Multidisciplinary team approach to diagnosing lymphangioleiomyomatosis.

A 42-year-old woman with chronic obstructive pulmonary disease was referred to the respiratory team due to shortness of breath on exertion and significant deterioration in pulmonary function tests. Her symptoms were progressively getting worse. This prompted a referral to the specialist team where further investigations were undertaken including a high-resolution CT scan followed by lung biopsy, which eventually revealed a diagnosis of lymphangioleiomyomatosis (LAM). Successful referral to the National LAM Centre in Nottingham provided the key therapeutic approach required to manage this rare condition. Diagnosing this rare condition was due to the multidisciplinary team approach, which involved input from the general practitioner, radiologist and respiratory consultant. The patient has been making good progress with pharmacological management.

Enzyme targeting strategies for prevention and treatment of cancer: Implications for cancer therapy.

Extensive growth of cancer in humans is a major cause of death. Numerous studies are being conducted to improve the early diagnosis, prevention, and treatment of cancer. Recent technological advancements in medical science and research indicate molecular target therapy holds much promise in cancer treatment. In the past, therapeutic and diagnostic targeting of non-glycolytic and glycolytic enzymes in cancer have been successful, and discoveries of biomarker enzymes in cancer hold promise for therapeutic treatments. In this review, we discuss the roles of several cancer-associated enzymes that could potentially act as therapeutic targets, and place special focus on non-glycolytic and glycolytic enzymes. This review indicates that the targeting of metabolic signaling offers a promising means of developing novel anti-cancer therapies.

Application of Medicinal Plants as a Source for Therapeutic Agents Against Streptococcus pyogenes Infections.

BACKGROUND: Streptococcus pyogenes, a major human pathogen, causes a wide variety of invasive systemic infections such as acute pharyngitis, skin and soft-tissue infections, especially necrotizing fasciitis. OBJECTIVE: This review focuses on the properties of pathogenicity of S. pyogenes and outlines ways to combat infection caused by these bacteria through alternative plant-based medicine. CONCLUSION: This Gram positive bacterium has an ability to form mature biofilm and this sessile life style plays an important role in S. pyogenes pathogenicity. The virulence of these bacteria is further strengthened by its ability to communicate within the micro-colonies through quorum sensing. Most treatments are now aimed at either elimination of this bacterium or suppression of its virulence. The emergence of antibiotic resistance among S. pyogenes and treatment failure has become an added concern globally. One of its virulence properties, biofilm formation, has made it more resistant to antibiotic therapy. This has vitalized the necessity for searching alternative therapies for its treatment. The growing research in herbal medicines has led to the discovery of various phytochemicals to limit the virulence of S. pyogenes.

Enhanced Killing and Antibiofilm Activity of Encapsulated Cinnamaldehyde against Candida albicans.

Candida sp. impelled opportunistic infection in immune-compromised patients ensuing from asymptomatic colonization to pathogenic forms. Moreover, slow spread of Candida species inducing refractory mucosal and invasive infections brings acute resistance to antifungal drugs. Hence, here we probed the effect of encapsulated preparation of cinnamaldehyde (CNMA) in multilamellar liposomes (ML) against Candida albicans. The efficacy of ML-CNMA against Candida biofilm was assessed by scanning electron microscopy, transmission electron microscopy, as well as light microscopy and its percent inhibition, was determined by XTT [2,3-bis-(2-methoxy-4-nitro-5-sulfophenyl)-2H-tetrazolium-5-carboxanilide] and crystal violet assay. ML-CNMA showed more fungicidal activity than free CNMA as well as multilamellar liposomal amphotericin B (ML-Amp B), which was further confirmed by spot test assay and Log-logistic dose-response analysis. Antifungal activity was driven by reactive oxygen species and cellular damage by sustained release of CNMA. Effect on hyphal formation during 48 h in presence/absence of ML-CNMA was observed under a microscope and further substantiated by RT-PCR by amplifying HWP1, the gene responsible for hyphal wall protein formation. Apoptotic programmed cell death was analyzed by FACS analysis which was further confirmed by cytochrome C release assay. This study elucidates the mechanistic insight of the enhanced antifungal activity of ML preparation of CNMA against Candida infections.

In vitro and in vivo inhibition of Streptococcus mutans biofilm by Trachyspermum ammi seeds: an approach of alternative medicine.

The aim of this study was to evaluate the influence of the crude and active solvent fraction of Trachyspermum ammi on S. mutans cariogenicity, effect on expression of genes involved in biofilm formation and caries development in rats. GC-MS was carried out to identify the major components present in the crude and the active fraction of T. ammi. The crude extract and the solvent fraction exhibiting least MIC were selected for further experiments. Scanning electron microscopy was carried out to observe the effect of the extracts on S. mutans biofilm. Comparative gene expression analysis was carried out for nine selected genes. 2-Isopropyl-5-methyl-phenol was found as major compound in crude and the active fraction. Binding site of this compound within the proteins involved in biofilm formation, was mapped with the help of docking studies. Real-time RT-PCR analyses revealed significant suppression of the genes involved in biofilm formation. All the test groups showed reduction in caries (smooth surface as well as sulcal surface caries) in rats. Moreover, it also provides new insight to understand the mechanism influencing biofilm formation in S. mutans. Furthermore, the data suggest the putative cariostatic properties of T. Ammi and hence can be used as an alternative medicine to prevent caries infection.

Observations on in vitro and in vivo antimicrofilarial effects of Bishop's weed (Trachispermum ammi).

The antimicrofilarial efficacy of Trachispermum ammi extacts in vitro and in vivo using Setaria cervi as a model, was investigated. T. ammi seed extracts were prepared using different solvents (with increasing order of polarity of the solvent) including petroleum ether, diethyl ether, chloroform, ethyl acetate, acetone, ethanol, and methanol. The extracts were tested for in vitro antimicrofilarial activity. The ethanolic and the methanolic extracts showed maximum activity in causing flaccidity in the microfilariae. The extracts were potent even at concentrations as low as 5 µl/ml. When orally administered to experimentally infected rats, the extracts eliminated circulating microfilariae within 2 weeks. It is inferred that the antimicrofilarial molecule(s), are polar in nature. They induce flaccidity in the microfilariae, by possibly inhibiting monoamine oxidase. This communication supplements the ethnopharmacological information for the use of T. ammi as an antihelminthic, and indicates that T. ammi could be used as a potential source of antimicrofilarial drugs.

Interaction of human brain acetylcholinesterase with cyclophosphamide: a molecular modeling and docking study.

This study describes the interaction between human acetylcholinesterase (AChE), a key regulator of central and peripheral cholinergic function, and the widely used nitrogen mustard alkylating agent, cyclophosphamide (CP). Modeling of the AChE sequence (NCBI Accession No: AAI05061.1) was performed using 'Swiss Model Workspace'. The protein-model was submitted to the Protein Model Database and was assigned accession number PM0077393. A plot showing normalized QMEAN scores versus protein size was made to compare the model with a non-redundant set of Protein Data Bank structures, which gave a Z-score QMEAN as -0.58. The predicted local error for the modeled structure was found to be well within tolerable limits. Z-score values for Cß interaction, all atom interaction, solvation and torsion were found to be -1.10, -0.90, -0.06 and -0.40, respectively. Docking between CP and AChE was performed using 'Autodock4.2'. Apart from other interaction-types, six carbon atoms of CP (C1, C2, C3, C4, C6 and C7) were determined to be involved in hydrophobic interactions with amino acid residues Y121, W233, L323, F331, F335 and Y338 of the 'acyl pocket' within AChE. Five carbon atoms of CP (C2, C4, C5, C6 and C7) were involved in hydrophobic interactions with 3 amino acid residues within the enzyme's 'catalytic site'. In conclusion, hydrophobic interactions play a major role in the appropriate positioning of CP within the 'acyl pocket' as well as 'catalytic site' of AChE to permit suitable orientation and allow docking. This information may aid the design of more potent and versatile AChE-inhibitors as pharmacologic tools and drugs to characterize and treat neurological disorders, and additionally provides a model whose value can be quantitatively assessed by X-ray crystallographic analysis of the AChECP three-dimensional structure.

Activity of solvent extracts of Prosopis spicigera, Zingiber officinale and Trachyspermum ammi against multidrug resistant bacterial and fungal strains.

BACKGROUND: The emerging trends of multidrug resistance among several groups of microorganisms against different classes of antibiotics led different researchers to develop efficient drugs from plant sources to counter multidrug resistant strains. This study investigated different solvent extracts of Prosopis spicigera (P. Spicigera), Zingiber officinale, and Trachyspermum ammi (T. ammi) to determine their efficacy against multidrug resistant microbes. METHODOLOGY: Successive extractions of these plants were performed using a Soxhlet apparatus, using solvents with increasing polarities. Preliminary phytochemical analysis was also performed. Minimum inhibitory concentration was determined by a two-fold serial dilution method followed by determination of minimum bactericidal/fungicidal concentration. Multidrug resistant (MDR) strains of Candida albicans, Candida krusei, Candida tropicalis, Candida glabrata, Escherichia coli and reference strains of Streptococcus mutans and Streptococcus bovis were used in the study. RESULTS: The ethanolic fraction of P. spicigera (least minimum inhibitory concentration [MIC] - 4.88 microg/ml) demonstrated a remarkable inhibition of the microorganisms while fractions obtained from those of Zingiber officinale (least MIC-78.125 microg/ml) exhibited little activity. The petroleum ether fraction of T. ammi (least MIC- 625 microg/ml) showed best activity when compared to its other fractions. Qualitative analysis of the phytoconstituents was also performed. CONCLUSIONS: The potency shown by these extracts recommends their use against multidrug resistant microorganisms. This study also showed that P. spicigera could be a potential source of new antimicrobial agents.

Antimicrobial activity of five herbal extracts against multi drug resistant (MDR) strains of bacteria and fungus of clinical origin.

Antimicrobial activities of the crude ethanolic extracts of five plants were screened against multidrug resistant (MDR) strains of Escherichia coli, Klebsiella pneumoniae and Candida albicans. ATCC strains of Streptococcus mutans, Staphylococcus aureus, Enterococcus faecalis, Streptococcus bovis, Pseudimonas aeruginosa, Salmonella typhimurium, Escherichia coli, Klebsiella pneumoniae and Candida albicans were also tested. The strains that showed resistance against the maximum number of antibiotics tested were selected for an antibacterial assay. The MDR strains were sensitive to the antimicrobial activity of Acacia nilotica, Syzygium aromaticum and Cinnamum zeylanicum, whereas they exhibited strong resistance to the extracts of Terminalia arjuna and Eucalyptus globulus. Community-acquired infections showed higher sensitivity than the nosocomial infections against these extracts. The most potent antimicrobial plant was A. nilotica (MIC range 9.75-313 microg/ml), whereas other crude plant extracts studied in this report were found to exhibit higher MIC values than A. nilotica against community acquired as well as nosocomial infection. This study concludes that A. nilotica, C. zeylanicum and S. aromaticum can be used against multidrug resistant microbes causing nosocomial and community acquired infections.

Aminoglycosides versus bacteria--a description of the action, resistance mechanism, and nosocomial battleground.

Since 1944, we have come a long way using aminoglycosides as antibiotics. Bacteria also have got them selected with hardier resistance mechanisms. Aminoglycosides are aminocyclitols that kill bacteria by inhibiting protein synthesis as they bind to the 16S rRNA and by disrupting the integrity of bacterial cell membrane. Aminoglycoside resistance mechanisms include: (a) the deactivation of aminoglycosides by N-acetylation, adenylylation or O-phosphorylation, (b) the reduction of the intracellular concentration of aminoglycosides by changes in outer membrane permeability, decreased inner membrane transport, active efflux, and drug trapping, (c) the alteration of the 30S ribosomal subunit target by mutation, and (d) methylation of the aminoglycoside binding site. There is an alarming increase in resistance outbreaks in hospital setting. Our review explores the molecular understanding of aminoglycoside action and resistance with an aim to minimize the spread of resistance.