Perioral dermabrasion: clinical and experimental studies

From 1985 through 1989, 54 patients with wrinkles around the lips and in the chin area were treated by dermabrasion. Significant improvement, lasting longer than three years, was achieved using both types of abrading tool: the wire brush and the diamond fraise. The side effects of dermabrasion were permanent but very slight bleaching in 66% of the patients and formation of milia in less than 20%. The surgical technique is described in detail. Dermabrading tools were tested at different speeds on excess cheek skin at facelift. Histological examination showed that the diamond fraise left a smooth abraded surface and the wire brush left an uneven surface. EMLA cream, usually used for skin surface analgesia, was tested as an adjunct to anesthesia in dermabrasion. EMLA's analgesic performance alone was insufficient in the sensitive perioral region, but it elevated pain threshold and decreased the required amount of local anesthetic solution. Five types of dressing were used and the speed of epithelialization and postoperative comfort were compared. At present Vigilon is the most suitable dressing for dermabrasion. The main advantage of dermabrasion over the chemical peel is the absence of severe depigmentation.

Central (third) fat pad of the upper eyelid

A clinical study on the surgical anatomy of the upper-eyelid fat pads was performed on 55 consecutive patients who underwent a blepharoplasty. It was confirmed that the periorbital fat is encapsulated in compartments and that the number of fat pads varies. In 56% of the cases there were two fat pads and in the 44% three fat pads in the upper eyelid. The third fat pad is anatomically and histologically an accessory medial extension of the lateral fat pad. However, for the sake of clarity, the term central fat pad of the upper eyelid is proposed as a denominator of this structure. The purpose of this article is to make the less experienced surgeons aware of variations in the configuration of the periorbital fat and to remind them that after two fat pads are removed from the upper eyelid there might still be a third.

Superiority of an antagonist of the luteinizing hormone releasing hormone with emphasis on arginine in position 8, named Argtide

In the research for more potent antagonists of the luteinizing hormone releasing hormone (LHRH), 13 new peptides with emphasis on arginine in position 8 were designed, synthesized and tested for anti-ovulatory activity (AOA). Two very potent analogs were achieved. N-Ac-D-3-Qal, D-pClPhe, D-3-Pal, Ser, cis-PzACA1a, D-PicLys, Leu, Arg, Pro, D-AlaNH2 showed 63% AOA at 0.125 microgram and 89% at 0.25 microgram, and an ED50 of 30.8 +/- 0.59 and presently may be the most promising antagonist reported. It is named Argtide. N-Ac-D-3-Qal, D-pClPhe, D-3-Pal, Ser, cis-PzACA1a, D-PicLys, Val, Arg, Pro, D-AlaNH2 showed 18% AOA at 0.125 microgram. Arg8 in antagonists may be significant for receptor binding.

Thrombin-inhibitory capacity of the injured vessel wall

The present study examined the appearance of thrombin activity in vitro after single and repeated in vivo balloon injury of the rabbit aorta. The in vitro ability of the injured vessel wall to bind and subsequently inhibit thrombin in the presence of defibrinogenated plasma was also assessed. Thrombin activity was assayed by measuring the levels of fibrinopeptide A generated in the presence of fibrinogen. These findings were correlated with the changes observed in light and electron microscopy. Thrombin activity on the vessel wall was increased five minutes and three hours after the initial and the repeated injury, and returned to control values one week after the initial injury. When the inhibition of thrombin was assayed in the presence of defibrinogenated plasma, a diminished inhibition capacity was observed after the repeated injury, which correlated with deposition of fibrin and an enhanced inflammatory reaction as measured by the density of granulocytes covering the injured neointima. Decreased thrombin inhibitory capacity of the injured neointima appears to be linked with its increased thrombogenicity.

Metabolic stability of the LHRH antagonist antide to cell-surface peptidases

The susceptibility to hydrolysis of LHRH and the decapeptide analogue Antide has been compared. The hydrolysis of LHRH by pig kidney brush border membranes is inhibited by phosphoramidon (I50 = 5.6 nM) implicating endopeptidase-24.11 in the initiation of hydrolysis. Under conditions in which LHRH is fully degraded by brush border membranes, Antide was completely resistant to hydrolysis. Similar results were obtained with purified preparations of both endopeptidase-24.11 and angiotensin converting enzyme. These data confirm that the remarkable duration of action of Antide is due principally to its stability to hydrolysis by cell-surface peptidases.

Increased potency of antagonists of substance P having asparagine in position 6

The general structure of antagonists of substance P (SP) which was found with the development of Spantide and analogs based on Spantide served for further refinement. The antagonistic potency was tested in vitro on guinea pig ileum and taenia coli. It was unexpectedly found that introduction of Asn6 gave rise to a considerable increase in potency. The exchange of Gln6 for Asn6 entails the shortening of the side chain by one CH2 unit and seems slight for steric advantages and potency increase. The analog [D-Arg1,D-Cl2Phe5,Asn6,D-Trp7,9,Nle11]SP had pA2 values of 7.4 (ileum) and 8.0 (taenia coli). We then used this sequence as a new lead to introduce new changes, which were made in positions 1, 3, 5, 7 and 9. It was found that Arg1 is important, but Lys3 can be exchanged. The Pal3 derivative had pA2 values of 8.1 and 8.0 and the Nle3 counterpart had 7.7 and 7.4 D-Cl2Phe is an effective substituent in position 5. D-Trp in positions 7 and 9 were superior to other alternatives.

Antide and related antagonists of luteinizing hormone release with long action and oral activity

Antide is the decapeptide N-Ac-D-Nal(2),D-Phe(pCl),D-Pal(3),Ser,Lys(Nic),D-Lys(Nic),Leu,Lys(iPr),P ro,D- Ala-NH2 [Nal(2) represents 3-(2-naphthyl)alanine; Phe(p-Cl) represents 3-(4-chlorophenyl)alanine; Pal(3) represents 3-(3-pyridyl)alanine; Lys(Nic) represents N epsilon-nicotinoyllysine; Lys-(iPr) represents N epsilon-isopropyllysine], which is an antagonist of luteinizing hormone-releasing hormone (LHRH), which has high antiovulatory activity, releases negligible histamine, and is scheduled for scale-up, safety testing, and evaluation in the experimental primate and in clinical medicine. Thirty-five more peptides were synthesized, designed on antide with variations in positions 5-8. Of these, N-Ac-D-Nal(2),D-Phe(pCl),D-Pal(3),Ser,Lys(Pic),cis-D- Ala(PzAC),Leu,Lys(iPr),Pro,D-Ala-NH2 [Lys(Pic) represents N epsilon-picoloyllysine; Ala(PzAC) represents 3-(4-pyrazinylcarbonylaminocyclohexyl)alanine] was not only the most potent but also had higher antiovulatory activity than antide--i.e., 73% per 0.25 microgram and 100% per 0.5 microgram vs. 36% per 0.5 microgram and 100% per 1.0 microgram. Antide showed significant (P less than 0.001) duration of action when injected at a dose of 10 micrograms 44 hr before injection of 50 ng of the agonist [D-Qal(3)6]LHRH [Qal(3) represents 3-(3-quinolyl)alanine]. Antide showed oral antiovulatory activity at 600 micrograms (73%) and at 1200 micrograms (100%) with negligible difference between water and corn oil oral formulations.

Blockade of sensory nerve mediated contraction of the rabbit iris sphincter by a series of novel tachykinin antagonists

Electrical stimulation of the isolated rabbit iris sphincter muscle in the presence of atropine gives rise to a contraction that can be blocked by tachykinin antagonists. The ability of a series of novel tachykinin antagonists to inhibit the contractile effect of SP on the guinea-pig taenia coli and to suppress the electrically evoked contraction of the atropinized rabbit iris sphincter was tested. Several of the novel antagonists were found to be more potent in terms of pA2 and pIC50 values than the two previously described analogs, [D-Pro2, D-Trp7,9]SP9(1-11) and [D-Arg1, D-Trp7,9, Leu11]SP-(1-11) (Spantide). Apart from D-Trp in positions 7 and 9 the characteristic features of the potent novel antagonists were D-Cl2Phe (or D-Cys(Bzl] in position 5, Asn in position 6 and Nle in position 11. In addition Pal in position 3 seemed to offer an enhanced potency.

Design, synthesis and bioassays of antagonists of LHRH which have high antiovulatory activity and release negligible histamine

Potent antagonists of the luteinizing hormone releasing hormone have been achieved which release negligible histamine. [N-Ac-D-2-Nal1, D-pClPhe2, D-3-Pal3, NicLys5, D-NicLys6, ILys8, D-Ala10]-LHRH showed 100%AOA/1 microgram and 36%/0. 5 micrograms; ED50 greater than 300. [N-Ac-D-2-Nal1,D-pClPhe2,D-3-Pal3, PicLys5, D-PicLys6, ILys8, D-Ala10]-LHRH showed 100% AOA/0.5 micrograms and 40%/0.25 micrograms; ED50, 93 +/- 11, and is the most potent of 52 new peptides. These antagonists feature designs with weakly basic acylated D-Lys6, notably D-NicLys6 and D-PicLys6 and alkylated Lys8 or Orn8, e.g., ILys8 and IOrn8, and NicLys5 and PicLys5. Concepts included balanced overall basicity, superiority of ILys8 and IOrn8 which are sequence dependent and sensitivity of positions 5 and 6 for potency.

Design and synthesis of antagonists of substance P

Synthesis and bioassay of about 65 analogs of substance P (SP) over five years yielded the antagonist [D-Arg1,D-Trp7,9,Leu11]-SP, which was named Spantide, and which was used by many investigators as a "tool". Spantide served as a reference antagonist for the design of 47 new peptides toward the goal of more potent inhibitors. Designs emphasized analogs with D-Trp7, D-Trp9, D-Trp10, D-pClPhe10, Nle11, Leu11, Ile11 and Met11, etc. Twenty-one/47 antagonists were superior in potency to that of Spantide, the best was [D-Arg1,D-Na1(5), D-Trp7,9,Nle11]-SP which required a 255-fold increase in SP concentration to give 50% of the maximum response at a concentration of 10(-5)M of the antagonist; this potency is ca. 5 times that of Spantide. For certain, but not all pairs of undecapeptides and truncated analogs, the undecapeptides may be significantly more potent than the truncated counterparts.