Structural insights into probe-dependent positive allosterism of the GLP-1 receptor.

Drugs that promote the association of protein complexes are an emerging therapeutic strategy. We report discovery of a G protein-coupled receptor (GPCR) ligand that stabilizes an active state conformation by cooperatively binding both the receptor and orthosteric ligand, thereby acting as a 'molecular glue'. LSN3160440 is a positive allosteric modulator of the GLP-1R optimized to increase the affinity and efficacy of GLP-1(9-36), a proteolytic product of GLP-1(7-36). The compound enhances insulin secretion in a glucose-, ligand- and GLP-1R-dependent manner. Cryo-electron microscopy determined the structure of the GLP-1R bound to LSN3160440 in complex with GLP-1 and heterotrimeric Gs. The modulator binds high in the helical bundle at an interface between TM1 and TM2, allowing access to the peptide ligand. Pharmacological characterization showed strong probe dependence of LSN3160440 for GLP-1(9-36) versus oxyntomodulin that is driven by a single residue. Our findings expand protein-protein modulation drug discovery to uncompetitive, active state stabilizers for peptide hormone receptors.

Widely applicable metallacarborane reagents for π-conjugated systems.

The compounds [N(CH3)4][3,3'-Co(8-(p-C6H4C2H3)-1,2-C2B9H10)(1',2'-C2B9H11)], [N(CH3)4][3,3'-Co(8-(p-C6H4CHO)-1,2-C2B9H10)(1',2'-C2B9H11)], and [N(CH3)4][3,3'-Co(8-(m-C6H4CHO)-1,2-C2B9H10)(1',2'-C2B9H11)] were synthesized using an easy methodology, in very good yields and large quantities, which are important requisites to be employed as starting reagents. They have been fully characterized by elemental analysis, IR, NMR, and MALDI-TOF-MS, and the crystal structures of [N(CH3)4][3,3'-Co(8-(p-C6H4C2H3)-1,2-C2B9H10)(1',2'-C2B9H11)] and [N(CH3)4][3,3'-Co(8-(p-C6H4CHO)-1,2-C2B9H10)(1',2'-C2B9H11)] were elucidated by single-crystal X-ray diffraction. These compounds, having terminal formyl and vinyl functional groups, are suitable platforms to involve the aromatic cobaltabisdicarbollide unit into extended π-conjugated systems. It is expected that these synthons will facilitate the applicability of metallacarboranes in a wide variety of different fields, where π-conjugated systems are needed to keep electronic communication.

Relaxed but highly compact diansa metallacyclophanes.

A series of monoansa [µ-1,1'-PR-3,3'-Co(1,2-C(2)B(9)H(10))(2)](-) and diansa [8,8'-µ-(1'',2''-benzene)-µ-1,1'-PR-3,3'-Co(1,2-C(2)B(9)H(9))(2)](-) (R = Ph, (t)Bu) cobaltabisdicarbollidephanes have been synthesized, characterized and studied by NMR, MALDI-TOF-MS, UV-visible spectroscopy, cyclic voltammetry, and DFT calculations. Single crystal X-ray diffraction revealed a highly relaxed structure characterized by the title angle α of 3.8° ([7](-)), this being the smallest angle α for a metallacyclophane. In such compounds, the metal-to-phosphorus distance is less than the sum of their van der Waals radii. The availability of a phosphorus lone pair causes an electron delocalization through the metal, as shown by the abnormal (31)P NMR chemical shift. Remarkably, the combination of a phosphine donor and a phenyl acceptor moieties causes a synergistic effect that is observed through the different techniques used in this study. The importance of having an available lone pair is demonstrated by the oxidation of phosphorus with hydrogen peroxide, sulfur, and elemental black selenium to produce the corresponding P(V) compounds. When the electron lone pair is used to form the bond with the corresponding chalcogen atom, the communication between the donor and acceptor moieties on the diansa metallacyclophane is shut down.

Sorption of Th(IV) onto iron corrosion products: EXAFS study.

Long-term performance assessment of nuclear waste repositories is affected by the ability of the outer barrier systems to retain radionuclides after possible corrosive leakage of waste containers. The mobility of the radionuclides released from the spent fuel depends strongly on the processes that take place in the backfill material. The interaction of steel corrosion products and radionuclides is part of such a scenario. In this work, the sorption of Th(IV) onto 2-line-ferrihydrite (FeOOH x H2O) and magnetite (Fe3O4), used as models for steel corrosion products, has been studied using EXAFS spectroscopy. Sorption samples were prepared in 0.1 M NaClO4 solutions at acidic pH (initial pH values in the range 3.0-4.2) either from undersaturation and supersaturation conditions with respect to amorphous ThO2. Two oxygen subshells, one at 2.37 A and another at 2.54 A, were observed in the first hydration sphere of Th in the case of the ferrihydrite samples. Th-Fe distances for the different ferrihydrite samples are approximately 3.60 A. These results indicate a corner sharing surface complex of Th(IV) ion onto the ferrihydrite surface where the Th atom shares one O atom with each of two coordinated octahedra. The longer Th-O distance accounts for coordinated water molecules. No significant changes in the structural environment of Th in terms of coordination numbers and distances were detected as a function of Th(IV) concentration. Magnetite samples sorbing Th(IV) also showed also a strong distortion of the O shell, but in contrast to ferrihydrite, two types of nearest Fe atoms were detected at 3.50 A and 3.70 A. These results indicate that Th(IV) ion sorbs onto the magnetite surface as bidentate-corner sharing arrangements to [FeO6] octahedra and [FeO4] tetrahedra.

Effects of cyclosporine, tacrolimus and sirolimus on vascular changes related to immune response.

BACKGROUND: Despite the use of newer immunosuppressors such as sirolimus (SRL) and tacrolimus (TRL) in heart transplantation, the rate of humoral rejection has remained unchanged. The aim of this study was to analyze the immunologic and histologic effects of cyclosporine (CsA), SRL, and TRL in a porcine model of arterial transplantation. METHODS: Each transplant recipient animal (n = 49) received an autograft and an allograft and was then allocated to one of four treatment groups and a 7- or 30-day follow-up period, as follows: a WOT group (without immunosuppressor treatment), 7 days (n = 6) and 30 days (n = 5); a CsA group, 7 days (n = 5) and 30 days (n = 6); an SRL group, 7 days (n = 7) and 30 days (n = 8); and a TRL group, 7 days (n = 6) and 30 days (n = 6). The presence of donor-specific antibodies (DSA) was tested at the end of the follow-up period. Morphometric parameters and inflammatory infiltration were analyzed in the explanted grafts. RESULTS: At 30-day follow-up, SRL was the only treatment capable of suppressing DSA formation (0 of 7 vs 4 of 5 in the WOT group; p < 0.05). SRL completely prevented aneurismal dilation and reduced the number of macrophages in the allografts. TRL treatment achieved a greater reduction of T lymphocytes. CsA did not prevent the reduction in total vascular area at 7 days that was achieved with the SRL and TRL groups. Animals treated with CsA had the largest number of T lymphocytes and macrophages in both follow-up periods. CONCLUSIONS: SRL prevented DSA formation and reduced the number of macrophages as compared with TRL and CsA.

Sequential determination of pharmacokinetics and pharmacodynamics of mycophenolic acid in liver transplant patients treated with mycophenolate mofetil.

BACKGROUND: In liver transplantation, mycophenolate mofetil (MMF) is habitually administered using fixed doses. We assessed whether mycophenolic acid (MPA) monitoring could be advisable in liver transplant patients. METHODS: In 15 liver transplant patients receiving tacrolimus, daclizumab and MMF (1 g bid, orally), we determined the 12-hour plasma MPA pharmacokinetic profile after one dose of MMF at days 6, 10, and 16, and months 3 and 6. The inhibitory capacity of serum MPA on proliferation of CEM cells, a cell line insensitive to other immunosuppressants, was also determined. RESULTS: A large interindividual variability in MPA profiles was observed at any time. Regardless of a gradual increase in individual MPA AUC and C(0) over time following transplantation, a substantial proportion of patients had these parameters below the ranges recommended in other organ transplantations throughout the study. When MPA AUC and C(0) were within the recommended ranges, CEM proliferation was inhibited by almost all serum samples, but when these pharmacokinetic parameters were below the recommended ranges, CEM proliferation was very variable and, therefore, unpredictable. No relationship between MPA pharmacokinetics and the efficacy of MMF could be established (only one patient developed rejection), probably due to the concomitant administration of tacrolimus and daclizumab. Gastrointestinal symptoms were the only adverse events with a significant relationship with MPA levels. CONCLUSIONS: During the first postoperative months, exposure to MPA is low in a considerable proportion of liver transplant patients receiving MMF at a fixed dose of 1 g bid. MPA monitoring appears necessary in these patients.

Macrocyclic peptidomimetic inhibitors of beta-secretase (BACE): first X-ray structure of a macrocyclic peptidomimetic-BACE complex.

The synthesis of novel macrocyclic peptidomimetic inhibitors of the enzyme BACE1 is described. These macrocycles are derived from a hydroxyethylene core structure. Compound 7 was co-crystallized with BACE1 and the X-ray structure of the complex elucidated at 1.6 Angstrom resolution. This molecule inhibits the production of the Abeta peptide in HEK293 cells overexpressing APP751sw.

Pharmacokinetics and pharmacodynamics of low dose mycophenolate mofetil in HIV-infected patients treated with abacavir, efavirenz and nelfinavir.

BACKGROUND: The use of mycophenolate mofetil in combination with highly active antiretroviral therapy (HAART) has been proposed in order to inhibit HIV replication. Due to the low doses involved, pharmacokinetic-pharmacodynamic monitoring is recommended. OBJECTIVE: The aim of this study was to characterise the pharmacokinetic and pharmacodynamic monitoring of low doses of mycophenolate mofetil (0.25 g twice daily) in HIV-infected patients treated with HAART and after programmed discontinuation of HAART, in order to assess whether low doses of this immunosuppressive agent provide a biological effect. METHODS: Mycophenolic acid (MPA) plasma levels (assessed by high-performance liquid chromatography) and the capacity of patients' sera to inhibit CEM cell line proliferation (assessed by (3)H-thymidine uptake) were measured post-dose at 0, 20, 40 minutes and 1, 2, 4, 6, 8, 10 and 12 hours in nine HIV-infected patients treated with a combination of abacavir, nelfinavir and efavirenz (HAART) and mycophenolate mofetil 0.25 g twice daily at days 7, 28, 120 and 150 (30 days without HAART) after the treatment initiation. A control group of eight patients was treated with HAART alone. RESULTS: In the 35 post-dose curves analysed, no differences were found in MPA levels between days 7, 28, 120 and 150: area under the plasma concentration-time curve - mean value 15.3 mg . h/L, range 10.4-24.4 mg . h/L; minimum plasma concentration - mean value 0.60 mg/L, range 0.20-4.67 mg/L; maximum plasma concentration mean value 2.60 mg/L, range 0.94-7.98 mg/L. Pretreatment patients' sera did not inhibit CEM proliferation. Post-treatment patients' sera inhibited CEM proliferation to <40% in 25 of 35 curves at 0 hours (six of nine patients), in 34 of 35 curves at 1 hour, in 32 of 35 curves at 2 hours, in 22 of 35 curves at 4 hours, and in 8 of 35 curves at 12 hours. The MPA level versus CEM proliferation inhibition had a concentration that produces 50% of the maximum drug effect (EC(50)) of 0.33 mg/L. Viral load at day 150 was >200 copies/mL in all control patients and in three of nine patients receiving mycophenolate mofetil. These three patients were the only ones repeatedly unable to inhibit pre-dose CEM proliferation to <40%. CONCLUSIONS: Mycophenolate mofetil pharmacokinetic profiles in HIV patients under HAART are not significantly different from those found in transplant patients. Sera from the majority of patients receiving low doses of mycophenolate mofetil inhibited lymphocyte proliferation during most of the inter-dose interval, despite low MPA plasma levels. For some patients, higher doses may be necessary: the capacity of sera to inhibit CEM proliferation may help to identify these patients.

A peroxisome proliferator-activated receptor alpha/gamma dual agonist with a unique in vitro profile and potent glucose and lipid effects in rodent models of type 2 diabetes and dyslipidemia.

LSN862 is a novel peroxisome proliferator-activated receptor (PPAR)alpha/gamma dual agonist with a unique in vitro profile that shows improvements on glucose and lipid levels in rodent models of type 2 diabetes and dyslipidemia. Data from in vitro binding, cotransfection, and cofactor recruitment assays characterize LSN862 as a high-affinity PPARgamma partial agonist with relatively less but significant PPARalpha agonist activity. Using these same assays, rosiglitazone was characterized as a high-affinity PPARgamma full agonist with no PPARalpha activity. When administered to Zucker diabetic fatty rats, LSN862 displayed significant glucose and triglyceride lowering and a significantly greater increase in adiponectin levels compared with rosiglitazone. Expression of genes involved in metabolic pathways in the liver and in two fat depots from compound-treated Zucker diabetic fatty rats was evaluated. Only LSN862 significantly elevated mRNA levels of pyruvate dehydrogenase kinase isozyme 4 and bifunctional enzyme in the liver and lipoprotein lipase in both fat depots. In contrast, both LSN862 and rosiglitazone decreased phosphoenol pyruvate carboxykinase in the liver and increased malic enzyme mRNA levels in the fat. In addition, LSN862 was examined in a second rodent model of type 2 diabetes, db/db mice. In this study, LSN862 demonstrated statistically better antidiabetic efficacy compared with rosiglitazone with an equivalent side effect profile. LSN862, rosiglitazone, and fenofibrate were each evaluated in the humanized apoA1 transgenic mouse. At the highest dose administered, LSN862 and fenofibrate reduced very low-density lipoprotein cholesterol, whereas, rosiglitazone increased very low-density lipoprotein cholesterol. LSN862, fenofibrate, and rosiglitazone produced maximal increases in high-density lipoprotein cholesterol of 65, 54, and 30%, respectively. These findings show that PPARgamma full agonist activity is not necessary to achieve potent and efficacious insulin-sensitizing benefits and demonstrate the therapeutic advantages of a PPARalpha/gamma dual agonist.

2-Alkoxydihydrocinnamates as PPAR agonists. Activity modulation by the incorporation of phenoxy substituents.

Herein we describe a series of potent and selective PPARgamma agonists with moderate PPARalpha affinity and little to no affinity for other nuclear receptors. In vivo studies in a NIDDM animal model (ZDF rat) showed that these compounds are efficacious at low doses in glucose normalization and plasma triglyceride reduction. Compound 1b (LY519818) was selected from our SAR studies to be advanced to clinical evaluation for the treatment of type II diabetes.

Synthesis and coordinating ability of an anionic cobaltabisdicarbollide ligand geometrically analogous to BINAP.

The anionic chelating ligand [1,1'-(PPh2)2-3,3'-Co(1,2-C2B9H10)2]- has been synthesized from [3,3'-Co(1,2-C2B9H11)2]- in very good yield in a one-pot process with an easy work-up procedure. The coordinating ability of this ligand has been studied with Group 11 metal ions (Ag, Au) and with transition-metal ions (Pd, Rh). The two dicarbollide halves of the [1,1'-(PPh2)2-3,3'-Co(1,2-C2B9H10)2]- ligand can swing about one axis in a manner analogous to the constituent parts of BINAP and ferrocenyl phosphine derivatives. All these ligands function as hinges, with the most important property in relation to the coordination requirements of the metal being the PP distance. [1,1'-(PPh2)2-3,3'-Co(1,2-C2B9H10)2]-, BINAP, ferrocenyl phosphine derivatives, and other hinge ligands present a range of different PP separations, and consequently different coordination spheres and dispositions around metal cations. To account for these differences, the equation Dphi2 = D02 + 4 R2cos2(90-phi/2) has been developed. It relates the PP distance (Dphi) in a complex with the minimum PP distance (D0) that is characteristic of the hinge-type ligand.

Formation of bridging alkene and conjugated dialkenes exclusively generated from alkynes on the [3,3'-Co(1,2-C2B9H11)2]- platform. The unique hydroboration role of [3,3'-Co(1,2-C2B9H11)2]-.

The unprecedented metal-mediated transformation of an alkyne into a B,B' bridging alkene is reported. Also, the unprecedented synthesis of a conjugated dialkene derivative of [3,3'-Co(1,2-C2B9H11)2]- generated only from an alkyne, contrary to the usual case where an alkyne and an alkene are needed, is described. This has been possible through the singular capacity of a B-H to produce hydroboration.

Pharmacodynamic approach to immunosuppressive therapies using calcineurin inhibitors and mycophenolate mofetil.

BACKGROUND: Graft survival depends on adequate immunosuppression. To evaluate the effect on the immune system of immunosuppressive therapies using calcineurin inhibitors (CNIs), several pharmacodynamic indices have been proposed to complement pharmacokinetic data. In this preliminary study we compared some of these parameters during combined immunosuppressant therapies. METHODS: We treated 65 stable renal transplant recipients with cyclosporin A (CsA; n = 16), tacrolimus (TRL; n = 10); CsA + mycophenolate mofetil (MMF; n = 14); TRL + MMF (n = 13), and MMF (n = 12). Twelve nontreated healthy controls were also included. Calcineurin activity (CNA) in peripheral blood mononuclear cells was measured using (32)P-labeled peptide. Interleukin-2 (IL-2) and interferon-gamma production in phytohemagglutinin-activated whole blood were measured at 0 and 2 h postdose. The areas under the curves, c(min), c(max), and concentration at 2 h (c(2 h)) were also measured. RESULTS: We found no differences in CNA between groups receiving CNIs alone or combined with MMF [median (25th-75th percentiles)]: CsA(2 h), 3.87 (3.00-6.85)% alkaline phosphatase (AP); CsA+MMF(2 h), 3.90 (1.78-5.19)% AP; TRL(2 h), 5.68 (3.02-16.00)% AP; TRL+MMF(2 h), 11.80 (4.05-14.63)% AP. In vitro IL-2 production was significantly lower in the groups receiving combined therapy than in groups receiving CNIs alone [median (25th-75th percentiles)]: CsA(2 h), 276.52 (190.41-385.25) ng/L; CsA+MMF(2 h), 166.48 (81.06-377.01) ng/L (P <0.001); TRL(2 h), 249.34 (127.48-363.50) ng/L; TRL+ MMF(2 h), 122.13 (51.02-180.00) ng/L (P <0.001). The correlations (r) between c(2 h) and CNA 2 h postdose were as follows: CsA, r = -0.74; CsA+MMF, r = -0.84; TRL, r = -0.70; TRL+ MMF, r = -0.70 (P <0.001 in all cases). CONCLUSIONS: The measurement of CNA may be of help in following the effect on the immune system of CNI treatments, even in combined therapies, but does not reflect the additional effect of MMF. In contrast, IL-2 in vitro production reflects the effect of both MMF and CNIs.

Relevance of the electronegativity of boron in eta5-coordinating ligands: regioselective monoalkylation and monoarylation in cobaltabisdicarbollide [3,3'-Co(1,2-C2B9H11)2]- clusters.

Regioselective monoalkylation and monoarylation in cobaltabisdicarbollide clusters has been achieved starting from Cs[8-I-3,3'-Co(1,2-C(2)B(9)H(10))(1',2'-C(2)B(9)H(11))] by cross-coupling reactions between a B-I fragment and an appropriate Grignard reagent in the presence of a Pd catalyst and CuI. A considerable number of monoalkylated and monoarylated derivatives have been synthesized, which allowed study of the influence of boron in metallocene-type ligands and the effect of alkyl and aryl substituents on boron in boron anionic clusters. Experimental data from UV/Vis spectroscopy, E(1/2) measurements, and X-ray diffraction analysis, and supported by EHMO and ab initio analyses, indicate that the participation of metal d orbitals in the HOMO is less than that in typical metallocene complexes. This can be explained in terms of the lower electronegativity of boron compared to carbon. Related to this is the -I character of alkyl groups when bonded to boron in boron anionic clusters, contrary to the common belief that alkyl groups are generally electron-releasing moieties.

Suicidio en la tercera edad: un problema de salud comunitario / Suicide in the elderly: a community health problem

Realizamos un estudio descriptivo retrospectivo del total de defunciones por suicidio ocurridos en Manicaragua (1992-1999) Villa Clara, ascendente a 40 casos de la tercera edad, con el objetivo de determinar si el estado depresivo y las enfermedades crónicas invalidantes son factores de riesgo en ancianos. Analizamos variables epidemiológicas y socio-culturales. Concluyendo que en los 8 a estudiados, 1992 no tuvo suicidas de la tercera edad, el método ahorcamiento en 77,5 porciento; el estado depresivo predominó con 65,0 porciento y enfermedades crónicas invalidantes con el 35,0 porciento