

Therapeutic drug monitoring (TDM) and model-informed precision dosing (MIPD) have evolved as important tools to inform rational dosing of antibiotics in individual patients with infections. In particular, critically ill patients display altered, highly variable pharmacokinetics and often suffer from infections caused by less susceptible bacteria. Consequently, TDM has been used to individualize dosing in this patient group for many years. More recently, there has been increasing research on the use of MIPD software to streamline the TDM process, which can increase the flexibility and precision of dose individualization but also requires adequate model validation and re-evaluation of existing workflows. In parallel, new minimally invasive and noninvasive technologies such as microneedle-based sensors are being developed, which-together with MIPD software-have the potential to revolutionize how patients are dosed with antibiotics. Nonetheless, carefully designed clinical trials to evaluate the benefit of TDM and MIPD approaches are still sparse, but are critically needed to justify the implementation of TDM and MIPD in clinical practice. The present review summarizes the clinical pharmacology of antibiotics, conventional TDM and MIPD approaches, and evidence of the value of TDM/MIPD for aminoglycosides, beta-lactams, glycopeptides, and linezolid, for which precision dosing approaches have been recommended.


Subject(s)
Anti-Bacterial Agents/administration & dosage , Anti-Bacterial Agents/pharmacology , Critical Illness , Drug Monitoring/methods , Precision Medicine/methods , Algorithms , Aminoglycosides/administration & dosage , Aminoglycosides/pharmacology , Anti-Bacterial Agents/adverse effects , Area Under Curve , Biomarkers , Dose-Response Relationship, Drug , Glycopeptides/administration & dosage , Glycopeptides/pharmacology , Half-Life , Humans , Linezolid/administration & dosage , Linezolid/pharmacology , Microbial Sensitivity Tests , Models, Biological , beta-Lactams/administration & dosage , beta-Lactams/pharmacology
3.
Adv Drug Deliv Rev ; 169: 152-167, 2021 02.
Article in English | MEDLINE | ID: mdl-33352223

ABSTRACT

Carbohydrates play essential structural and biochemical roles in all living organisms. Glycopolymers are attractive as well-defined biomimetic analogs to study carbohydrate-dependent processes, and are widely applicable biocompatible materials in their own right. Glycopolypeptides have shown great promise in this area since they are closer structural mimics of natural glycoproteins than other synthetic glycopolymers and can serve as carriers for biologically active carbohydrates. This review highlights advances in the area of design and synthesis of such materials, and their biomedical applications in therapeutic delivery, tissue engineering, and beyond.


Subject(s)
Drug Delivery Systems , Glycopeptides/administration & dosage , Peptides/administration & dosage , Animals , Drug Design , Glycopeptides/chemistry , Humans , Peptides/chemistry , Tissue Engineering
4.
Int J Mol Sci ; 22(1)2020 Dec 22.
Article in English | MEDLINE | ID: mdl-33374986

ABSTRACT

In previous work we evaluated an opioid glycopeptide with mixed µ/δ-opioid receptor agonism that was a congener of leu-enkephalin, MMP-2200. The glycopeptide analogue showed penetration of the blood-brain barrier (BBB) after systemic administration to rats, as well as profound central effects in models of Parkinson's disease (PD) and levodopa (L-DOPA)-induced dyskinesia (LID). In the present study, we tested the glycopeptide BBI-11008 with selective δ-opioid receptor agonism, an analogue of deltorphin, a peptide secreted from the skin of frogs (genus Phyllomedusa). We tested BBI-11008 for BBB-penetration after intraperitoneal (i.p.) injection and evaluated effects in LID rats. BBI-11008 (10 mg/kg) demonstrated good CNS-penetrance as shown by microdialysis and mass spectrometric analysis, with peak concentration levels of 150 pM in the striatum. While BBI-11008 at both 10 and 20 mg/kg produced no effect on levodopa-induced limb, axial and oral (LAO) abnormal involuntary movements (AIMs), it reduced the levodopa-induced locomotor AIMs by 50% after systemic injection. The N-methyl-D-aspartate receptor antagonist MK-801 reduced levodopa-induced LAO AIMs, but worsened PD symptoms in this model. Co-administration of MMP-2200 had been shown prior to block the MK-801-induced pro-Parkinsonian activity. Interestingly, BBI-11008 was not able to block the pro-Parkinsonian effect of MK-801 in the LID model, further indicating that a balance of mu- and delta-opioid agonism is required for this modulation. In summary, this study illustrates another example of meaningful BBB-penetration of a glycopeptide analogue of a peptide to achieve a central behavioral effect, providing additional evidence for the glycosylation technique as a method to harness therapeutic potential of peptides.


Subject(s)
Disease Models, Animal , Dyskinesia, Drug-Induced/physiopathology , Glycopeptides/pharmacology , Motor Activity/drug effects , Parkinson Disease, Secondary/physiopathology , Receptors, Opioid, delta/agonists , Analgesics, Opioid/administration & dosage , Analgesics, Opioid/pharmacokinetics , Analgesics, Opioid/pharmacology , Animals , Corpus Striatum/metabolism , Dizocilpine Maleate/pharmacology , Dyskinesia, Drug-Induced/metabolism , Glycopeptides/administration & dosage , Glycopeptides/pharmacokinetics , Levodopa , Male , Motor Activity/physiology , Neuroprotective Agents/pharmacology , Parkinson Disease, Secondary/chemically induced , Parkinson Disease, Secondary/metabolism , Rats, Sprague-Dawley , Receptors, Opioid, delta/metabolism
5.
Ann Hematol ; 99(11): 2547-2553, 2020 Nov.
Article in English | MEDLINE | ID: mdl-32974837

ABSTRACT

Patients with acute myeloid leukemia (AML) are often exposed to broad-spectrum antibiotics and thus at high risk of Clostridioides difficile infections (CDI). As bacterial infections are a common cause for treatment-related mortality in these patients, we conducted a retrospective study to analyze the incidence of CDI and to evaluate risk factors for CDI in a large uniformly treated AML cohort. A total of 415 AML patients undergoing intensive induction chemotherapy between 2007 and 2019 were included in this retrospective analysis. Patients presenting with diarrhea and positive stool testing for toxin-producing Clostridioides difficile were defined to have CDI. CDI was diagnosed in 37 (8.9%) of 415 AML patients with decreasing CDI rates between 2013 and 2019 versus 2007 to 2012. Days with fever, exposition to carbapenems, and glycopeptides were significantly associated with CDI in AML patients. Clinical endpoints such as length of hospital stay, admission to ICU, response rates, and survival were not adversely affected. We identified febrile episodes and exposition to carbapenems and glycopeptides as risk factors for CDI in AML patients undergoing induction chemotherapy, thereby highlighting the importance of interdisciplinary antibiotic stewardship programs guiding treatment strategies in AML patients with infectious complications to carefully balance risks and benefits of anti-infective agents.


Subject(s)
Carbapenems/administration & dosage , Clostridioides difficile , Glycopeptides/administration & dosage , Induction Chemotherapy , Length of Stay , Leukemia, Myeloid, Acute , Adolescent , Adult , Aged , Aged, 80 and over , Enterocolitis, Pseudomembranous/drug therapy , Enterocolitis, Pseudomembranous/epidemiology , Female , Humans , Incidence , Leukemia, Myeloid, Acute/drug therapy , Leukemia, Myeloid, Acute/epidemiology , Leukemia, Myeloid, Acute/microbiology , Male , Middle Aged , Retrospective Studies , Risk Factors
6.
Nutrients ; 12(9)2020 Sep 04.
Article in English | MEDLINE | ID: mdl-32899700

ABSTRACT

Protein is the most satiating macronutrient, increasing secretion of gastrointestinal hormones and diet induced thermogenesis. In phenylketonuria (PKU), natural protein is restricted with approximately 80% of intake supplied by a synthetic protein source, which may alter satiety response. Casein glycomacropeptide (CGMP-AA), a carbohydrate containing peptide and alternative protein substitute to amino acids (AA), may enhance satiety mediated by its bioactive properties. AIM: In a three-year longitudinal; prospective study, the effect of AA and two different amounts of CGMP-AA (CGMP-AA only (CGMP100) and a combination of CGMP-AA and AA (CGMP50) on satiety, weight and body mass index (BMI) were compared. METHODS: 48 children with PKU completed the study. Median ages of children were: CGMP100; (n = 13), 9.2 years; CGMP50; (n = 16), 7.3 years; and AA (n = 19), 11.1 years. Semi-quantitative dietary assessments and anthropometry (weight, height and BMI) were measured every three months. RESULTS: The macronutrient contribution to total energy intake from protein, carbohydrate and fat was similar across the groups. Adjusting for age and gender, no differences in energy intake, weight, BMI, incidence of overweight or obesity was apparent between the groups. CONCLUSION: In this three-year longitudinal study, there was no indication to support a relationship between CGMP and satiety, as evidenced by decreased energy intake, thereby preventing overweight or obesity. Satiety is a complex multi-system process that is not fully understood.


Subject(s)
Amino Acids/administration & dosage , Caseins/administration & dosage , Diet, Protein-Restricted/methods , Energy Intake/drug effects , Glycopeptides/administration & dosage , Phenylketonurias/diet therapy , Satiation/drug effects , Adolescent , Anthropometry , Body Mass Index , Body Weight/drug effects , Child , Child, Preschool , Diet Surveys , Female , Humans , Longitudinal Studies , Male , Nutrients , Phenylalanine/blood , Phenylketonurias/physiopathology , Prospective Studies
7.
Cancer Immunol Immunother ; 69(5): 703-716, 2020 May.
Article in English | MEDLINE | ID: mdl-32034426

ABSTRACT

Cancer is one of the main causes of mortality worldwide and a major public health concern. Among various strategies, therapeutic vaccines have been developed to stimulate anti-tumoral immune responses. However, in spite of extensive studies, this approach suffers from a lack of efficacy. Recently, we designed the MAG-Tn3 vaccine, aiming to induce antibody responses against Tn, a tumor-associated carbohydrate antigen. The Tn antigen is of interest because it is expressed by several adenocarcinomas, but not normal cells. The fully synthetic glycopeptide vaccine MAG-Tn3 is composed of four arms built on three adjacent Tn moieties associated with the tetanus toxin-derived peptide TT830-844 CD4+ T-cell epitope. This promiscuous CD4+ T-cell epitope can bind to a wide range of HLA-DRB molecules and is thus expected to activate CD4+ T-cell responses in a large part of the human population. The MAG-Tn3 vaccine was formulated with the GSK-proprietary immunostimulant AS15, composed of CpG7909, MPL, and QS21, which has been shown to stimulate both innate and humoral responses, in addition to being well tolerated. Here, seven patients with localized breast cancer with a high-risk of relapse were immunized with the MAG-Tn3 vaccine formulated with AS15. The first results of phase I clinical trial demonstrated that all vaccinated patients developed high levels of Tn-specific antibodies. Moreover, these antibodies specifically recognized Tn-expressing human tumor cells and killed them through a complement-dependent cytotoxicity mechanism. Overall, this study establishes, for the first time, the capacity of a fully synthetic glycopeptide cancer vaccine to induce specific immune responses in humans.


Subject(s)
Antibodies, Neoplasm/blood , Antigens, Tumor-Associated, Carbohydrate/immunology , Breast Neoplasms/therapy , Cancer Vaccines/immunology , Neoplasm Recurrence, Local/prevention & control , Adjuvants, Immunologic/administration & dosage , Adult , Aged , Animals , Antibodies, Neoplasm/immunology , Antigens, Tumor-Associated, Carbohydrate/administration & dosage , Antigens, Tumor-Associated, Carbohydrate/genetics , Breast Neoplasms/blood , Breast Neoplasms/immunology , Cancer Vaccines/administration & dosage , Cancer Vaccines/genetics , Female , Glycopeptides/administration & dosage , Glycopeptides/genetics , Glycopeptides/immunology , Humans , Immunogenicity, Vaccine , Injections, Intramuscular , Jurkat Cells , Middle Aged , Neoplasm Recurrence, Local/immunology , Treatment Outcome , Vaccination/methods , Vaccines, Synthetic/administration & dosage , Vaccines, Synthetic/genetics , Vaccines, Synthetic/immunology
8.
Eur Rev Med Pharmacol Sci ; 23(2 Suppl): 76-85, 2019 Apr.
Article in English | MEDLINE | ID: mdl-30977874

ABSTRACT

OBJECTIVE: The aim of this study was to review the characteristics of patients with septic arthritis after ACL reconstruction comparing our results with those deriving from the literature review. PATIENTS AND METHODS: Patients with suspected post arthroscopic septic arthritis of the knee occurring within 6 months after surgery were evaluated to be included in the investigation. Septic arthritis was defined by i) clinical evidence; ii) laboratory investigations; iii) synovial fluid leukocyte count of more than 2,5 x 104/µL or positive cultures obtained by synovial fluid aspirate. RESULTS: Thirty-nine patients (median age 25 years, range 17-42) with septic arthritis following ACL reconstruction were enrolled. Staphylococci were the main bacteria identified. Resolution within 4 weeks of local signs was observed more frequently in those receiving arthroscopic debridement and synovectomy coupled with antibiotic therapy (18/21 vs. 9/18, p<0.05). Fever was present in 33 (85%) cases. Fever disappearance and CRP normalization within 4 weeks were reported more frequently in patients receiving intravenous antibiotics (17/20 vs. 9/19, p<0.05). Similar findings were retrieved by literature analysis. CONCLUSIONS: An intravenous antibiotic therapy with surgical debridement is the first-line treatment for septic arthritis. Staphylococci are the main causative agents, justifying an empiric therapeutic approach with an anti-MRSA agent and cephalosporin.


Subject(s)
Anti-Bacterial Agents/pharmacology , Arthritis, Infectious/drug therapy , Arthritis, Infectious/surgery , Arthroscopy/adverse effects , Cephalosporins/pharmacology , Glycopeptides/pharmacology , Anti-Bacterial Agents/administration & dosage , Arthritis, Infectious/microbiology , Cephalosporins/administration & dosage , Glycopeptides/administration & dosage , Humans , Injections, Intravenous , Methicillin-Resistant Staphylococcus aureus/drug effects , Treatment Outcome
9.
ACS Infect Dis ; 5(7): 1223-1230, 2019 07 12.
Article in English | MEDLINE | ID: mdl-31002491

ABSTRACT

In 2016, the World Health Organization deemed antibiotic resistance one of the biggest threats to global health, food security, and development. The need for new methods to combat infections caused by antibiotic resistant pathogens will require a variety of approaches to identifying effective new therapeutic strategies. One approach is the identification of small molecule adjuvants that potentiate the activity of antibiotics of demonstrated utility, whose efficacy is abated by resistance, both acquired and intrinsic. To this end, we have identified compounds that enhance the efficacy of antibiotics normally ineffective against Gram-negative pathogens because of the outer membrane permeability barrier. We identified two adjuvant compounds that dramatically enhance sensitivity of Acinetobacter baumannii to macrolide and glycopeptide antibiotics, with reductions in minimum inhibitory concentrations as high as 256-fold, and we observed activity across a variety of clinical isolates. Mode of action studies indicate that these adjuvants likely work by modulating lipopolysaccharide synthesis or assembly. The adjuvants were active in vivo in a Galleria mellonella infection model, indicating potential for use in mammalian infections.


Subject(s)
Acinetobacter Infections/drug therapy , Acinetobacter baumannii/drug effects , Anti-Bacterial Agents/administration & dosage , Small Molecule Libraries/administration & dosage , Animals , Anti-Bacterial Agents/pharmacology , Bacterial Outer Membrane/drug effects , Disease Models, Animal , Drug Resistance, Multiple, Bacterial/drug effects , Drug Synergism , Glycopeptides/administration & dosage , Glycopeptides/pharmacology , Macrolides/administration & dosage , Macrolides/pharmacology , Microbial Sensitivity Tests , Moths , Small Molecule Libraries/pharmacology
10.
Molecules ; 24(6)2019 Mar 13.
Article in English | MEDLINE | ID: mdl-30871262

ABSTRACT

Background: The GRPR-antagonist 68Ga-SB3 visualized prostate cancer lesions in animal models and in patients. Switching radiometal from 68Ga to 111In impaired tumor targeting in mice, but coinjection of the neprilysin (NEP)-inhibitor phosphoramidon (PA) stabilized 111In-SB3 in circulation and remarkably increased tumor uptake. We herein report on the biological profile of 111In-SB4: 111In-[dAla11]SB3. Methods: The biological responses of 111In-SB3/SB4 were compared in PC-3 cells and animal models. Results: Gly11/dAla11-replacement deteriorated GRPR-affinity (SB4 IC50: 10.7 ± 0.9 nM vs. SB3 IC50: 4.6 ± 0.3 nM) and uptake in PC-3 cells (111In-SB4: 1.3 ± 0.4% vs. 111In-SB3 16.2 ± 0.8% at 1 h). 111In-SB4 was more stable than 111In-SB3, but PA-coinjection stabilized both radiotracers in peripheral mice blood. Unmodified 111In-SB3 showed higher uptake in PC-3 xenografts (8.8 ± 3.0%ID/g) vs. 111In-SB4 (3.1 ± 1.1%ID/g) at 4 h pi. PA-coinjection improved tumor uptake, with 111In-SB3 still showing superior tumor targeting (38.3 ± 7.9%ID/g vs. 7.4 ± 0.3%ID/g for 111In-SB4). Conclusions: Replacement of Gly11 by dAla11 improved in vivo stability, however, at the cost of GRPR-affinity and cell uptake, eventually translating into inferior tumor uptake of 111In-SB4 vs. unmodified 111In-SB3. On the other hand, in-situ NEP-inhibition turned out to be a more efficient and direct strategy to optimize the in vivo profile of 111In-SB3, and potentially other peptide radiotracers.


Subject(s)
Biosimilar Pharmaceuticals/chemistry , Glycopeptides/pharmacokinetics , Indium Radioisotopes/chemistry , Prostatic Neoplasms/diagnostic imaging , Trastuzumab/chemistry , Animals , Bombesin/metabolism , Cell Line, Tumor , Drug Stability , Glycopeptides/administration & dosage , Glycopeptides/chemistry , Humans , Male , Mice , Neprilysin/antagonists & inhibitors , Prostatic Neoplasms/metabolism , Receptors, Bombesin/metabolism , Tissue Distribution
11.
Drug Des Devel Ther ; 12: 2875-2885, 2018.
Article in English | MEDLINE | ID: mdl-30237697

ABSTRACT

PURPOSE: Development of new semisynthetic glycopeptides with improved antibacterial efficacy and reduced pseudoallergic reactions. METHODS: Semisynthetic glycopeptides 3-6 were synthesized from vancomycin (1) or eremomycin (2) by the condensation with pyrrolidine or piperidine. The minimum inhibitory concentration (MIC) for the new derivatives was measured by the broth micro-dilution method on a panel of clinical isolates of Staphylococcus and Enterococcus. Acute toxicity (50% lethal dose, maximum tolerated doses), antibacterial efficacy on model of systemic bacterial infection with S. aureus and pseudoallergic inflammatory reaction (on concanavalin A) of eremomycin pyrrolidide (5) were evaluated in mice according to standard procedures. RESULTS: The eremomycin pyrrolidide (5) was the most active compound and showed a high activity against Gram-positive bacteria: vancomycin-susceptible staphylococci and enterococci (minimum inhibitory concentrations [MICs] 0.13-0.25 mg/L), as well as vancomycin-intermediate resistant Staphylococcus aureus (MICs 1 mg/L). Antimicrobial susceptibility tested on a panel of 676 isolates showed that 5 had similar activity for the genera Staphylococcus and Enterococcus with MIC90=0.5 mg/L, while vancomycin had MIC90=1-2 mg/L. The number of resistant strains of Enterococcus faecium (vancomycin-resistant enterococci) (MIC =64 mg/L) with this value was 7 (8%) for vancomycin (1) and 0 for the compound 5. In vivo comparative studies in a mouse model of systemic bacterial infection with S. aureus demonstrated that the efficacy of 5 was notably higher than that of the original antibiotics 1 and 2. In contrast to 1, compound 5 did not induce pseudoallergic inflammatory reaction (on concanavalin A). CONCLUSION: The new semisynthetic derivative eremomycin pyrrolidide (5) has high activity against staphylococci and enterococci including vancomycin-resistant strains. Compound 5 has a higher efficacy in a model of staphylococcal sepsis than vancomycin (1) or eremomycin (2). In striking contrast to natural antibiotics, the novel derivative 5 does not induce a pseudoallergic inflammatory reaction to concanavalin A and therefore has no histamine release activity. These results indicate the advantages of a new semisynthetic glycopeptide antibiotic eremomycin pyrrolidide (5) which may be a prospective antimicrobial agent for further pre-clinical and clinical evaluations.


Subject(s)
Anti-Bacterial Agents/pharmacology , Enterococcus faecium/drug effects , Glycopeptides/pharmacology , Pyrrolidines/pharmacology , Staphylococcus aureus/drug effects , Vancomycin Resistance/drug effects , Animals , Anti-Bacterial Agents/administration & dosage , Anti-Bacterial Agents/chemistry , Dose-Response Relationship, Drug , Drug Resistance, Bacterial , Female , Glycopeptides/administration & dosage , Glycopeptides/chemistry , Glycopeptides/therapeutic use , Mice , Mice, Hairless , Mice, Inbred CBA , Microbial Sensitivity Tests , Molecular Conformation , Pyrrolidines/administration & dosage , Pyrrolidines/chemistry , Pyrrolidines/therapeutic use , Shock, Septic/drug therapy , Staphylococcal Infections/drug therapy , Structure-Activity Relationship
12.
Eur J Anaesthesiol ; 35(9): 682-690, 2018 09.
Article in English | MEDLINE | ID: mdl-29750698

ABSTRACT

BACKGROUND: Copeptin levels in conjunction with cardiac troponin may be used to rule out early myocardial infarction in patients presenting with chest pain. Raised pre-operative copeptin has been shown to be associated with postoperative cardiac events. However, very little is known about the peri-operative time course of copeptin or the feasibility of very early postoperative copeptin measurement to diagnose or rule-out myocardial injury. OBJECTIVES: In this preparatory analysis for a larger trial, we sought to examine the time course of peri-operative copeptin and identify the time at which concentrations returned to pre-operative levels. Second, in an explorative analysis, we sought to examine the association of copeptin in general and at various time points with myocardial injury occurring within the first 48 h. DESIGN: Preparatory analysis of a prospective, observational cohort study. SETTING: Single university centre from February to July 2016. PATIENTS: A total of 30 consecutive adults undergoing vascular surgery. INTERVENTION: Serial peri-operative copeptin measurements. MAIN OUTCOME MEASURE: We measured copeptin concentrations before and immediately after surgery (0 h), then at 2, 4, 6 and 8 h after surgery and on the first and second postoperative day. Postoperative concentrations were compared with pre-operative levels with a Wilcoxon signed-rank test. Second, we explored an association between postoperative copeptin concentrations and myocardial injury by the second postoperative day. Myocardial injury was defined as a 5 ng l increase between pre-operative and postoperative high-sensitivity cardiac troponin T with an absolute peak of at least 20 ng l. RESULTS: Immediate postoperative copeptin concentrations (median [interquartile range]) increased nearly eight-fold from pre-operative values (8.5 [3.6 to 13.8] to 64.75 pmol l [29.6 to 258.7]; P < 0.001). Copeptin concentrations remained elevated until returning to baseline on the second postoperative day. Postoperative copeptin was significantly higher in patients experiencing myocardial injury than in those who did not (P = 0.02). The earliest most promising single time point for diagnosis may be immediately after surgery (0 h). The receiver-operating characteristics curve for immediate postoperative copeptin and myocardial injury by the second postoperative day was 0.743 (95% confidence interval 0.560 to 0.926). CONCLUSION: Copeptin concentrations are greatly increased after vascular surgery and remain so until the 2nd postoperative day. Postoperative copeptin concentrations appear to be higher in patients who go on to exhibit myocardial injury. Immediate postoperative copeptin concentrations show promise for eliminating or identifying those at risk of myocardial injury. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT02687776, Mauermann/Lurati Buse.


Subject(s)
Glycopeptides/administration & dosage , Glycopeptides/blood , Myocardial Infarction/blood , Perioperative Care/methods , Troponin T/blood , Vascular Surgical Procedures/adverse effects , Aged , Aged, 80 and over , Biomarkers/blood , Cohort Studies , Female , Humans , Male , Middle Aged , Myocardial Infarction/diagnosis , Myocardial Infarction/epidemiology , Perioperative Care/trends , Postoperative Complications/blood , Postoperative Complications/diagnosis , Postoperative Complications/epidemiology , Prospective Studies , Vascular Surgical Procedures/trends
13.
Int J Pharm ; 543(1-2): 300-310, 2018 May 30.
Article in English | MEDLINE | ID: mdl-29608954

ABSTRACT

Restoration of the Chol homeostasis in the Central Nervous System (CNS) could be beneficial for the treatment of Huntington's Disease (HD), a progressive, fatal, adult-onset, neurodegenerative disorder. Unfortunately, Chol is unable to cross the blood-brain barrier (BBB), thus a novel strategy for a targeted delivery of Chol into the brain is highly desired. This article aims to investigate the production of hybrid nanoparticles composed by Chol and PLGA (MIX-NPs) modified with g7 ligand for BBB crossing. We described the impact of ratio between components (Chol and PLGA) and formulation process (nanoprecipitation or single emulsion process) on physico-chemical and structural characteristics, we tested MIX-NPs in vitro using primary hippocampal cell cultures evaluating possible toxicity, uptake, and the ability to influence excitatory synaptic receptors. Our results elucidated that both formulation processes produce MIX-NPs with a Chol content higher that 40%, meaning that Chol is a structural particle component and active compound at the same time. The formulation strategy impacted the architecture and reorganization of components leading to some differences in Chol availability between the two types of g7 MIX-NPs. Our results identified that both kinds of MIX-NPs are efficiently taken up by neurons, able to escape lysosomes and release Chol into the cells resulting in an efficient modification in expression of synaptic receptors that could be beneficial in HD.


Subject(s)
Cholesterol/chemistry , Drug Delivery Systems , Glycopeptides/chemistry , Lactic Acid/chemistry , Nanoparticles/chemistry , Polyglycolic Acid/chemistry , Animals , Cell Survival/drug effects , Cells, Cultured , Cholesterol/administration & dosage , Embryo, Mammalian , Glycopeptides/administration & dosage , Hippocampus/cytology , Lactic Acid/administration & dosage , Nanoparticles/administration & dosage , Neurons/drug effects , Neurons/metabolism , Poloxamer/chemistry , Polyglycolic Acid/administration & dosage , Polylactic Acid-Polyglycolic Acid Copolymer , Polyvinyl Alcohol/chemistry , Rats , Receptors, N-Methyl-D-Aspartate/metabolism , Surface-Active Agents/administration & dosage , Surface-Active Agents/chemistry
14.
Future Microbiol ; 12: 1001-1016, 2017 09.
Article in English | MEDLINE | ID: mdl-28758800

ABSTRACT

Antibiotics are often used in neonates despite the absence of relevant dosing information in drug labels. For neonatal dosing, clinicians must extrapolate data from studies for adults and older children, who have strikingly different physiologies. As a result, dosing extrapolation can lead to increased toxicity or efficacy failures in neonates. Driven by these differences and recent legislation mandating the study of drugs in children and neonates, an increasing number of pharmacokinetic studies of antibiotics are being performed in neonates. These studies have led to new dosing recommendations with particular consideration for neonate body size and maturation. Herein, we highlight the available pharmacokinetic data for commonly used systemic antibiotics in neonates.


Subject(s)
Anti-Bacterial Agents/administration & dosage , Anti-Bacterial Agents/pharmacokinetics , Infant, Newborn/physiology , Adult , Aminoglycosides/administration & dosage , Aminoglycosides/adverse effects , Aminoglycosides/pharmacokinetics , Anti-Bacterial Agents/adverse effects , Birth Weight/drug effects , Body Size/drug effects , Cephalosporins/administration & dosage , Child , Clindamycin/administration & dosage , Clindamycin/adverse effects , Clindamycin/pharmacokinetics , Glycopeptides/administration & dosage , Glycopeptides/adverse effects , Glycopeptides/pharmacokinetics , Humans , Infant , Medication Reconciliation , Meropenem , Metronidazole/administration & dosage , Metronidazole/adverse effects , Metronidazole/pharmacokinetics , Penicillanic Acid/administration & dosage , Penicillanic Acid/analogs & derivatives , Piperacillin/administration & dosage , Piperacillin, Tazobactam Drug Combination , Thienamycins/administration & dosage , Thienamycins/adverse effects , Thienamycins/pharmacokinetics , beta-Lactams/administration & dosage , beta-Lactams/adverse effects , beta-Lactams/pharmacokinetics
15.
Pharmacotherapy ; 37(8): e90-e92, 2017 Aug.
Article in English | MEDLINE | ID: mdl-28543367

ABSTRACT

Staphylococcus aureus remains the most common causative pathogen in osteomyelitis. New or alternative therapies are often needed to treat S. aureus infections adequately in patients with drug allergies, treatment failures, or drug interactions. Oritavancin is a novel long-acting lipoglycopeptide approved by the U.S. Food and Drug Administration in 2014 for the treatment of acute bacterial skin and skin structure infections. With a terminal half-life of 8-10 days, oritavancin dosing regimens with infrequent parenteral administration now exist to treat infectious diseases such as osteomyelitis that would otherwise require daily dosing of intravenous antimicrobials for weeks; however, clinical experience is lacking. In this article, the first case of S. aureus osteomyelitis resulting from traumatic injury, successfully treated with oritavancin, is presented. Removal of the nail used for a comminuted tibial shaft fracture repair followed by a 6-week treatment course with oritavancin resulted in clinical response.


Subject(s)
Anti-Bacterial Agents/therapeutic use , Glycopeptides/therapeutic use , Osteomyelitis/drug therapy , Staphylococcal Infections/drug therapy , Surgical Wound Infection/drug therapy , Administration, Intravenous , Anti-Bacterial Agents/administration & dosage , Female , Glycopeptides/administration & dosage , Humans , Lipoglycopeptides , Methicillin/pharmacology , Middle Aged , Staphylococcus aureus/drug effects , Tibial Fractures/surgery
16.
Intensive Care Med ; 43(7): 1021-1032, 2017 Jul.
Article in English | MEDLINE | ID: mdl-28409203

ABSTRACT

Critically ill patients with severe infections are at high risk of suboptimal antimicrobial dosing. The pharmacokinetics (PK) and pharmacodynamics (PD) of antimicrobials in these patients differ significantly from the patient groups from whose data the conventional dosing regimens were developed. Use of such regimens often results in inadequate antimicrobial concentrations at the site of infection and is associated with poor patient outcomes. In this article, we describe the potential of in vitro and in vivo infection models, clinical pharmacokinetic data and pharmacokinetic/pharmacodynamic models to guide the design of more effective antimicrobial dosing regimens. Individualised dosing, based on population PK models and patient factors (e.g. renal function and weight) known to influence antimicrobial PK, increases the probability of achieving therapeutic drug exposures while at the same time avoiding toxic concentrations. When therapeutic drug monitoring (TDM) is applied, early dose adaptation to the needs of the individual patient is possible. TDM is likely to be of particular importance for infected critically ill patients, where profound PK changes are present and prompt appropriate antibiotic therapy is crucial. In the light of the continued high mortality rates in critically ill patients with severe infections, a paradigm shift to refined dosing strategies for antimicrobials is warranted to enhance the probability of achieving drug concentrations that increase the likelihood of clinical success.


Subject(s)
Anti-Bacterial Agents , Drug Monitoring/methods , Aminoglycosides/administration & dosage , Animals , Anti-Bacterial Agents/administration & dosage , Anti-Bacterial Agents/pharmacokinetics , Anti-Bacterial Agents/pharmacology , Biomarkers/blood , Critical Illness/therapy , Disease Models, Animal , Dose-Response Relationship, Drug , Glycopeptides/administration & dosage , Humans , Intensive Care Units , Quinolones/administration & dosage , Severity of Illness Index , beta-Lactams/administration & dosage
17.
J Agric Food Chem ; 65(4): 777-783, 2017 Feb 01.
Article in English | MEDLINE | ID: mdl-28051864

ABSTRACT

Ovomucin is a glycoprotein from egg white with potential to act as an anti-adhesive agent against infectious diseases. This study aimed to determine whether ovomucin or ovomucin hydrolysates could prevent adhesion of two porcine K88 enterotoxigenic Escherichia coli (ETEC) strains. Adhesion was assessed in vitro using a hemagglutination assay. Ovomucin hydrolysates, but not intact ovomucin, prevented adhesion of ETEC to porcine erythrocytes. The ovomucin hydrolysate prepared by acid protease II exhibited the best anti-agglutinating activity against both strains; this hydrolysate was fractionated by cation exchange chromatography and reverse-phase high-performance liquid chromatography (HPLC). The most active fractions, F3(9) and F7(1), with minimal inhibitory concentrations of 0.03 and 0.25 g/L against strains ECL13795 and ECL13998, respectively, were subjected to structural characterization. Six identified glycopeptides were all derived from α-ovomucin, composed of a pentasaccharide core of two N-acetylglucosamine and three mannose residues (GlcNAc2Man3) and a bisecting N-acetylglucosamine (GlcNAc). The terminal ß-linked galactose from these glycopeptides could be one of the binding sites for K88ac fimbriae.


Subject(s)
Bacterial Adhesion/drug effects , Enterotoxigenic Escherichia coli/drug effects , Escherichia coli Infections/drug therapy , Glycopeptides/administration & dosage , Ovomucin/chemistry , Swine Diseases/drug therapy , Adhesins, Escherichia coli/genetics , Adhesins, Escherichia coli/metabolism , Agglutination/drug effects , Animals , Chickens , Enterotoxigenic Escherichia coli/genetics , Enterotoxigenic Escherichia coli/physiology , Escherichia coli Infections/microbiology , Escherichia coli Proteins , Glycopeptides/chemistry , Glycopeptides/isolation & purification , Intestinal Mucosa/microbiology , Ovomucin/administration & dosage , Swine , Swine Diseases/microbiology
18.
PLoS One ; 12(1): e0169501, 2017.
Article in English | MEDLINE | ID: mdl-28052136

ABSTRACT

Intranasal vaccination is more potent than parenteral injection for the prevention of influenza. However, because the poor efficiency of antigen uptake across the nasal mucosa is a key issue, immunostimulatory adjuvants are essential for intranasal vaccines. The immunomodulator mannatide or polyactin (PA) has been used for the clinical treatment of impaired immunity in China, but its adjuvant effect on an inactivated trivalent influenza vaccine (ITIV) via intranasal vaccination is unclear. To explore the adjuvant effect of PA, an inactivated trivalent influenza virus with or without PA or MF59 was instilled intranasally once a week in BALB/c mice. Humoral immunity was assessed by both the ELISA and hemagglutination inhibition (HI) methods using antigen-specific antibodies. Splenic lymphocyte proliferation and the IFN-γ level were measured to evaluate cell-mediated immunity. The post-vaccination serum HI antibody geometric mean titers (GMTs) for the H1N1 and H3N2 strains, antigen-specific serum IgG and IgA GMTs, mucosal SIgA GMT, splenic lymphocyte proliferation, and IFN-γ were significantly increased in the high-dose PA-adjuvanted vaccine group. The seroconversion rate and the mucosal response for the H3N2 strain were significantly elevated after high-dose PA administration. These adjuvant effects of high-dose PA for the influenza vaccine were comparable with those of the MF59 adjuvant, and abnormal signs or pathological changes were not found in the evaluated organs. In conclusion, PA is a novel mucosal adjuvant for intranasal vaccination with the ITIV that has safe and effective mucosal adjuvanticity in mice and successfully induces both serum and mucosal antibody responses and a cell-mediated response.


Subject(s)
Adjuvants, Immunologic/therapeutic use , Glycopeptides/immunology , Immunization , Influenza Vaccines/therapeutic use , Polysorbates/therapeutic use , Squalene/therapeutic use , Administration, Intranasal , Animals , Antibodies/immunology , Antibody Formation , Antigens, Viral/immunology , Cell Proliferation , Epitopes/immunology , Female , Glycopeptides/administration & dosage , Hemagglutination Inhibition Tests , Immunity, Cellular , Immunoglobulin A/blood , Immunoglobulin G/blood , Interferon-gamma/metabolism , Male , Mice, Inbred BALB C , Nasal Mucosa/pathology , Polysorbates/administration & dosage , Spleen/cytology , Squalene/administration & dosage , Trachea/immunology
19.
Acta Radiol ; 58(9): 1094-1100, 2017 Sep.
Article in English | MEDLINE | ID: mdl-28103709

ABSTRACT

Background Boron neutron capture therapy (BNCT) is a molecular radiation therapy approach based on the 10B (n, α) 7Li nuclear reaction in cancer cells. In BNCT, delivery of 10B in the form of 4-borono-phenylalanine conjugated with fructose (BPA-fr) to the cancer cells is important. The PET tracer 4-borono-2-18F-fluoro-phenylalanine (FBPA) has been used to predict the accumulation of BPA-fr before BNCT. Purpose To determine the biodistribution and dosimetric parameters in 18F-BPA PET/CT studies. Material and Methods Human biokinetic data were obtained during clinical 18F-BPA PET studies between February and June 2015 at one institution. Nine consecutive patients were studied prospectively. The internal radiation dose was calculated on the basis of radioactivity data from blood, urine, and normal tissue of the heart, liver, spleen, kidney, and other parts of the body at each time point using OLINDA/EXM1.1 program. We compared our calculations with published 18F-FDG data. Results Adult patients (3 men, 3 women; age range, 28-68 years) had significantly smaller absorbed doses than pediatric patients (3 patients; age range, 5-12 years) ( P = 0.003). The mean effective dose was 57% lower in adult patients compared with pediatric patients. Mean effective doses for 18F-BPA were 25% lower than those for 18F-FDG presented in International Commission of Radiation Protection (ICRP) publication 106. Conclusion We found significant differences in organ absorbed doses for 18F-BPA against those for 18F-FDG presented in ICRP publication 106. Mean effective doses for 18F-BPA were smaller than those for 18F-FDG in the publication by 0.5-38% (mean difference, 25%).


Subject(s)
Boron Compounds/administration & dosage , Boron Compounds/pharmacokinetics , Boron Neutron Capture Therapy , Fluorine Radioisotopes/administration & dosage , Fluorine Radioisotopes/pharmacokinetics , Glycopeptides/administration & dosage , Glycopeptides/pharmacokinetics , Positron Emission Tomography Computed Tomography , Radiation Dosage , Adolescent , Adult , Aged , Child , Child, Preschool , Female , Humans , Male , Middle Aged , Prospective Studies , Radiographic Image Interpretation, Computer-Assisted
20.
J Cell Physiol ; 232(3): 526-539, 2017 Mar.
Article in English | MEDLINE | ID: mdl-27255231

ABSTRACT

Malignant glioma continues to be a clinical challenge with an urgent need for developing curative therapeutic intervention. Apoptosis induction in tumor-associated endothelial cells represent a central mechanism that counteracts angiogenesis in glioma and other solid tumors. We previously demonstrated that intraperitoneal administration of sheep erythrocyte membrane glycopeptide T11-target structure (T11TS) in rodent glioma model inhibits PI3K/Akt pathway and Raf/MEK/ERK signaling in glioma-associated brain endothelial cells. In the present study, we investigated whether T11TS treatment influence apoptosis signaling in vivo in glioma-associated brain endothelial cells. Annexin-V/PI staining showed that T11TS treatment in glioma-induced rats increases apoptosis of glioma-associated endothelial cells within glioma milieu compared to brain endothelial cells in glioma induced and control groups. Flowcytometric JC-1 assay revealed that T11TS administration triggers loss of mitochondrial membrane potential in glioma-associated brain endothelial cells. Flowcytometry, immunoblotting, and in situ immunofluoresecnt imaging were employed to investigate the effect of T11TS on apoptotic regulatory proteins in brain endothelial cells. T11TS treatment-upmodulated expression of p53, Bax, Fas, FasL, and FADD in glioma associated endothelial cells and downregulated Bcl-2 protein. T11TS therapy induced cytochrome-c release into cytosol, activated caspase -9, 8, 3, and cleaved Bid in glioma associated brain endothelial cells. The study demonstrates that T11TS induces apoptosis in glioma-associated brain endothelial cells via p53 accumulation and activation of intrinsic as well as Fas-dependent extrinsic pathway. The pro-apoptotic action of T11TS on glioma-associated endothelial cells provides crucial insight into how T11TS exerts its anti-angiogenic function in glioma. J. Cell. Physiol. 232: 526-539, 2017. © 2016 Wiley Periodicals, Inc.


Subject(s)
Angiogenesis Inhibitors/therapeutic use , Apoptosis/drug effects , Brain Neoplasms/drug therapy , Endothelial Cells/pathology , Glioma/pathology , Glycopeptides/pharmacology , Glycopeptides/therapeutic use , Membrane Glycoproteins/pharmacology , Membrane Glycoproteins/therapeutic use , Neovascularization, Pathologic/drug therapy , Angiogenesis Inhibitors/pharmacology , Animals , BH3 Interacting Domain Death Agonist Protein/metabolism , Brain Neoplasms/pathology , Caspases/metabolism , Cytochromes c/metabolism , Cytosol/metabolism , Endothelial Cells/drug effects , Enzyme Activation , Fas Ligand Protein/metabolism , Fas-Associated Death Domain Protein/metabolism , Female , Glycopeptides/administration & dosage , Male , Membrane Glycoproteins/administration & dosage , Membrane Potential, Mitochondrial/drug effects , Models, Biological , Neovascularization, Pathologic/pathology , Rats , Sheep , Tumor Suppressor Protein p53/metabolism , bcl-2-Associated X Protein/metabolism , fas Receptor/metabolism
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