Long-term efficacy and safety of baricitinib in patients with severe alopecia areata: 104-week results from BRAVE-AA1 and BRAVE-AA2.

BACKGROUND: Efficacy of the Janus kinase (JAK) inhibitor baricitinib for severe alopecia areata (AA) continuously increased over 52 weeks in two Phase 3 trials. There are limited long-term data on JAK inhibitors in AA. OBJECTIVES: To evaluate efficacy and safety of baricitinib for severe AA through 104 weeks of continuous therapy. METHODS: Integrated data from the BRAVE-AA1 and BRAVE-AA2 Phase 3 trials included adults with Severity of Alopecia Tool (SALT) scores ≥50 (≥50% scalp hair loss) randomized to and continuously treated with 2-mg or 4-mg baricitinib through Week 104. Patients who qualified to remain on continuous treatment included subjects who achieved SALT score ≤20 at Week 52 (Week-52 responders; 2-mg: N = 65; 4-mg: N = 129) and baricitinib 4-mg-treated patients who had SALT score >20 at Week 52 but achieved SALT score ≤20 at prior visit(s) and/or had significant improvement in eyebrow or eyelash hair growth relative to baseline by Week 52 (Week-52 mixed responders; N = 110). Week-104 outcomes included the proportion of patients achieving SALT score ≤20 (≤20% scalp hair loss). Data were censored after treatment discontinuation. RESULTS: Among baricitinib 4-mg-treated and baricitinib 2-mg-treated Week-52 responders, 90.7% and 89.2%, respectively, maintained SALT score ≤20 at Week 104. Among Week-52 mixed responders, 39.1% reached SALT score ≤20 by Week 104. Continued improvement in eyebrow and eyelash regrowth was observed across groups. The most frequent treatment-emergent adverse events were COVID-19, upper respiratory tract infection, headache, nasopharyngitis, acne, urinary tract infection and creatine phosphokinase increase. CONCLUSIONS: Baricitinib demonstrated a high level of maintenance of efficacy over 104 weeks in patients with severe AA. Efficacy increased in Week-52 mixed responders, illustrating that long-term treatment is necessary to observe maximum benefit in some patients. No new safety signals were observed.

Novel lanthanide(III) 4-methylbenzoylhydrazide complexes as precursors for lanthanide oxide nanophotocatalysts.

A series of metal complexes were prepared from separate reactions of lanthanide nitrate salts (La(iii), Ce(iii), Sm(iii), Gd(iii) and Ho(iii)) with 4-methylbenzoylhydrazide. The structures of the complexes were confirmed by analytical studies, spectral measurements and thermal studies. Complexes were formed with different stoichiometries of 1 : 2 and 1 : 3 (M : L). The ligand chelates by the nitrogen and oxygen atoms of the amino and carbonyl groups of the hydrazide moiety in the neutral keto form. The coordination compounds were converted to metal oxide nanoparticles (MONPs) through solid state thermal decomposition as monocular source precursors. The obtained MONPs were investigated via XRD, TEM and UV-Vis spectra. As a representative, CeO2 was utilized as a nanophotocatalyst to examine the photocatalytic activity of the MONPs for methylene blue (MB) photodegradation. CeO2 showed high removal of MB dye by 90.1% after UV illumination for 220 min. The reported method provides a generalized and systematic method for the preparation of many metal oxide nanoparticles with manageable and reproducible features.

Synthesis and characterization of fluorinated anatase nanoparticles and subsequent N-doping for efficient visible light activated photocatalysis.

Fluorinated-titanium dioxide (TiO2-F) nanoparticles in a pure anatase polymorph was precipitated from solution by hydrolysis of titanium oxychloride, using urea and ammonia as precipitation agents and potassium fluoride as a source of fluorine anion. A further wet attrition milling in presence of glycine completed by a heat treatment allowed an additional nitrogen doping of TiO2 (TiO2-F&N-HT). The morphology and crystalline structure of the as-synthesized powder was determined by transmission electron microscopy (TEM) and X-ray diffraction (XRD) and showed that TiO2 powder was composed of nanoparticles with narrow size distribution which crystallized in the anatase phase. X-ray photoelectron spectroscopy (XPS) revealed that fluorine and nitrogen are present in TiO2 as surface fluorination and interstitial doping, respectively. UV-vis diffuse reflectance spectroscopy (DRS) showed an increased optical absorption in the visible for TiO2-F&N-HT sample. Under visible light irradiation, TiO2-F nanoparticles showed a high photocatalytic performance, showing the high potential of an improved surface fluorination for Escherichia coli (E. coli) disinfection in suspension. These results show the importance of anatase-TiO2 nanoparticles synthesis and modification by using a wet chemical approach leading to low aggregation and high specific surface area for effective bacterial inactivation. The co-doped TiO2-F&N-HT powder showed slightly improved performance compared to the fluorinated sample. The significant degree of aggregation after the heat treatment is postulated as being a limiting factor in its photocatalytic activity.

Fcγ-RI, Fcγ-RII and IL-10 as predictive biomarkers for post-therapeutic cicatrization time in monocytes from cutaneous leishmaniasis patients.

Cutaneous leishmaniasis (CL) treatment is based on therapy with Glucantime® , yet, there are few laboratory methods to monitor its success. In this study, ex vivo and in vitro evaluations of peripheral blood monocytes were performed in a longitudinal study to characterize the impact of Glucantime® on overall phenotypic/functional features of these cells from CL patients to identify predictive biomarkers for post-therapeutic monitoring by flow cytometry. The ex vivo evaluation from CL patients demonstrated a modulatory profile before treatment, with a decrease in TLR-2, FcγRII, HLA-DR, CD86, IFN-γR, TNF, IL-12, NO, and an increase in FcγRIII and IL-10R. Conversely, treatment changes some of these biomarker expressions by decreasing FcγRIII and IL-10R and increasing IFN-γR, IL-12 and NO. Moreover, an in vitro analysis of these patients showed a reduced phagocytic capacity of Leishmania braziliensis and higher levels of IL-10 and TGF-ß modulating functional profile. Regardless of the compromised L. braziliensis phagocytic capacity, treatment re-established the production of IL-12, IL-10, TGF-ß and NO at the basal level. Notably, monocytes from patients with early cicatrization showed enhanced FcγRI and FcγRII expressions and reduced IL-10, which was further corroborated by a baseline fold change analysis. Finally, the logistic regression model emphasized the performance of FcγRI, FcγRII and IL-10 as robust predictive biomarkers for post-therapeutic cicatrization during cutaneous leishmaniasis.

Alopecia areata: a review of disease pathogenesis.

BACKGROUND: Alopecia areata is a disorder that results in nonscarring hair loss. The psychological impact can be significant, leading to feelings of depression and social isolation. Objectives In this article, we seek to review the pathophysiological mechanisms proposed in recent years in a narrative fashion. METHODS: We searched MEDLINE and Scopus for articles related to alopecia areata, with a particular emphasis on its pathogenesis. RESULTS: The main theory of alopecia areata pathogenesis is that it is an autoimmune phenomenon resulting from a disruption in hair follicle immune privilege. What causes this breakdown is an issue of debate. Some believe that a stressed hair follicle environment triggers antigen presentation, while others blame a dysregulation in the central immune system entangling the follicles. Evidence for the latter theory is provided by animal studies, as well investigations around the AIRE gene. Different immune-cell lines including plasmacytoid dendritic cells, natural killer cells and T cells, along with key molecules such as interferon-γ, interleukin-15, MICA and NKG2D, have been identified as contributing to the autoimmune process. CONCLUSIONS: Alopecia areata remains incurable, although it has been studied for years. Available treatment options at best are beneficial for milder cases, and the rate of relapse is high. Understanding the exact mechanisms of hair loss in alopecia areata is therefore of utmost importance to help identify potential therapeutic targets.

Refinement of nano-structured fibroin thin films by near-IR pulsed laser deposition from targets consolidated with autogenous binder.

Silk fibroin (SF) powders were mixed with an autogenous binder from a natural cocoon after degumming with Na(2)CO(3) and liquefied with LiBr. An all-fibroin ablation target, SLT, obtained from the mixture after compression at ambient temperature, was compared with those without autogenous binder, SWT, or with a simple, non-autogenous binder, hydroxypropyl methylcellulose, SHT. The targets were then irradiated by a 1064 nm laser beam to obtain nano-structured thin films of fibroin by pulsed laser deposition (PLD) on Si (100). The properties of PLD films were examined mainly by atomic force microscope (AFM) or scanning electron microscope (SEM) for microstructures and morphology. By using an autogenous binder, significant increase was observed in the rate of nanofilm deposition with simultaneous decrease in the fraction of large debris. Size reduction of smallest protein units (SPUs) was also recognized by AFM. The autogenous binder turned out to be significantly superior over conventional, non-autogenous ones.

Stability of amorphous indomethacin compounded with silica.

The stability of indomethacin (IM) compounded with SiO(2) either by co-grinding or by melt-quenching was examined by recrystallization kinetics under the conditions 30 degrees C and 11% relative humidity. A decrease of the recrystallization rate with and without an appreciable induction period was observed in both compounds. Higher stability of amorphous IM compounded with SiO(2) was attained by prolonged co-grinding than by melt-quenching. This was explained by the stronger chemical interaction at the interface between IM and SiO(2) by co-grinding, as revealed by (29)Si and (13)C solid state NMR. Incomplete co-grinding with the rest of the crystalline state, however, made the amorphous state appreciably unstable, since the remaining crystallites serve as seeds for recrystallization.

Tris(1,10-phenanthroline-N,N')iron(II) dithiocyanate trihydrate.

The title mononuclear iron(II) complex, [Fe(C(12)H(8)N(2))(3)](NCS)(2).3H(2)O, has a slightly distorted octahedral coordination. One of the thiocyanate ions and one of the water molecules of crystallization show positional disorder.

Trypanosoma cruzi: characterization and isolation of a 57/51,000 m.w. surface glycoprotein (GP57/51) expressed by epimastigotes and bloodstream trypomastigotes.

We have recently described the application of a purified glycoprotein of 25,000 Mr (GP25) of Trypanosoma cruzi in serodiagnosis of Chagas' disease. Purified GP25 lacks appreciable immunogenicity in some animal species, in spite of being generally antigenic to parasitized hosts. The underlying cause for these contrasting observations has not been determined, but it may relate to the drastic extraction conditions used in the original isolation procedure, and possible damage inflicted to the native form of this antigen. This report describes the molecular properties of a GP25-related primary antigen, and a fast performance liquid chromatographic (FPLC) procedure to attain its isolation under gentle conditions. The expression of GP25-related antigen by epimastigotes or bloodstream forms was investigated with a high-affinity monoclonal antibody to GP25, SC11G10, as well as with monospecific antisera to GP25. Immunochemical analysis of Nonidet P-40 lysates supplemented with protease inhibitors indicated that GP25 is not synthesized as such; instead, a 57,000 Mr component (GP57) was identified as the primary antigen product. Partial enzymatic conversion to GP25 was observed when inhibitors were deliberately omitted from cell extracts. Most significantly, GP57 was established as the primary biosynthetic product in [35S]-labeled bloodstream trypomastigotes after immunoprecipitation with SC11G10 antibody. This analysis when applied to metabolically labeled epimastigotes has consistently revealed a minor antigen component of 51,000 Mr (GP51), in addition to GP57. The former was identified as the antigenically related product exposed at the parasite cell surface after external radioiodination of viable trypanosomes. Access to the native form of this widely distributed surface glycoprotein should stimulate the investigation of functional and structural aspects of its immunologic activity.

Chagas' disease: serodiagnosis with purified Gp25 antigen.

Development of a highly specific test system for the diagnosis of Chagas' disease (CD) was sought using Gp25, a surface glycoprotein recently isolated from Trypanosoma cruzi culture forms. Radioimmunoprecipitation assays were performed to screen 567 sera for IgG antibodies to Gp25. Correct diagnosis was attained in 97.8% of the 321 sera collected from chagasic patients in several endemic areas of South America. Sera from patients with various clinical forms of chronic disease displayed similar levels of antibodies (Abs) to Gp25. Moreover, there was little cross-reactivity when assayed against 246 sera from non-chagasic individuals, including 105 samples from individuals infected with unrelated trypanosomatids. Cross-reactivity was found in two such sera; these were used to identify a minor protein contaminant as the nonspecific antigen. Residual cross-reactive molecules were eliminated from Gp25 by affinity purification on Concanavalin A (Con A) columns. We recommend this antigen-antibody system for use in routine screening of blood donors.