99mTc tetrofosmin myocardial perfusion scintigraphy in CAD. Performance with early and standard delayed acquisition and fractional flow reserve

AIM

Early stress imaging (15 min after injection of the radiopharmaceutical) in 99mTc tetrofosmin myocardial perfusion scintigraphy (MPS) has been shown feasible in comparison to standard imaging after 45 minutes, but the effects on image quality and diagnostic accuracy ask for further evaluation.

PATIENTS, METHODS

97 patients (61 men, 36 women, age 69 ± 11 years) underwent both early (EA) and standard (SA) acquisition (after 14 ± 4 min and 43 ± 6 min, respectively) using 99mTc tetrofosmin gated SPECT with iterative reconstruction. Sub-diaphragmatic tracer activity and image quality was scored in a 4-point scale by blinded observers. Semiquantitative myocardial perfusion analysis was performed on a 17-segment model using standard cardiac quantification SPECT software (4 DM-SPECT). Stenoses of indeterminate haemodynamic significance were validated by measurement of fractional flow reserve (FFR).

RESULTS

Extra-cardiac tracer activity was more commonly found in EA (43%) than in SA (38%), but without any diagnostic impact in > 95% of the patients. The mean summed stress score was significantly higher for early than standard imaging (6.4 ± 6.3 vs. 5.6 ± 6.1, p = 0.009). The amount of ischaemic area was not significantly different (EA: 9.1 ± 6.7 % vs. SA: 7.8 ± 6.9 %). The mean stress ejection fraction was 52 ± 11% (EA) compared to 55 ± 11 % (SA) (p = ns). FFR was inversely related to SDS at early (r = -0.704, p < 0.05) and standard (r = -0.678, p < 0.05) acquisition. All patients with a FFR < 0.8 (considered as hemodynamically significant stenoses) revealed a positive scan.

CONCLUSION

Stress 99mTc tetrofosmin MPS with early acquisition is feasible and at least equally accurate when iterative reconstruction is applied.

Lack of renal protection of ultrafiltration during cardiac surgery: a randomized clinical trial

AIM

The objective of this study was to determine the intraoperative ultrafiltration effect on postoperative AKI.

METHODS

In this prospective randomized clinical trail, 159 patients scheduled for elective cardiac surgery, were randomly assigned to either hemofilter (N.=87) or control group (N.=72). The primary and secondary outcomes were AKI (defined as ≥50% increase in the serum creatinine level) and increased urinary neutrophil gelatinase-associated lipocalin (NGAL) in the postoperative period, respectively.

RESULTS

The two groups were similar with respect to comorbidities and also surgical procedure, except ultrafiltration. The incidence of AKI was equal in the both groups (11% vs. 5%, P=0.2, respectively). Creatinine increased after surgery (P=0.00) without significant differences between the both groups (P=0.2). Urinary NGAL also showed no significant difference between the groups. Age, euroscore, hyperlipidemia, pulmonary disease and urinary volume during operation correlated with the development of AKI. Postoperative blood loss was less in the hemofilter than control group (820±550 mL vs. 1100±630 mL, P=0.04). There was no difference in the length of intubation and stay in intensive care unit.

CONCLUSION

Routine use of ultrafiltration during cardiac surgery offers no advantages in renal protection and reduction of AKI incidence.

Analysis of reliability metrics and quality enhancement measures in current density imaging

Low frequency current density imaging (LFCDI) is a magnetic resonance imaging (MRI) technique which enables calculation of current pathways within the medium of study. The induced current produces a magnetic flux which presents itself in phase images obtained through MRI scanning. A class of LFCDI challenges arises from the subject rotation requirement, which calls for reliability analysis metrics and specific image registration techniques. In this study these challenges are formulated and in light of proposed discussions, the reliability analysis of calculation of current pathways in a designed phantom and a pig heart is presented. The current passed is measured with less than 5% error for phantom, using CDI method. It is shown that Gauss's law for magnetism can be treated as reliability metric in matching the images in two orientations. For the phantom and pig heart the usefulness of image registration for mitigation of rotation errors is demonstrated. The reliability metric provides a good representation of the degree of correspondence between images in two orientations for phantom and pig heart. In our CDI experiments this metric produced values of 95% and 26%, for phantom, and 88% and 75% for pig heart, for mismatch rotations of 0 and 20 degrees respectively.

Imaging of bone metastases in prostate cancer: an update

Assessing bone metastases is often beyond the scope of plain - film radiography, and nuclear imaging in particular with bone scintigraphy has proved the mainstay for detection of bony disease for over 40 years. Bone scanning with 99mTechnetium - labeled diphosphonates relies on the detection of pathological osteoblastic response elicited from malignant cells. This technique offers the advantage of whole body examination, low cost, availability and high sensitivity. However, it suffers from relative low specificity. The addition of single-photon emission computed tomography (SPECT) to bone scintigraphy has markedly improved the diagnostic benefit. Although the accuracy of SPECT is significantly higher than that of planar scintigraphy, there is still room for improvement of anatomic localization and morphological characterization, a limitation that has currently been mainly overcome with the upcoming of combined SPECT-CT (computed tomography). Positron emission tomography (PET), a modality with higher spatial resolution than that of SPECT can be particularly helpful in detecting small lesions. Moreover, PET imaging using various specific radiotracers has the advantage of detecting malignant disease in both bone and soft tissues. It is highly sensitive mainly in detecting early bone marrow as well as for diagnosing lytic bony metastases and can be also reliably used to monitor therapy response. In this review, we present the current role of SPECT and PET in the imaging of skeletal metastases from prostate cancer.

Fluorocholine (18F) and sodium fluoride (18F) PET/CT in the detection of prostate cancer: prospective comparison of diagnostic performance determined by masked reading

AIM

The aim of this paper was to compare the diagnostic performance of positron emission tomography/computed tomography (PET/CT) with fluorocholine (18F) (FCH) or fluoride(18F) (FNa) for the detection of bone metastasis in patients with prostate cancer complaining from osteoarticular pain, taking into account whether they were referred for initial staging or recurrence localization. The initial hypothesis was that FCH site-based specificity would be superior to that of F Na, with no loss in sensitivity.

METHODS

Forty-two patients were enrolled in this prospective study, underwent both PET/CTs and were then followed-up for at least 6 months. The standard of truth (SOT) about the presence/absence and location of bone metastasis could be determined in 40 patients, by 2 independent medical assessors, blinded to the results of both PET/CTs. The comparison was performed according to the guideline of the European Medicines Agency, i.e. based on the results of blind reading with SOT as reference.

RESULTS

Bone extension was present in 22 patients and absent in 18. Patient-based performance for FCH vs. FNa was 91% vs. 91% for sensitivity, 89% vs. 83% for specificity and 90% vs. 88% for accuracy (no significant difference). Of 360 skeletal sites, 68 were malignant and 292 non-invaded. There was no significant difference in site-based performance in the group of patients referred at initial staging, but in the group of patients referred for suspicion of recurrence, FCH was significantly more specific than FNa (96% vs. 91%, P=0.033 with Obuchowski's correction) while sensitivity was the same, 89%.

CONCLUSION

Both radiopharmaceuticals, based on a very different metabolic approach, showed good diagnostic performance. If FCH is available, it should be preferred in patients after initial treatment.

Radicular cyst associated with a primary first molar: A case report

Radicular cysts arising from deciduous teeth are rare. This report presents a case of radicular cyst associated with a primary molar following pulp therapy and discusses the relationship between pulp therapy and the rapid growth of the cyst. The treatment consisted of enucleation of the cyst sac and extraction of the involved primary teeth and 20 months follow up of the patient. Early diagnosis of the lesion would have lead to a less aggressive treatment plan.

Prevalence of dyspepsia and its correlation with demographic factors and lifestyle in shiraz, southern iran

BACKGROUND Dyspepsia is a common disorder that can present many clinical dilemmas in patient management. Although not life-threatening, the symptoms are long-lasting, interfere with daily activities and have a significant impact upon quality of life. The aim of this study was to determine prevalence of dyspepsia and its relationship with demographic and socioeconomic factors, and lifestyle in an apparently healthy population in Shiraz, southern Iran. METHODS In a population-based study, 1978 subjects aged 35 years or older were interviewed from April to September 2004. A questionnaire consisting of demographic factors, lifestyle data and gastrointestinal symptoms was completed for each participant. The validity and reliability of the questionnaire were determined. RESULTS The prevalence of dyspepsia was 29.9%. The dyspeptic patients were classified as having ulcer-like (27.9%), dysmotility-like (26.2%) or unspecified dyspepsia (45.9%). The prevalence was higher in females, water-pipe smokers, NSAIDs users, and in those with psychological distress, recurrent headache, anxiety, nightmares and past history of gastrointestinal disease. Dyspepsia had an inverse relationship with consumption of pickles, fruits and vegetables, and with duration of meal ingestion. Subjects with dyspepsia symptoms were more likely to restrict their diet, take herbal medicine, use over-the-counter drugs, consult with physicians and consume medication advised by their friends. CONCLUSION This study reveals that dyspepsia has a high prevalence in Shiraz, southern Iran and is associated with several demographic factors, lifestyle and health-seeking behavior.

Posttherapeutic (131)I SPECT-CT offers high diagnostic accuracy when the findings on conventional planar imaging are inconclusive and allows a tailored patient treatment regimen

PURPOSE

The purpose of this prospective study was to determine the diagnostic impact and influence on patient treatment of posttherapeutic (131)I SPECT-CT when the findings on planar posttherapeutic whole-body scintigraphy (ptWBS) were inconclusive.

MATERIALS AND METHODS

A total of 53 SPECT-CT scans were performed in 41 patients with thyroid cancer after high-dose (131)I therapy (2.944 to 7.526 GBq (131)I) because of diagnostic uncertainty on ptWBS. Physiological uptake in the salivary glands, gastric mucosa, gut, nasal mucosa, urinary tract and liver were considered to be normal. Any other foci of increased (131)I uptake, except iodine uptake clearly located in the thyroid bed, were considered to be abnormal. The data were evaluated on a lesion and a patient basis.

RESULTS

Regarding neck lesions, SPECT-CT provided a diagnostic impact in 26/90 lesions (28.9%) and confirmed the diagnosis in 64/90 lesions (71.1%). On a patient basis, SPECT-CT changed N status in 12/33 patients (36.4%), provided a diagnostic impact in 21/33 patients (63.6%) and led to a treatment change in 8/33 patients (24.2%). Regarding lesions distant from the neck, SPECT-CT confirmed the diagnosis in 62/71 lesions (87.3%) and had a diagnostic impact in 9/71 lesions (12.7%). On a patient basis, SPECT-CT changed M status in 4/19 patients (21.1%), had a diagnostic impact in 14/19 patients (73.7%) and led to a treatment change in 2/19 patients (10.5%). Considering all patients, SPECT-CT led to a treatment change in 10/41 patients (24.4%).

CONCLUSION

Integrated SPECT-CT is a useful tool, especially in cases of diagnostic uncertainty and helps to individualize patient management.

FDG gamma camera PET equipped with one inch crystal and XCT. Assessment of myocardial viability

Metabolic imaging with 2-[fluorine-18]-fluoro-2-deoxy-D-glucose (FDG) is actually considered as the best method to detect and quantitatively assess myocardial tissue viability. The aim of this study was to investigate the accuracy of FDG gamma camera positron emission tomography (GCPET) imaging equipped with one inch NaI crystals in comparison to FDG dedicated PET (dPET) imaging as a "gold standard" in phantom and clinical studies.

PATIENTS, METHODS

Nineteen patients with coronary artery disease (CAD) underwent both imaging modalities. Phantom and clinical GCPET imaging were performed with a dual-headed, coincidence based gamma camera equipped with 1 inch thick NaI crystals and an x-ray tube (XCT) for attenuation correction (AC), as well as with a dedicated PET scanner with AC. (99m)Tc tetrofosmin single-photon emission tomography (SPET) studies were performed for assessment of myocardial perfusion, with AC.

RESULTS

Phantom studies showed a significant relation in segmental activity between FDG imaging with AC using GCPET and dPET (r = 0.91, p < 0.001). In clinical studies with AC correlation coefficients of mean segmental FDG uptake and regional defect size were r = 0.87 (p < 0.0001) and r = 0.83 (p < 0.0001), respectively. In regional analysis close agreement was even found in the most attenuated regions of the heart if AC was used in GCPET imaging. The overall agreement for detection of viable myocardium was 81% between FDG-dPET (AC) and FDG-GCPET (AC) and 74% between FDG-dPET (AC) and FDG-GCPET (NC).

CONCLUSION

This study suggests that the assessment of myocardial metabolism by means of FDG is feasible with a coincidence based gamma camera equipped with 1 inch thick NaI crystals if AC is performed. The results reveal a close concordance and agreement between FDG-dPET (AC) and FDG-GCPET (AC) as compared to FDG-GCPET (NC).

FDG gamma camera PET equipped with one inch crystal and XCT

Metabolic imaging with 2-[fluorine-18]-fluoro- 2-deoxy-D-glucose (FDG) is actually considered as the best method to detect and quantitatively assess myocardial tissue viability. The aim of this study was to investigate the accuracy of FDG gamma camera positron emission tomography (GCPET) imaging equipped with one inch NaI crystals in comparison to FDG dedicated PET (dPET) imaging as a „gold standard“ in phantom and clinical studies. Patients, methods: Nineteen patients with coronary artery disease (CAD) underwent both imaging modalities. Phantom and clinical GCPET imaging were performed with a dual-headed, coincidence based gamma camera equipped with 1 inch thick NaI crystals and an x-ray tube (XCT) for attenuation correction (AC), as well as with a dedicated PET scanner with AC. 99mTc tetrofosmin single-photon emission tomography (SPET) studies were performed for assessment of myocardial perfusion, with AC. Results: Phantom studies showed a significant relation in segmental activity between FDG imaging with AC using GCPET and dPET (r = 0.91, p <0.001). In clinical studies with AC correlation coefficients of mean segmental FDG uptake and regional defect size were r = 0.87 (p <0.0001) and r = 0.83 (p <0.0001), respectively. In regional analysis close agreement was even found in the most attenuated regions of the heart if AC was used in GCPET imaging. The overall agreement for detection of viable myocardium was 81% between FDG-dPET (AC) and FDG-GCPET (AC) and 74% between FDG-dPET (AC) and FDG-GCPET (NC). Conclusion: This study suggests that the assessment of myocardial metabolism by means of FDG is feasible with a coincidence based gamma camera equipped with 1 inch thick NaI crystals if AC is performed. The results reveal a close concordance and agreement between FDG-dPET (AC) and FDG-GCPET (AC) as compared to FDG-GCPET (NC).

Value of combined XCT/SPECT technology for avoiding false positive planar (123)I-MIBG scintigraphy

AIM

The clinical value of combined XCT/SPECT technology in a single device in patients undergoing (123)I-MIBG scintigraphy was analyzed.

METHODS

31 patients (19 men, 12 women; mean age 55 years, range: 31-79 years) demonstrating focal accumulation in planar (123)I-MIBG scan were further investigated with a double headed gamma camera with an X-ray tomograph mounted on the same gantry (GE Medical Systems, Millennium VG with Hawkeye, Milwaukee, USA) for anatomical definition of the focal (123)I-MIBG uptake. The patients were referred to (123)I-MIBG scintigraphy because of biochemically (81%) and/or clinically (19%) suspected pheochromocytoma.

RESULTS

In 23 out of 31 patients (74%) the fused images demonstrated physiological accumulation (i. e. intestinal, renal) of (123)I-MIBG. In two patients (6%) suspected adrenal MIBG-accumulation was caused by inhomogeneous liver uptake. In two patients (6%) focal abdominal accumulation was correctly localised in the adrenal glands. Furthermore, the differentiation of bone metastasis from a local recurrence for phaeochromocytoma was accurately possible for two patients (6%). Adrenal lesions mimicking liver foci were correctly localised in the remaining two patients (6%).

CONCLUSION

Our study demonstrates the clinical value of XCT/SPECT in a single device in patients demonstrating focal (123)I-MIBG uptake in planar scintigraphy. The combined XCT/SPECT technology provides a higher diagnostic accuracy.

Iodine-123-vascular endothelial growth factor-165 (123I-VEGF165). Biodistribution, safety and radiation dosimetry in patients with pancreatic carcinoma

AIM

Imaging with radiolabelled vascular endothelial growth factor (VEGF) has been developed for the localisation and diagnosis of a variety of human solid tumors including gastrointestinal tumors.

METHODS

In this study we investigated the biodistribution, safety and absorbed dose of iodine-123 radiolabelled VEGF(165) ((123)I-VEGF(165)) in 9 patients with pancreatic carcinoma. Following intravenous administration of (123)I-VEGF(165) (189+/-17 MBq; <130 pmole (<5 microg) VEGF(165) per patient), sequential images were recorded during the initial 30 min PI. Serial whole-body images were acquired in anterior and posterior views at various time points. All patients underwent single-photon emission tomography (SPET) imaging. Dosimetry calculations were performed on the basis of gamma camera data. Estimates of radiation absorbed dose were calculated using the MIRDOSE 3 program.

RESULTS

The highest absorbed organ doses were found to be thyroid (0.058+/-0.004 mGy/MBq), spleen (0.046+/- 0.017 mGy/MBq), urinary bladder (0.04+/-0.02 mGy/MBq), lungs (0.034+/-0.009 mGy/MBq) and kidneys (0.033+/-0.005 mGy/MBq). The effective dose was estimated to be 0.017+/-0.002 mSv/MBq. A majority of primary pancreatic tumors and their metastases were visualized by (123)I-VEGF(165) scan.

CONCLUSION

In vitro binding results confirmed specific binding of (123)I-VEGF(165) to pancreatic tumor cells and tissues. (123)I-VEGF(165) shows favorable dosimetry and is a safe radiopharmaceutical that may be of potential value for the imaging of VEGF receptor status in vivo.

Oral fluoroquinolone therapy results in drug adsorption on ureteral stents and prevention of biofilm formation

The oral administration of ciprofloxacin (250mg bid) and ofloxacin (300mg bid) in 40 patients with ureteral stents, led to drug levels on all the device surfaces that were higher than the minimum inhibitory concentration (MIC) of Escherichia coli (0.004--0.015 mg/l), the most common uropathogen. The drug levels in the film were higher than the MIC of other common pathogens, namely Pseudomonas aeruginosa (0.25--1.0 mg/l), Enterococcus faecalis (0.25--2.0 mg/l) and Staphylococcus aureus (0.12--0.5 mg/l) in a few cases (six, three and 14 cases out of 40, respectively). For both antibiotics, the concentrations were greater than the MIC of many uropathogens on the film surrounding the devices (0.89 vs 0.31 mg/l respectively, P=0.05), and on the devices themselves (0.22 vs. 0.12 mg/l, P=0.207). Adsorption of the antibiotics was higher to the film than to the stent (P<0.0001). Ciprofloxacin concentration on the film surrounding the stents was significantly higher than that of ofloxacin (P=0.05), while there was no statistical concentration difference between the two antibiotics adsorbed onto the actual devices (P=0.207). No bacteria were found in patients' urine and no biofilms were detected. This is the first report of an oral antibiotic being adsorbed onto medical devices. It potentially provides a new approach of preventing infection, and avoids the need to pre-coat devices with agents whose use will be restricted once bacteria develop resistance to them. If biomaterial properties can be enhanced to increase further the adsorptive concentration of drug, the risk of infections and recalcitrant biofilm formation could be significantly reduced in a highly susceptible patient population.

N-(3-Acyloxy-2-benzylpropyl)-N'-(4-hydroxy-3-methoxybenzyl) thiourea derivatives as potent vanilloid receptor agonists and analgesics

A series of N-(3-acyloxy-2-benzylpropyl)-N'-(4-hydroxy-3-methoxybenzyl) thiourea derivatives were investigated as vanilloid receptor ligands in an effort to discover a novel class of analgesics. The proposed pharmacophore model of resiniferatoxin. which includes the C20 homovanillic moiety, the C3-carbonyl and the orthoester phenyl ring as key pharmacophoric groups, was utilized as a guide for drug design. The compounds were synthesized after several steps from diethylmalonate and evaluated in vitro in a receptor binding assay and in a capsaicin-activated channel assay. Additional evaluation of analgesic activity, anti-inflammatory activity and pungency was conducted in animal models by the writhing test, the ear edema assay, and the eye-wiping test, respectively. Among the new compounds, 23 and 28 were found to be the most potent receptor agonists of the series with Ki values of 19 nM and 11 nM, respectively. Their strong in vitro potencies were also reflected by an excellent analgesic profile in animal tests with ED50 values of 0.5 microg kg for 23 and 1.0 microg/kg for 28. Relative to capsaicin these compounds appear to be ca. 600 and 300 times more potent. Both 23 and 28 were found to be less pungent than capsaicin based on the eye-wiping test. However, the compounds did not show significant anti-inflammatory activity. A molecular modeling study comparing the energy-minimized structures of resiniferatoxin and 35 demonstrated a good correlation in the spatial disposition of the corresponding key pharmacophores. The thioureas described in this investigation, which were designed as simplified resiniferatoxin surrogates, represent a novel class of potent vanilloid receptor agonists endowed with potent analgesic activity and reduced pungency.

Effect of a tyrosine 155 to phenylalanine mutation of protein kinase cdelta on the proliferative and tumorigenic properties of NIH 3T3 fibroblasts

Tyrosine phosphorylation has emerged as an important mechanism in the regulation of enzyme function. In this paper, we describe a mutant of PKCdelta altered at a single tyrosine residue which has the opposite effect compared with wild-type PKCdelta on the growth characteristics of NIH 3T3 cells. Overexpression of wild-type PKCdelta results in a decreased growth rate and a lower cell density at confluency. On the other hand, overexpression of PKCdelta with a mutation from tyrosine to phenylalanine at position 155 results in a significantly higher rate of growth and a higher density at confluency compared with vector controls. Moreover, these cells are able to grow in soft agar and to form tumors in nude mice. In contrast to kinase negative PKC constructs, this mutant maintains in vitro kinase activity and shows a subcellular localization and a translocation pattern that are similar to those of the wild-type PKCdelta. Whether the altered biological effect is due to the missing phosphorylation on tyrosine or the mutation from tyrosine to phenylalanine per se remains under investigation.

The guanine nucleotide exchange factor RasGRP is a high -affinity target for diacylglycerol and phorbol esters

RasGRP is a recently described guanine nucleotide exchange factor (GEF) that possesses a single C1 domain homologous to that of protein kinase C (PKC). The phorbol ester [(3)H]phorbol 12, 13-dibutyrate ([(3)H]PDBu) bound to this C1 domain (C1-RasGRP) with a dissociation constant of 0.58 +/- 0.08 nM, similar to that observed previously for PKC. Likewise, the potent PKC activator bryostatin 1, a compound currently in clinical trials, showed high affinity binding for C1-RasGRP. Structure activity analysis using several phorbol ester analogs showed both similarities and differences in ligand selectivity compared with PKC; the differences were comparable in magnitude to those between different PKC isoforms. Similarly, the potency of the PKC inhibitor calphostin C to inhibit [(3)H]PDBu binding to C1-RasGRP was similar to that observed for PKC. In contrast to the relative similarities in ligand recognition, the lipid cofactor requirements differed between RasGRP and PKC. The C1 domain plus the EF-hand motif of RasGRP (C1EF-RasGRP) was markedly less dependent on acidic phospholipids than was PKCalpha. The differences in lipid requirements were reflected in differential ligand selectivity under conditions of limiting lipid. Despite the presence of twin EF-hand like motifs, calcium did not affect the binding of [(3)H]PDBu to C1EF-RasGRP. We conclude that RasGRP is a high affinity receptor for phorbol esters and diacylglycerol. RasGRP thus provides a direct link between diacylglycerol generation or phorbol ester/bryostatin treatment and Ras activation.

Differential roles of the tandem C1 domains of protein kinase C delta in the biphasic down-regulation induced by bryostatin 1

Bryostatin 1 (Bryo), currently in clinical trials, has been shown to induce a biphasic concentration-response curve for down-regulating protein kinase C (PKC) delta, with protection of the enzyme from down-regulation at high Bryo doses. In our ongoing studies to identify the basis for this unique behavior of PKCdelta, we examined the participation of the two ligand binding sites (C1a and C1b) in the regulatory domain of the enzyme. Three mutants of PKCdelta prepared by introducing a point mutation in either C1a or Clb or both C1a and Clb were overexpressed in NIH 3T3 cells. All of the constructs retained a biphasic response to down-regulation assessed after 24-h treatment with Bryo. However, the roles of the individual C1 domains were different for the two phases of the response. For down-regulation, both the C1a and the C1b mutants displayed equivalent 3-4-fold reductions in their affinities for the ligand. For protection from down-regulation, a reduced protection was observed for the C1a mutant, which showed a broader biphasic curve compared with those for wild-type PKCdelta and the Clb mutant. Like wild-type PKCdelta, all of the mutants showed the same subcellular partitioning of the protected enzyme to the particulate fraction of the cells, arguing against changes in sensitivity to Bryo due to differences in localization. Likewise, relatively similar patterns of localization were observed using green fluorescent protein-PKCdelta constructs. We conclude that the C1 domains of PKCdelta do not have equivalent roles in inducing protection against Bryo-induced down-regulation. The C1a domain plays a critical role in conferring the degree of protection at high concentrations of Bryo. Elucidation of the differential effect of Bryo on PKCdelta may suggest strategies for the design of novel ligands with Bryo-like activities.

3-Acyloxy-2-phenalkylpropyl amides and esters of homovanillic acid as novel vanilloid receptor agonists

A series of 3-acyloxy-2-phenalkylpropyl amides and esters of homovanillic acid were designed and synthesized as vanilloid receptor agonists containing the three principal pharmacophores of resiniferatoxin. Amide analogues 23, 5 and 11 were found to be potent agonists in vanilloid receptor assay both for ligand binding and for activation.

Conformationally constrained analogues of diacylglycerol (DAG). 15. The indispensable role of the sn-1 and sn-2 carbonyls in the binding of DAG-lactones to protein kinase C (PK-C)

The binding mode of DAG-lactones to PK-C was investigated using the C1b domain from the X-ray structure of the phorbol ester/C1b complex of PK-C delta as a template. Modeling experiments revealed two binding alternatives in which one of the carbonyls of the DAG lactones remained uninvolved with the protein. Experimentally, however, the removal of either sn-1 or sn-2 carbonyls caused a dramatic drop in binding affinity towards PK-C. Although it was not possible to discriminate between the two binding alternatives of the DAG-lactones, the study demonstrates an important role for the additional carbonyl group. The function of this group could be equivalent to that of the C-9(OH)/C-13 (C = O) motif in phorbol esters, which also appears free of interactions in the phorbol ester/C1b complex. This role presumably reflects interaction with the phosholipid head groups required for high affinity binding under the conditions of the biological assays.