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1.
Wilderness Environ Med ; 32(2): 240-246, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33839017

RESUMO

Over the past 2 decades, tickborne disease has been increasingly recognized as a threat to humans as a result of the growing geographic range of ticks. This review describes 2 tickborne diseases, Borrelia miyamotoi and Powassan virus, that likely have a significant impact on humans, yet are underdiagnosed compared to most other tickborne diseases. We performed a literature search from 2015 to 2020. Borrelia miyamotoi is a tickborne pathogen that infects and co-infects ticks along with other pathogens, including Borrelia burgdorferi. Because B miyamotoi infects the same Ixodes ticks as B burgdorferi, B miyamotoi may cover a similar geographic range. B miyamotoi infection may be underdiagnosed for 2 reasons. First, a presumptive treatment approach to Lyme disease may result in B miyamotoi infection treatment without identification of the actual cause. Second, the absence of readily available testing and diagnostic criteria makes it difficult to diagnose B miyamotoi infection. Powassan virus is a tickborne flavivirus similar to the dengue virus. Powassan virus disease appears to have an asymptomatic or minimally symptomatic presentation in most people but can cause devastating and fatal encephalitis. The Powassan virus may be transmitted in less than 15 min of tick feeding. Powassan virus disease is a difficult diagnosis because testing capabilities are limited and because there may be co-infection with other tickborne pathogens.


Assuntos
Borrelia , Vírus da Encefalite Transmitidos por Carrapatos , Ixodes , Doença de Lyme , Animais , Humanos , Doença de Lyme/diagnóstico , Doença de Lyme/epidemiologia
2.
MMWR Morb Mortal Wkly Rep ; 69(37): 1277-1282, 2020 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-32941410

RESUMO

The spontaneous death or loss of a fetus during pregnancy is termed a fetal death. In the United States, national data on fetal deaths are available for losses at ≥20 weeks' gestation.* Deaths occurring during this period of pregnancy are commonly known as stillbirths. In 2017, approximately 23,000 fetal deaths were reported in the United States (1). Racial/ethnic disparities exist in the fetal mortality rate; however, much of the known disparity in fetal deaths is unexplained (2). CDC analyzed 2015-2017 U.S. fetal death report data and found that non-Hispanic Black (Black) women had more than twice the fetal mortality rate compared with non-Hispanic White (White) women and Hispanic women. Fetal mortality rates also varied by maternal state of residence. Cause of death analyses were conducted for jurisdictions where >50% of reports had a cause of death specified. Still, even in these jurisdictions, approximately 31% of fetal deaths had no cause of death reported on a fetal death report. There were differences by race and Hispanic origin in causes of death, with Black women having three times the rate of fetal deaths because of maternal complications compared with White women. The disparities suggest opportunities for prevention to reduce the U.S. fetal mortality rate. Improved documentation of cause of death on fetal death reports might help identify preventable causes and guide prevention efforts.


Assuntos
Etnicidade/estatística & dados numéricos , Mortalidade Fetal/etnologia , Disparidades nos Níveis de Saúde , Grupos Raciais/estatística & dados numéricos , Adulto , Feminino , Humanos , Gravidez , Estados Unidos/epidemiologia , Estatísticas Vitais , Adulto Jovem
3.
Wilderness Environ Med ; 31(2): 157-164, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32205041

RESUMO

INTRODUCTION: A history of preexisting hypertension is common in people participating in mountain activities; however, the relationship between blood pressure (BP), preexisting hypertension, and acute mountain sickness (AMS) is not well studied. We sought to determine these relationships among trekkers in the Everest region of Nepal. METHODS: This was a prospective observational cohort study of a convenience sample of adult, nonpregnant volunteers trekking in the Everest Base Camp region in Nepal. We recorded Lake Louise Scores for AMS and measured BP at 2860 m, 3400 m, and 4300 m. The primary outcome was AMS. RESULTS: A total of 672 trekkers (including 60 with history of preexisting hypertension) were enrolled at 2860 m. We retained 529 at 3400 m and 363 at 4300 m. At 3400 m, 11% of participants had AMS, and 13% had AMS at 4300 m. We found no relationship between AMS and measured BP values (P>0.05), nor was there any relation of BP to AMS severity as measured by higher Lake Louise Scores (P>0.05). Preexisting hypertension (odds ratio [OR] 0.16; 95% CI 0.025-0.57), male sex (OR 0.59; 95% CI 0.37-0.96), and increased SpO2 (OR 0.93; 95% CI 0.87-0.98) were associated with reduced rates of AMS in multivariate analyses adjusting for known risk factors for AMS. CONCLUSIONS: AMS is common in trekkers in Nepal, even at 3400 m. There is no relationship between measured BP and AMS. However, a medical history of hypertension may be associated with a lower risk of AMS. More work is needed to confirm this novel finding.


Assuntos
Doença da Altitude/epidemiologia , Altitude , Hipertensão/complicações , Montanhismo , Doença Aguda/epidemiologia , Adulto , Idoso , Doença da Altitude/etiologia , Doença da Altitude/fisiopatologia , Pressão Sanguínea , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nepal/epidemiologia , Prevalência , Estudos Prospectivos , Fatores de Risco
4.
Cancer Res ; 77(22): 6282-6298, 2017 11 15.
Artigo em Inglês | MEDLINE | ID: mdl-28978635

RESUMO

Androgen receptor (AR) mediates the growth of prostate cancer throughout its course of development, including in abnormal splice variants (AR-SV)-driven advanced stage castration-resistant disease. AR stabilization by androgens makes it distinct from other steroid receptors, which are typically ubiquitinated and degraded by proteasomes after ligand binding. Thus, targeting AR in advanced prostate cancer requires the development of agents that can sustainably degrade variant isoforms for effective therapy. Here we report the discovery and characterization of potent selective AR degraders (SARD) that markedly reduce the activity of wild-type and splice variant isoforms of AR at submicromolar doses. Three SARDs (UT-69, UT-155, and (R)-UT-155) bind the amino-terminal transcriptional activation domain AF-1, which has not been targeted for degradation previously, with two of these SARD (UT-69 and UT-155) also binding the carboxy-terminal ligand binding domain. Despite different mechanisms of action, all three SARDs degraded wild-type AR and inhibited AR function, exhibiting greater inhibitory potency than the approved AR antagonists. Collectively, our results introduce a new candidate class of next-generation therapeutics to manage advanced prostate cancer. Cancer Res; 77(22); 6282-98. ©2017 AACR.


Assuntos
Antagonistas de Receptores de Andrógenos/farmacologia , Regulação Neoplásica da Expressão Gênica/efeitos dos fármacos , Neoplasias de Próstata Resistentes à Castração/tratamento farmacológico , Receptores Androgênicos/genética , Processamento Alternativo , Antagonistas de Receptores de Andrógenos/química , Anilidas/química , Anilidas/farmacologia , Animais , Linhagem Celular Tumoral , Proliferação de Células/efeitos dos fármacos , Proliferação de Células/genética , Perfilação da Expressão Gênica/métodos , Humanos , Indóis/química , Indóis/farmacologia , Masculino , Camundongos Endogâmicos NOD , Camundongos Knockout , Camundongos SCID , Estrutura Molecular , Neoplasias de Próstata Resistentes à Castração/genética , Neoplasias de Próstata Resistentes à Castração/metabolismo , Receptores Androgênicos/metabolismo , Ensaios Antitumorais Modelo de Xenoenxerto
5.
High Alt Med Biol ; 18(3): 267-277, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28787190

RESUMO

Keyes, Linda E., Thomas Douglas Sallade, Charles Duke, Jennifer Starling, Alison Sheets, Sushil Pant, David S. Young, David Twillman, Nirajan Regmi, Benoit Phelan, Purshotam Paudel, Matthew McElwee, Luke Mather, Devlin Cole, Theodore McConnell, and Buddha Basnyat. Blood pressure and altitude: an observational cohort study of hypertensive and nonhypertensive Himalayan trekkers in Nepal. High Alt Med Biol. 18:267-277, 2017. OBJECTIVES: To determine how blood pressure (BP) changes with altitude in normotensive versus hypertensive trekkers. Secondary aims were to evaluate the prevalence of severe hypertension (BP ≥180/100 mmHg) and efficacy of different antihypertensive agents at high altitude. METHODS: This was an observational cohort study of resting and 24-hour ambulatory BP in normotensive and hypertensive trekkers at 2860, 3400, and 4300 m in Nepal. RESULTS: We enrolled 672 trekkers age 18 years and older, 60 with a prior diagnosis of hypertension. Mean systolic and diastolic BP did not change between altitudes in normotensive or hypertensive trekkers, but was higher in those with hypertension. However, there was large interindividual variability. At 3400 m, the majority (60%, n = 284) of normotensive participants had a BP within 10 mmHg of their BP at 2860 m, while 21% (n = 102) increased and 19% (n = 91) decreased. The pattern was similar between 3400 and 4300 m (64% [n = 202] no change, 21% [n = 65] increased, 15% [n = 46] decreased). BP decreased in a greater proportion of hypertensive trekkers versus normotensives (36% [n = 15] vs. 21% at 3400 m, p = 0.01 and 30% [n = 7] vs. 15% at 4300 m, p = 0.05). Severe hypertension occurred in both groups, but was asymptomatic. In a small subset of participants, 24-hour ambulatory BP monitoring showed that nocturnal BP decreased in normotensive (n = 4) and increased in hypertensive trekkers (n = 4). CONCLUSIONS: Most travelers, including those with well-controlled hypertension, can be reassured that their BP will remain relatively stable at high altitude. Although extremely elevated BP may be observed at high altitude in normotensive and hypertensive people, it is unlikely to be symptomatic. The ideal antihypertensive regimen at high altitude remains unclear.


Assuntos
Aclimatação/fisiologia , Altitude , Pressão Sanguínea/fisiologia , Hipertensão/fisiopatologia , Montanhismo/fisiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nepal , Estudos Prospectivos
6.
J Travel Med ; 23(6)2016 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-27503853

RESUMO

BACKGROUND: The number of tourists in Nepal doubled between 2003 and 2013 is nearly 800 000. With the increased popularity of trekking, the number of those with pre-existing medical conditions requiring access to healthcare is likely to increase. We therefore sought to characterize the demographics and health status of trekkers on the Everest Base Camp route in the Solukhumbu Valley. In addition, we report cases that illustrate the potential complications of an ageing and medicated population of trekkers with underlying diseases. METHODS: Trekkers over 18 years were enrolled in a larger observational cohort study on blood pressure at high altitude at 2860 m. They answered a questionnaire regarding demographics, medical history and current medications. Acute medical problems relating to medication use that were brought to the attention of investigators were documented and are presented as case reports. RESULTS: We enrolled 670 trekkers, 394 (59%) male, with a mean age of 48 years (range 18-76). Pre-existing medical conditions were reported by 223 participants (33%). The most frequent conditions included hypertension, hypercholesterolemia, migraines and thyroid dysfunction. A total of 276 participants (41%) reported taking one or more medications. The most common medications were acetazolamide (79, 12%), antihypertensives (50, 8%) and NSAIDs (47, 7%), with 30 classes of drugs represented. Excluding acetazolamide, older trekkers (age >50 years) were more likely than younger ones to take medications (OR = 2.17; 95% CI 1.57-3.00; P <0.05). Acetazolamide use was not related to age. CONCLUSIONS: Our findings illustrate a wide variety of medical conditions present in trekkers in Nepal with wide-ranging potential complications that could pose difficulties in areas where medical care is scarce and evacuation difficult. Our cases illustrate the potential problems polypharmacy poses in trekkers, and the need for local and expedition healthcare workers to be aware of, and prepared for the common medical conditions present.


Assuntos
Doença da Altitude/epidemiologia , Montanhismo/estatística & dados numéricos , Doenças Profissionais/epidemiologia , Polimedicação , Automedicação , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nepal , Fatores de Risco , Adulto Jovem
7.
Expert Opin Ther Pat ; 22(5): 541-65, 2012 May.
Artigo em Inglês | MEDLINE | ID: mdl-22583332

RESUMO

INTRODUCTION: Androgen receptor (AR) antagonists are predominantly used as chemical castration to treat prostate cancer (i.e., in conjunction with androgen deprivation therapy (ADT)). Unfortunately, castration-resistant prostate cancer (CRPC) typically develops that is refractory to targeted therapy. Insights into CRPC biology have led to the emergence of a promising clinical candidate MDV3100 (1) and a resurgence in this field. A pipeline of preclinical competitive (C-terminally directed) antagonists was discovered using a variety of innovative screening paradigms. Some inhibit nuclear translocation, selectively downregulate or degrade AR (SARD), antagonize wild-type and escape mutant AR (pan-antagonists) and/or antagonize AR target organs in vivo. Separately, the N-terminal domain has emerged as a promising novel target for noncompetitive antagonists. AREAS COVERED: AR antagonists whose patents published between 2008 and 2011 are reviewed. Antagonists are organized based on the screening paradigm reported as discussed above. EXPERT OPINION: Novel mechanisms provide a more informed basis for selecting a competitive antagonist; however, high potency and favorable in vivo properties remain paramount. Noncompetitive antagonists have theoretical advantages suggestive of improved clinical efficacy, but no clinical proof of concept as of yet.


Assuntos
Antagonistas de Receptores de Andrógenos/farmacologia , Antineoplásicos Hormonais/farmacologia , Neoplasias da Próstata/tratamento farmacológico , Receptores Androgênicos/efeitos dos fármacos , Antagonistas de Receptores de Andrógenos/química , Animais , Antineoplásicos Hormonais/química , Desenho de Fármacos , Resistencia a Medicamentos Antineoplásicos , Humanos , Legislação de Medicamentos , Masculino , Estrutura Molecular , Mutação , Patentes como Assunto , Neoplasias da Próstata/genética , Neoplasias da Próstata/metabolismo , Neoplasias da Próstata/patologia , Transporte Proteico , Receptores Androgênicos/genética , Receptores Androgênicos/metabolismo , Relação Estrutura-Atividade
8.
Pharm Res ; 29(8): 2079-91, 2012 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-22451249

RESUMO

PURPOSE: Overexpression of the androgen receptor (AR) and anti-apoptotic genes including X-linked inhibitor of apoptosis protein (XIAP) provide tumors with a proliferative advantage. Therefore, our objective was to determine whether novel antiandrogen (CBDIV17) and XIAP inhibitor based combination therapy can treat advanced prostate cancer. METHODS: CBDIV17 and embelin-6g were synthesized and their effect on cell proliferation, apoptosis, cell cycle and AR and XIAP gene silencing determined. RESULTS: CBDIV17 was more potent than bicalutamide and inhibited proliferation of C4-2 and LNCaP cells, IC(50) for CBDIV17 was ≈ 12 µM and ≈ 21 µM in LNCaP and C4-2 cells, respectively, whereas bicalutamide had IC(50) of ≈ 46 µM in LNCaP cells and minimal effect in C4-2 cells. CBDIV17 induced apoptosis more effectively compared to bicalutamide and significantly inhibited DNA replication. Combination of CBDIV17 and embelin resulted in supra-additive antiproliferative and apoptotic effects. Embelin downregulated AR expression and decreased androgen-mediated AR phosphorylation at Ser(81). These hydrophobic drugs were solubilized using micelles prepared with polyethylene glycol-b-poly (carbonate-co-lactide) (PEG-b-p(CB-co-LA)) copolymer. Combination therapy inhibited prostate tumor growth more effectively compared to control or monotherapy in vivo. CONCLUSIONS: Our results demonstrated that CBDIV17 in combination with embelin can potentially treat advanced prostate cancer.


Assuntos
Antagonistas de Androgênios/uso terapêutico , Anilidas/uso terapêutico , Antineoplásicos/uso terapêutico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Benzoquinonas/uso terapêutico , Hidroxibutiratos/uso terapêutico , Neoplasias da Próstata/tratamento farmacológico , Proteínas Inibidoras de Apoptose Ligadas ao Cromossomo X/antagonistas & inibidores , Antagonistas de Androgênios/administração & dosagem , Antagonistas de Androgênios/farmacologia , Anilidas/administração & dosagem , Anilidas/farmacologia , Animais , Antineoplásicos/administração & dosagem , Antineoplásicos/farmacologia , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Protocolos de Quimioterapia Combinada Antineoplásica/farmacologia , Apoptose/efeitos dos fármacos , Benzoquinonas/administração & dosagem , Benzoquinonas/farmacologia , Ciclo Celular/efeitos dos fármacos , Linhagem Celular Tumoral , Regulação Neoplásica da Expressão Gênica/efeitos dos fármacos , Humanos , Hidroxibutiratos/administração & dosagem , Hidroxibutiratos/farmacologia , Masculino , Camundongos , Micelas , Nitrilas/farmacologia , Próstata/efeitos dos fármacos , Próstata/metabolismo , Próstata/patologia , Neoplasias da Próstata/genética , Neoplasias da Próstata/metabolismo , Neoplasias da Próstata/patologia , Receptores Androgênicos/genética , Receptores Androgênicos/metabolismo , Compostos de Tosil/farmacologia , Proteínas Inibidoras de Apoptose Ligadas ao Cromossomo X/genética , Proteínas Inibidoras de Apoptose Ligadas ao Cromossomo X/metabolismo
9.
J Med Chem ; 54(11): 3973-6, 2011 Jun 09.
Artigo em Inglês | MEDLINE | ID: mdl-21506597

RESUMO

Several new androgen receptor antagonists were synthesized and found to have varying activities across typically anti-androgen resistant mutants (Thr877 → Ala and Trp741 → Leu) and markedly improved potency over previously reported pan-antagonists. X-ray crystallography of a new anti-androgen in an androgen receptor mutant (Thr877 → Ala) shows that the receptor can accommodate the added bulk presented by phenyl to naphthyl substitution, casting doubt on previous reports of predicted binding orientation and the causes of antagonism in bulky-B-ring antagonists.


Assuntos
Antagonistas de Androgênios/química , Antagonistas de Receptores de Andrógenos/química , Androgênios/química , Resistencia a Medicamentos Antineoplásicos/genética , Neoplasias da Próstata/genética , Receptores Androgênicos/metabolismo , Antagonistas de Androgênios/síntese química , Antagonistas de Androgênios/metabolismo , Antagonistas de Receptores de Andrógenos/síntese química , Antagonistas de Receptores de Andrógenos/metabolismo , Antagonistas de Receptores de Andrógenos/farmacologia , Androgênios/farmacologia , Cristalografia por Raios X , Desenho de Fármacos , Humanos , Masculino , Estrutura Molecular , Terapia de Alvo Molecular , Neoplasias da Próstata/tratamento farmacológico , Ligação Proteica , Receptores Androgênicos/química , Relação Estrutura-Atividade
10.
Drug Metab Dispos ; 39(4): 636-43, 2011 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-21233217

RESUMO

3-(1H-Indol-2-yl)phenyl)(3,4,5-trimethoxyphenyl)methanone (I-387) is a novel indole compound with antitubulin action and potent antitumor activity in various preclinical models. I-387 avoids drug resistance mediated by P-glycoprotein and showed less neurotoxicity than vinca alkaloids during in vivo studies. We examined the pharmacokinetics and metabolism of I-387 in mice as a component of our preclinical development of this compound and continued interest in structure-activity relationships for antitubulin agents. After a 1 mg/kg intravenous dose, noncompartmental pharmacokinetic analysis in plasma showed that clearance (CL), volume of distribution at steady state (Vd(ss)), and terminal half-life (t(1/2)) of I-387 were 27 ml per min/kg, 5.3 l/kg, and 7 h, respectively. In the in vitro metabolic stability study, half-lives of I-387 were between 10 and 54 min by mouse, rat, dog, monkey, and human liver microsomes in the presence of NADPH, demonstrating interspecies variability. I-387 was most stable in rat liver microsomes and degraded quickly in monkey liver microsomes. Liquid chromatography-tandem mass spectrometry was used to identify phase I metabolites. Hydroxylation, reduction of a ketone group, and O-demethylation were the major metabolites formed by the liver microsomes of the five species. The carbonyl group of I-387 was reduced and identified as the most labile site in human liver microsomes. The results of these drug metabolism and pharmacokinetic studies provide the foundation for future structural modification of this pharmacophore to improve stability of drugs with potent anticancer effects in cancer patients.


Assuntos
Antimitóticos/metabolismo , Benzofenonas/metabolismo , Indóis/metabolismo , Microssomos Hepáticos/metabolismo , NADP/metabolismo , Membro 1 da Subfamília B de Cassetes de Ligação de ATP/metabolismo , Animais , Antimitóticos/sangue , Antimitóticos/síntese química , Antimitóticos/farmacologia , Benzofenonas/sangue , Benzofenonas/síntese química , Benzofenonas/farmacologia , Biotransformação , Cães , Estabilidade de Medicamentos , Meia-Vida , Haplorrinos , Humanos , Hidroxilação , Indóis/sangue , Indóis/síntese química , Indóis/farmacologia , Injeções Intravenosas , Desintoxicação Metabólica Fase I , Desintoxicação Metabólica Fase II , Camundongos , Microssomos Hepáticos/efeitos dos fármacos , Ratos , Especificidade da Espécie , Relação Estrutura-Atividade
11.
Cancer Chemother Pharmacol ; 67(2): 293-304, 2011 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-20383708

RESUMO

PURPOSE: Microtubules are one of the most useful subcellular targets in chemotherapy. We identified a novel indole, (3-(1H-indol-2-yl)phenyl)(1H-indol-2-yl)methanone (15), that inhibits tubulin action and exhibits potent antitumor activity in various preclinical models. METHODS: In vitro cancer cell growth inhibition was measured by SRB or MTT assay in human cancer cell lines. Apoptosis induced by 15 was examined in LNCaP and PC-3 cells. Effects of 15 on cell cycle distribution and tubulin were investigated via in vitro models. In vivo toxicity and xenograft efficacy studies were conducted in mice. RESULTS: Indole 15 inhibited the in vitro growth of a number of human cancer cell lines, including drug-resistant cell lines that over-express P-glycoprotein, multidrug resistance-associated proteins, and breast cancer resistance protein with IC(50) values in the range of 34-162 nM. Nanomolar concentrations of the compound caused down-regulation of bcl-2, induced PARP cleavage, and induced apoptosis in both LNCaP and PC-3 prostate cancer cells, as confirmed by anti-histone ELISA and DNA laddering. In vitro studies revealed that the compound inhibited polymerization of purified tubulin and induced a strong and concentration-dependent G(2)M arrest in PC-3 cells. In vivo studies in immunodeficient mice bearing PC-3 tumor xenografts showed that the compound effectively inhibited tumor growth. CONCLUSIONS: The potent in vitro and in vivo antitumor activities of this novel indole suggest that drugs with this novel chemical scaffold might be developed for treatment of drug-resistant prostate cancer.


Assuntos
Indóis/farmacologia , Indóis/uso terapêutico , Microtúbulos/efeitos dos fármacos , Neoplasias da Próstata/tratamento farmacológico , Moduladores de Tubulina/farmacologia , Moduladores de Tubulina/uso terapêutico , Membro 1 da Subfamília B de Cassetes de Ligação de ATP/metabolismo , Membro 2 da Subfamília G de Transportadores de Cassetes de Ligação de ATP , Transportadores de Cassetes de Ligação de ATP/metabolismo , Animais , Apoptose/efeitos dos fármacos , Sítios de Ligação , Ligação Competitiva , Ciclo Celular/efeitos dos fármacos , Linhagem Celular Tumoral , Proliferação de Células/efeitos dos fármacos , Humanos , Indóis/química , Indóis/metabolismo , Indóis/toxicidade , Concentração Inibidora 50 , Masculino , Dose Máxima Tolerável , Camundongos , Camundongos Endogâmicos ICR , Camundongos Nus , Estrutura Molecular , Proteínas Associadas à Resistência a Múltiplos Medicamentos/metabolismo , Proteínas de Neoplasias/metabolismo , Podofilotoxina/metabolismo , Neoplasias da Próstata/patologia , Taxa de Sobrevida , Tubulina (Proteína)/metabolismo , Moduladores de Tubulina/química , Moduladores de Tubulina/metabolismo , Moduladores de Tubulina/toxicidade , Vimblastina/metabolismo , Ensaios Antitumorais Modelo de Xenoenxerto
12.
Mol Cancer Ther ; 9(11): 2859-68, 2010 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-20829196

RESUMO

(3-(1H-indol-2-yl)phenyl)(3,4,5-trimethoxyphenyl)methanone (I-387) is a novel synthetic compound that inhibits tubulin action and exhibits potent antitumor activity in various preclinical models. I-387 inhibited the in vitro growth of several human cancer cell lines with IC50 values in the range of 15 to 39 nmol/L. Nanomolar concentrations of the compound induced apoptosis and caused phosphorylation of the antiapoptotic protein Bcl-2. I-387 induced a strong and concentration-dependent G2-M arrest in PC-3 cells by constitutive activation of Cdc2/cyclin B1 complex and destabilized polymerization of purified tubulin in vitro by binding to the colchicine-binding site. In vivo, I-387 treatment effectively inhibited tumor growth in mice bearing PC-3 tumor xenografts. In vitro studies of nerve growth factor-dependent neurite outgrowth in PC12 pheochromocytoma cells and in vivo studies of mouse behavior showed that I-387 was less neurotoxic than vinblastine and vincristine, tubulin destabilizers with known neurotoxicity. Interestingly, multidrug-resistant cell lines that overexpressed P-glycoprotein (P-gp), multidrug resistance-associated proteins, and breast cancer resistance protein were rendered resistant to docetaxel, vinblastine, SN-38, and doxorubicin, but not to I-387. I-387 dosed at 10 mg/kg was equally effective with 76% tumor growth inhibition in xenograft models using MES-SA uterine sarcoma cells and MES-SA/DX5 cells overexpressing P-gp. In contrast, docetaxel and vinblastine were not effective in MES-SA/DX5 xenograft models. The potent in vitro and in vivo antitumor activity of I-387 suggests that it may represent a new antimitotic agent for management of various malignancies, particularly for patients with drug-resistant cancer.


Assuntos
Antineoplásicos/efeitos adversos , Antineoplásicos/farmacologia , Benzofenonas/farmacologia , Indóis/farmacologia , Neurônios/efeitos dos fármacos , Neurônios/patologia , Animais , Antimitóticos/efeitos adversos , Antimitóticos/farmacologia , Antimitóticos/uso terapêutico , Antineoplásicos/uso terapêutico , Apoptose/efeitos dos fármacos , Benzofenonas/efeitos adversos , Benzofenonas/uso terapêutico , Células Cultivadas , Células HT29 , Humanos , Indóis/efeitos adversos , Indóis/uso terapêutico , Células K562 , Masculino , Camundongos , Camundongos Endogâmicos ICR , Camundongos Nus , Síndromes Neurotóxicas/epidemiologia , Síndromes Neurotóxicas/patologia , Células PC12 , Ratos , Ensaios Antitumorais Modelo de Xenoenxerto
13.
J Pharmacol Exp Ther ; 334(2): 439-48, 2010 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-20444881

RESUMO

Women experience a decline in estrogen and androgen levels after natural or surgically induced menopause, effects that are associated with a loss of sexual desire and bone mineral density. Studies in our laboratories have shown the beneficial effects of selective androgen receptor modulators (SARMs) in the treatment of osteoporosis and muscle wasting in animal models. A series of S-3-(phenoxy)-2-hydroxy-2-methyl-N-(4-cyano-3-trifluoromethyl-phenyl)-propionamide analogs was synthesized to evaluate the effects of B-ring substitutions on in vitro and in vivo pharmacologic activity, especially female sexual motivation. The androgen receptor (AR) relative binding affinities ranged from 0.1 to 26.5% (relative to dihydrotestosterone) and demonstrated a range of agonist activity at 100 nM. In vivo pharmacologic activity was first assessed by using male rats. Structural modifications to the B-ring significantly affected the selectivity of the SARMs, demonstrating that single-atom substitutions can dramatically and unexpectedly influence activity in androgenic (i.e., prostate) and anabolic (i.e., muscle) tissues. (S)-N-(4-cyano-3-trifluoromethyl-phenyl)-3-(3-fluoro,4-chlorophenoxy)-2-hydroxy-2-methyl-propanamide (S-23) displayed full agonist activity in androgenic and anabolic tissues; however, the remaining SARMs were more prostate-sparing, selectively maintaining the size of the levator ani muscle in castrated rats. The partner-preference paradigm was used to evaluate the effects of SARMs on female sexual motivation. With the exception of two four-halo substituted analogs, the SARMs increased sexual motivation in ovariectomized rats, with potency and efficacy comparable with testosterone propionate. These results indicate that the AR is important in regulating female libido given the nonaromatizable nature of SARMs and it could be a superior alternative to steroidal testosterone preparations in the treatment of hypoactive sexual desire disorder.


Assuntos
Androgênios , Anilidas/farmacologia , Receptores Androgênicos/fisiologia , Comportamento Sexual Animal/efeitos dos fármacos , Anilidas/química , Animais , Ligação Competitiva , Linhagem Celular , Feminino , Hormônio Foliculoestimulante/sangue , Humanos , Hormônio Luteinizante/sangue , Masculino , Orquiectomia , Tamanho do Órgão , Ovariectomia , Próstata/anatomia & histologia , Próstata/efeitos dos fármacos , Ensaio Radioligante , Ratos , Ratos Sprague-Dawley , Fatores Sexuais , Estereoisomerismo , Relação Estrutura-Atividade , Ativação Transcricional , Útero/anatomia & histologia , Útero/efeitos dos fármacos
14.
Acta Crystallogr Sect E Struct Rep Online ; 66(Pt 2): m148, 2010 Jan 13.
Artigo em Inglês | MEDLINE | ID: mdl-21579627

RESUMO

The structure of the title compound, [Cr(C(10)H(12)O(2))(CO)(3)], is presented. The distorted piano-stool geometry features an off-center Cr(CO)(3) fragment which reduces contact with the dioxolane ring. The dioxolane ring, in twisted conformation, is syn-oriented towards the Cr(CO)(3) moiety.

15.
BMC Pregnancy Childbirth ; 9: 58, 2009 Dec 17.
Artigo em Inglês | MEDLINE | ID: mdl-20017922

RESUMO

BACKGROUND: Stillbirths need to count. They constitute the majority of the world's perinatal deaths and yet, they are largely invisible. Simply counting stillbirths is only the first step in analysis and prevention. From a public health perspective, there is a need for information on timing and circumstances of death, associated conditions and underlying causes, and availability and quality of care. This information will guide efforts to prevent stillbirths and improve quality of care. DISCUSSION: In this report, we assess how different definitions and limits in registration affect data capture, and we discuss the specific challenges of stillbirth registration, with emphasis on implementation. We identify what data need to be captured, we suggest a dataset to cover core needs in registration and analysis of the different categories of stillbirths with causes and quality indicators, and we illustrate the experience in stillbirth registration from different cultural settings. Finally, we point out gaps that need attention in the International Classification of Diseases and review the qualities of alternative systems that have been tested in low- and middle-income settings. SUMMARY: Obtaining high-quality data will require consistent definitions for stillbirths, systematic population-based registration, better tools for surveys and verbal autopsies, capacity building and training in procedures to identify causes of death, locally adapted quality indicators, improved classification systems, and effective registration and reporting systems.


Assuntos
Coleta de Dados/métodos , Morte Fetal/classificação , Morte Fetal/epidemiologia , Sistema de Registros/estatística & dados numéricos , Natimorto/epidemiologia , Causas de Morte/tendências , Feminino , Morte Fetal/prevenção & controle , Saúde Global , Humanos , Mortalidade Infantil/tendências , Recém-Nascido , Classificação Internacional de Doenças , Gravidez , Serviços Preventivos de Saúde/organização & administração , Projetos de Pesquisa , Fatores de Risco
16.
BMC Pregnancy Childbirth ; 9: 22, 2009 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-19515228

RESUMO

A carefully classified dataset of perinatal mortality will retain the most significant information on the causes of death. Such information is needed for health care policy development, surveillance and international comparisons, clinical services and research. For comparability purposes, we propose a classification system that could serve all these needs, and be applicable in both developing and developed countries. It is developed to adhere to basic concepts of underlying cause in the International Classification of Diseases (ICD), although gaps in ICD prevent classification of perinatal deaths solely on existing ICD codes.We tested the Causes of Death and Associated Conditions (Codac) classification for perinatal deaths in seven populations, including two developing country settings. We identified areas of potential improvements in the ability to retain existing information, ease of use and inter-rater agreement. After revisions to address these issues we propose Version II of Codac with detailed coding instructions.The ten main categories of Codac consist of three key contributors to global perinatal mortality (intrapartum events, infections and congenital anomalies), two crucial aspects of perinatal mortality (unknown causes of death and termination of pregnancy), a clear distinction of conditions relevant only to the neonatal period and the remaining conditions are arranged in the four anatomical compartments (fetal, cord, placental and maternal).For more detail there are 94 subcategories, further specified in 577 categories in the full version. Codac is designed to accommodate both the main cause of death as well as two associated conditions. We suggest reporting not only the main cause of death, but also the associated relevant conditions so that scenarios of combined conditions and events are captured.The appropriately applied Codac system promises to better manage information on causes of perinatal deaths, the conditions associated with them, and the most common clinical scenarios for future study and comparisons.


Assuntos
Causas de Morte , Classificação/métodos , Mortalidade Perinatal , Vocabulário Controlado , Saúde Global , Humanos , Recém-Nascido , Variações Dependentes do Observador , Reprodutibilidade dos Testes
17.
Pharm Res ; 26(9): 2081-92, 2009 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-19415464

RESUMO

PURPOSE: To examine the effect of bicalutamide and embelin on the growth of prostate cancer cells in vitro and in vivo METHODS: Cell viability was determined by MTT assay. Micelles were fabricated with polyethylene glycol-b-polylactic acid (PEG-PLA) copolymer and characterized in terms of particle size, micellar solubilization and drug loading, followed by evaluation in nude mice bearing LNCaP xenografts. RESULTS: Embelin induced caspase 3 and 9 activation in LNCaP and C4-2 cells by decreasing XIAP expression and was more potent than bicalutamide in killing prostate tumor cells irrespective of their androgen status. As analyzed by isobologram analysis the combination of bicalutamide and embelin was synergistic for C4-2 but additive and slightly antagonistic for LNCaP cells. Micellar formulation resulted in at least 60-fold increase in the aqueous solubility of bicalutamide and embelin. Tumor growth was effectively regressed upon treatment with bicalutamide, but the extent of tumor regression was significantly higher when bicalutamide was formulated in micelles. However, tumor response to bicalutamide stopped after prolonged treatment and began to grow. Sequential treatment with XIAP inhibitor embelin resulted in regression of these hormone refractory tumors. CONCLUSION: Combined treatment with bicalutamide and embelin may be an effective strategy for treating hormone refractory prostate cancer.


Assuntos
Anilidas/uso terapêutico , Antineoplásicos/uso terapêutico , Benzoquinonas/uso terapêutico , Micelas , Nitrilas/uso terapêutico , Neoplasias da Próstata/tratamento farmacológico , Compostos de Tosil/uso terapêutico , Anilidas/administração & dosagem , Anilidas/farmacologia , Animais , Antineoplásicos/administração & dosagem , Antineoplásicos/farmacologia , Apoptose/efeitos dos fármacos , Sequência de Bases , Benzoquinonas/administração & dosagem , Benzoquinonas/farmacologia , Linhagem Celular Tumoral , Primers do DNA , Humanos , Masculino , Camundongos , Camundongos Nus , Nitrilas/administração & dosagem , Nitrilas/farmacologia , Compostos de Tosil/administração & dosagem , Compostos de Tosil/farmacologia , Transplante Heterólogo
18.
J Phys Chem A ; 113(12): 2666-76, 2009 Mar 26.
Artigo em Inglês | MEDLINE | ID: mdl-19231828

RESUMO

We review recent studies of processes relevant to photoinduced linkage isomerization of organometallic systems with the goal of preparing organometallics with an efficient and ultrafast photochromic response. The organometallic system thus corresponds to two linkage isomers with different electronic environments that are responsible for different optical properties. Much of this work has focused on examining processes following irradiation of cyclopentadienyl manganese tricarbonyl derivatives (compounds 3-21) including solvent coordination, thermal relaxation, solvent displacement by tethered functional groups (chelation), dissociation of tethered functional groups, and linkage isomerization. A new platform is investigated for obtaining a photochromic response in new experiments with arene chromium dicarbonyl complexes. A photochromic response is observed for arene chromium dicarbonyl complexes with tethered pyridine and olefin functional groups based on light-driven linkage isomerization on the nanosecond time scale. Irradiation at 532 nm of 23 ([Cr{eta(6)-C(6)H(5)CH(2-Py-kappaN)CH(2)CH=CH(2)}(CO)(2)]) (Py = pyridine) results in the isomerization to 22 ([Cr{eta(6)-C(6)H(5)CH(2-Py)CH(2)-eta(2)-CH=CH(2)}(CO)(2)]), and 355 nm irradiation isomerizes 22 to 23. The ultrafast linkage isomerization has been investigated at room temperature in n-heptane solution on the picosecond to microsecond time scale with UV- or visible-pump and IR-probe transient absorption spectroscopy by comparing the dynamics with model compounds containing only a tethered pyridine. Irradiation of 24 ([Cr{eta(6)-C(6)H(5)(CH(2))(3)(2-Py)}(CO)(3)]) and 25 ([Cr{eta(6)-C(6)H(5)(CH(2))(2)(2-Py)}(CO)(3)]) at 289 nm induces CO loss to immediately yield a Cr-heptane solvent coordinated intermediate of the unsaturated Cr fragment, which then converts to the kappaN(1)-pyridine chelate within 200 and 100 ns, respectively. Irradiation of 26 ([Cr{eta(6)-C(6)H(5)CH(2)(2-Py)}(CO)(3)]) also induces CO loss to immediately yield three species: the Cr-heptane solvent coordinated intermediate, a kappaN(1)-Py nitrogen chelate, and an agostic eta(2)-chelate in which the pyridine is coordinated to the metal center via a C-H agostic bond as opposed to the nitrogen lone pair. Both the transient Cr-heptane coordinated intermediate and the agostic pyridine chelate convert to the stable kappaN(1)-pyridine chelate within 50 ns. Similar reaction dynamics and transient species are observed for the chelate 33 ([Cr{eta(6)-C(6)H(5)CH(2)(2-Py)-kappaN}(CO)(2)]) where a Cr-Py bond, not a Cr-CO bond, initially cleaves.

19.
J Phys Chem A ; 111(30): 6933-7, 2007 Aug 02.
Artigo em Inglês | MEDLINE | ID: mdl-17628047

RESUMO

The chelation dynamics of three new [Cr{eta6-C6H5C(O)R}(CO)3] complexes, 1 [R = CH2(SCH3)], 2 [R = CH(SCH3)2], and 3 [R = C(SCH3)3], has been investigated on the picosecond to millisecond time scales by UV pump/IR probe transient absorption spectroscopy following photodissociation of CO in room temperature n-heptane, tetrahydrofuran (THF), and acetonitrile. In n-heptane, UV irradiation of 1, 2, or 3 dissociates CO to initially yield a Cr-S chelate (in which the pendant sulfide moiety is coordinated to the metal center) and a transient Cr-heptane solvate in approximately 1:2, 1:2, and 2:1 ratios, respectively. The Cr-heptane solvate is unstable and converts to the Cr-S chelate within 30 ns in each case. Irradiation of 2 or 3 in THF yields both the Cr-S chelate and Cr-THF solvate in approximately 1:3 and 1:1 ratios, respectively. The Cr-THF solvate converts to the Cr-S chelate on the second or longer time scale. All three complexes appear to yield the Cr-NCCH3 solvate exclusively within 50 ps following irradiation in acetonitrile. The solvent effect on chelation is in striking contrast to that previously reported for the analogous RCpMn(CO)3 derivatives, 4-6. In acetonitrile, only chelation is observed for the Mn series and only solvent coordination is observed for the Cr series, but in heptane both chelation and solvent coordination are observed in both series.

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