Antitumor effectiveness and mechanism of action of Ru(II)/amino acid/diphosphine complexes in the peritoneal carcinomatosis progression.

Peritoneal carcinomatosis is considered as a potentially lethal clinical condition, and the therapeutic options are limited. The antitumor effectiveness of the [Ru(l-Met)(bipy)(dppb)]PF6(1) and the [Ru(l-Trp)(bipy)(dppb)]PF6(2) complexes were evaluated in the peritoneal carcinomatosis model, Ehrlich ascites carcinoma-bearing Swiss mice. This is the first study that evaluated the effect of Ru(II)/amino acid complexes for antitumor activity in vivo. Complexes 1 and 2 (2 and 6 mg kg-1) showed tumor growth inhibition ranging from moderate to high. The mean survival time of animal groups treated with complexes 1 and 2 was higher than in the negative and vehicle control groups. The induction of Ehrlich ascites carcinoma in mice led to alterations in hematological and biochemical parameters, and not the treatment with complexes 1 and 2. The treatment of Ehrlich ascites carcinoma-bearing mice with complexes 1 and 2 increased the number of Annexin V positive cells and cleaved caspase-3 levels and induced changes in the cell morphology and in the cell cycle phases by induction of sub-G1 and G0/G1 cell cycle arrest. In addition, these complexes reduce angiogenesis induced by Ehrlich ascites carcinoma cells in chick embryo chorioallantoic membrane model. The treatment with the LAT1 inhibitor decreased the sensitivity of the Ehrlich ascites carcinoma cells to complexes 1 and 2 in vitro-which suggests that the LAT1 could be related to the mechanism of action of amino acid/ruthenium(II) complexes, consequently decreasing the glucose uptake. Therefore, these complexes could be used to reduce tumor growth and increase mean survival time with less toxicity than cisplatin. Besides, these complexes induce apoptosis by combination of different mechanism of action.

Using a virtual patient system for the teaching of pharmaceutical care.

PURPOSE: The communication skills of pharmacists are essential for the identification and reduction of patient́s drug related problems. Therefore, Pharmacy courses started the process of teaching Pharmaceutical Care to students in order to improve their communication skills. The use of virtual patients (VP) has been a widely used technique in health care courses, but many of the VP tools in Pharmacy field are in English and do not have clinical cases that are common in tropical countries, such as Brazil. The aim of this work is to describe the PharmaVP system, developed with the purpose of training Latin America students in Pharmaceutical Care. The main differential of PharmaVP is the availability in three languages (Portuguese, English and Spanish) and the possibility of clinical case evolution, simulating several visits made by the patient. METHODS: The system was developed according to an incremental and interactive methodology, well suited for conducting multidisciplinary projects. Real clinical cases were collected from a Pharmaceutical Care program and added in PharmaVP to simulate the virtual patients. Then, 31 students of a Pharmacy course were trained and invited to participate of the evaluation study. They used the software and answered adapted instruments that assess the students' acceptance of, use of, learning of, and satisfaction with the system. RESULTS: The results showed that the students found the cases realistic and learned significantly using the software. Another positive point is that the application process of PharmaVP did not consume much time. DISCUSSION: We can conclude that the virtual patient tool contributed to the development of the skills required for the practice of Pharmaceutical Care, but should be used as complementary technique.

Cis-[RuCl(BzCN)(N-N)(P-P)]PF6 complexes: Synthesis and in vitro antitumor activity: (BzCN=benzonitrile; N-N=2,2'-bipyridine; 1,10-phenanthroline; P-P=1,4-bis(diphenylphosphino) butane, 1,2-bis(diphenylphosphino)ethane, or 1,1'-(diphenylphosphino)ferrocene).

The motivation to use ruthenium complexes in cancer treatment has led our research group to synthesize complexes with this metal and test them against several types of tumor cells, yielding promising results. In this paper the results of biological tests, assessed by the MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) assay, were carried out on the complexes cis-[RuCl(BzCN)(bipy)(dppe)]PF6 (1), cis-[RuCl(BzCN)(bipy)(dppb)]PF6 (2), cis-[RuCl(BzCN)(bipy)(dppf)]PF6 (3) and cis-[RuCl(BzCN)(phen)(dppb)]PF6 (4) which are described [BzCN = b enzonitrile; bipy = 2,2'-bipyridine; phen = 1,10-phenanthroline; dppe = 1,2-bis(diphenylphosphino) ethane; dppb = 1,4-bis-(diphenylphosphino)butane; dppf = 1,1'-bis(diphenylphosphino)ferrocene]. The present study is focused on the cytotoxic activity of complexes (1)-(4) against four tumor cell lines and on the apoptosis and changes in the cell cycle and gene expression observed in the sarcoma 180 (S180) tumor cell line treated with complex (1). The results demonstrated that this complex inhibits S180 cell growth, with an IC50 of 17.02 ± 8.21 µM, while exhibiting lower cytotoxicity (IC50 = 53.73 ± 5.71 µM) towards lymphocytes (normal cells). Flow cytometry revealed that the complex inhibits the growth of tumor cells by inducing apoptosis as evidenced by an increase in the proportion of cells positive for annexin V staining and G0/G1 phase cell-cycle arrest. Further investigation showed that complex (1) induces a drop in the mitochondrial membrane potential and provokes a decrease in Bcl-2 protein expression and increase in caspase 3 activation, while the increased activation of caspase 8 caused a decrease in the gene expression in caspases 3 and 9. Increases in Tp53 and Bax expressions were also observed.

Importância do estudo genético pré-natal / Importance of prenatal genetic diagnosis

O desenvolvimento de técnicas, como o cariótipo e ensaios enzimáticos em células fetais, a determinação de metabólitos no líquido amniótico e a ultrassonografia, propiciaram o diagnóstico pré-natal de desordens genéticas. A investigação genética pré-natal permite a detecção, ainda no útero, de doenças que, de outra forma, somente seriam diagnosticadas após o nascimento. Diversas técnicas são utilizadas para avaliação do estado fetal, algumas como a biópsia de vilos coriais, a amniocentese e a cordocentese. Com desenvolvimento tecnológico, novas técnicas moleculares foram desenvolvidas apresentando-se de forma mais refinada e de rápido resultado. A utilização dessas técnicas é fundamental para o desenvolvimento fetal, podendo então indicar uma conduta adequada para cada caso. Dessa forma, o conhecimento e a aplicação da genética clínica, utilizando o aconselhamento genético, trazem a certeza de um bom acompanhamento pré-natal necessário à assistência médica.

The development of techniques, such as karyotype and enzymatic assay in fetal cells, the determination of metabolites in amniotic liquid and the ultrasonography, allowed prenatal diagnosis of genetic disorders. The prenatal genetic investigation allowed the detection, in the womb, of diseases that, in other way, just could be diagnosed after birth. Many techniques are used to fetal state assessment, some of them such as villi cori biopsy, the amniocentesis and cordocentesis. Through the technological development, new molecular techniques were developed. They present a more refined and fast results. The use of these techniques is fundamental to fetal development, enabling the use of adequate conduct in each case. In this way, the knowledge and application of genetic clinic, using genetic counseling, bring the certainty of a good prenatal care, which is necessary to medic assistance.