Effect of salicylate on the uptake of cefmetazole into brain of mice

Cefmetazole distribution into mice cerebral cortex was minimal when the drug was administered alone. However, the co-administration of salicylate or diethyl maleate enhanced cefmetazole uptake into the cerebral cortex, while it decreased the level of reduced nonprotein sulfhydryls in cerebral cortex. The enhanced cerebral uptake of cefmetazole was suppressed by the simultaneous administration of cysteamine with a concomitant recovery of the reduced nonprotein sulfhydryl concentration in cerebral cortex.

Potentiation of enteral absorption of human interferon alpha and selective transfer into lymphatics in rats

Enhancement of human leucocyte interferon (HuIFN-α) absorption from rat large intestine was studied with the aid of lipid, surfactant and lipid-surfactant mixed micelles. Neither the emulsified lipid (linoleic acid) nor the surfactant (HCO60, polyoxyethylated [60 moles] hydrogenated castor oil) alone were able to enhance the absorption of HuIFN-α. However, linoleic acid-HCO60 mixed micelles enhanced the absorption of HuIFN-α from the large intestine. Highly selective delivery of HuIFN-α into the lymphatics compared to the blood was also observed.

Enhanced selective lymphatic delivery of cyclosporin a by solubilizers and intensified immunosuppressive activity against mice skin allograft

The absorption and lymphatic delivery of a new immunosuppressive drug, cyclosporin A (CsA), were studied in rats by administering CsA orally after solubilization with HCO-60 (polyoxyethylated hydrogenated castor oil), sugar ester, and oils. After the administration of solubilized CsA (7 mg/kg) to rats with thoracic lymph duct cannulas, both plasma and lymph CsA levels were measured over 6 hr. The lymph CsA levels were strongly affected by the solubilizers. The rank order of the solubilizers in enhancing lymph absorption was HCO-60 (57 µg/ml) > sugar ester (46 µg/ml) > sesame oil (3.5 µg/ml) > linoleic acid (0.4 µg/ml), where the parentheses show the maximum lymph CsA levels. Plasma CsA levels were below 2 µg/ml in each group of animals and were barely altered by the solubilizers. These results support the selective lymphatic delivery of CsA with solubilizers such as HCO-60 and sugar ester. The immunosuppressive activity of CsA (1 mg/kg) solubilized with HCO-60 was nearly equivalent to the sesame oil solution with 7 to 15 mg/kg CsA in the skin-allograft mice model.

Switching tenofovir/emtricitabine plus lopinavir/r to raltegravir plus Darunavir/r in patients with suppressed viral load did not result in improvement of renal function but could sustain viral suppression: a randomized multicenter trial

Background

Whether tenofovir nephrotoxicity is reversible after its withdrawal is unknown. Furthermore, there are no data on the viral efficacy of raltegravir (RAL) plus ritonavir-boosted Darunavir (DRV/r) in patients with suppressed viral load.

Methods

This multicenter, randomized trial compared renal function and viral efficacy in patients with suppressed viral load treated with RAL+DRV/r and ritonavir-boosted lopinavir (LPV/r) plus tenofovir/emtricitabine (TVD), who had been previously on LPV/r+TVD. The primary endpoint was the proportion of patients with >10% improvement in estimated glomerular filtration rate (eGFR) at 48 weeks calculated with Cockcroft-Gault equation.

Results

58 randomized and treatment-exposed patients were analyzed (28 on RAL+DRV/r and 30 on LPV/r+TVD). Greater than 10% improvement in eGFR was noted in 6 (25%) out of 24 with RAL+DRV/r and 3 (11%) of 28 with LPV/r+TVD, and the difference was not statistically significant (p=0.272, 95% CI -0.067 to 0.354). Sensitivity analyses using three other equations for eGFR showed the same results. Urinary β2 microglobulin, a sensitive marker of tenofovir tubulopathy, significantly improved with RAL+DRV/r than with LPV/r+TVD (-271 versus -64 µg/gCr, p=0.026). Per protocol analysis showed that the HIV-RNA was <50 copies/mL at week 48 in all patients of both arms (24 in RAL+DRV and 29 in LPV/r+TVD).

Conclusions

Switching LPV/r+TVD to RAL+DRV/r did not significantly increase the proportion of patients who showed >10% improvement in renal function among those with relatively preserved eGFR. However, the switch improved urinary β2 microglobulin, suggesting that discontinuation of TDF might be beneficial in the long-term. RAL+DRV/r showed favorable viral efficacy in patients with suppressed viral load.

Trial Registration

ClinicalTrials.gov NCT01294761 http://clinicaltrials.gov/ct2/show/NCT01294761?term=SPARE&rank=2, Umin Clinical Trials Registry UMIN000005116 http://upload.umin.ac.jp/cgi-open-bin/ctr/ctr.cgi?function=brows&action=brows&type=summary&recptno=R000006083&language=J)

Improvements in smoothness of chewing cycles in adults with mandibular prognathism after surgery: a longitudinal study

Although adults with mandibular prognathism are known to show impaired smoothness of masticatory jaw movements, it remains uncertain whether/how the surgical-orthodontic treatment is effective to improve masticatory jaw movements. The aims of this study were (i) to verify whether the surgical-orthodontic treatment of patients with mandibular prognathism improve smoothness of the chewing jaw movements post-operatively and, if so, (ii) to examine whether the improved parameters show similar quantities as those of the control subjects. The chewing jaw movements for 13 patients with mandibular prognathism were recorded at pre- and post-treatment stages. The patient group was divided into two groups: Class III(closed) showed full occlusal contact at the habitual intercuspal position, whereas Class III(open) showed inability of occlusal contact between the upper and lower anterior teeth. The control group (CG) consisted of 52 subjects having acceptably good occlusion. The normalised jerk cost (NJC), movement duration and peak velocity in jaw closing were compared. For both Class III(open) and Class III(closed) groups, statistical comparisons revealed that the NJC and movement duration were decreased after the treatment, whereas the peak velocity was increased (all P < 0·01). For the Class III(open), these quantities at the post-treatment stage did not show any significant differences compared with those for the CG. It is concluded that the smoothness of chewing jaw movements for patient with mandibular prognathism were improved after treatment, and for the patients with anterior open bite at pre-treatment, the post-operatively achieved smoothness of jaw-closing movements did not differ from those of the CG.

Abacavir/lamivudine versus tenofovir/emtricitabine with atazanavir/ritonavir for treatment-naive Japanese patients with HIV-1 infection: a randomized multicenter trial

OBJECTIVE

To compare the efficacy and safety of fixed-dose abacavir/lamivudine (ABC/3TC) and tenofovir/emtricitabine (TDF/FTC) with ritonavir-boosted atazanavir (ATV/r) in treatment-naïve Japanese patients with HIV-1 infection.

METHODS

A 96-week multicenter, randomized, open-label, parallel group pilot study was conducted. The endpoints were times to virologic failure, safety event and regimen modification.

RESULTS

109 patients were enrolled and randomly allocated (54 patients received ABC/3TC and 55 patients received TDF/FTC). All randomized subjects were analyzed. The time to virologic failure was not significantly different between the two arms by 96 weeks (HR, 2.09; 95% CI, 0.72-6.13; p=0.178). Both regimens showed favorable viral efficacy, as in the intention-to-treat population, 72.2% (ABC/3TC) and 78.2% (TDF/FTC) of the patients had an HIV-1 viral load <50 copies/mL at 96 weeks. The time to the first grade 3 or 4 adverse event and the time to the first regimen modification were not significantly different between the two arms (adverse event: HR 0.66; 95% CI, 0.25-1.75, p=0.407) (regimen modification: HR 1.03; 95% CI, 0.33-3.19, p=0.964). Both regimens were also well-tolerated, as only 11.1% (ABC/3TC) and 10.9% (TDF/FTC) of the patients discontinued the allocated regimen by 96 weeks. Clinically suspected abacavir-associated hypersensitivity reactions occurred in only one (1.9%) patient in the ABC/3TC arm.

CONCLUSION

Although insufficiently powered to show non-inferiority of viral efficacy of ABC/3TC relative to TDF/FTC, this pilot trial suggested that ABC/3TC with ATV/r is a safe and efficacious initial regimen for HLA-B*5701-negative patients, such as the Japanese population.

Doxorubicin enhances transient expression of p-glycoprotein and modulates activity and isoform expression of protein-kinase-C in ah66 rat hepatoma-cells

Intracellular changes in enzyme activity and the isoform pattern of protein kinase C (PKC) during treatment with doxorubicin (DXR) were examined in a rat ascites hepatoma AH66 parental cell line (AH66P), which shows slight expression of P-glycoprotein (Pgp) on the cell membrane and is classified as an intrinsic multidrug-resistant cell. AH66P cells, treated for 10 days with DXR at the concentrations of 0.3 or 5.0 muM, exhibited moderate to severe inhibition of PKC activity after transient increase of the activity, which mainly was either Ca2+-independent and phospholipid-dependent or Ca2+-independent and phospholipid-independent. PKC isoform analysis of the treated cells also indicated the transient 1.5- and 1.8-fold increase of PKC-delta and PKC-zeta as well as slight increase of PKC-alpha in treatment with 0.3 muM DXR and 1.9- and 1.6-fold increase of PKC-alpha and PKC-zeta with slight increase of PKC-delta in treatment with 5.0 muM, respectively. A small, but interesting discrepancy between the markedly elevated enzyme activity, which was composed particularly of both cofactor-independent forms, and the relatively low levels of isoform expression, was found when the cells were treated with 5.0 muM DXR. It is of great interest that DXR-treatment, while only slight increasing P-glycoprotein (Pgp) phosphorylation, enhanced the transient expression of Pgp on the cell membrane with good correlation with the fluctuating change in PKC activity. These results indicate that the possible expression of some or novel specific isoform(s) of PKC may modulate and be associated with expression of the Pgp.

Characteristic changes in protein-kinase-C activity and isoforms in ah66 cells during the acquisition of multidrug-resistant phenotype

Changes in enzyme activity and the isoform pattern of protein kinase C (PKC) during the process of acquiring of drug resistance to doxorubicin (DXR) was examined in rat ascites hepatoma AH66 parental cells (AH66P) and several established clones of DXR-resistant AH66DR cells. In the weakly resistant cell line, AH66DR-0.3, which was resistant to DXR at the concentration of 0.3 mu M, reduced PKC activity and significantly decreased expression of its isoforms (alpha, delta and zeta) were observed. By contrast, AH66DR-30, the clone with the highest resistance, showed increased PKC activity, which was mainly either Ca2+-independent and phospholipid-dependent or Ca2+-independent and phospholipid-independent. PKC-isoform analysis of the AH66DR-30 cells disclosed high levels of PKC-delta and -zeta and a quite low level of PKC-alpha relative to that of the AH66P cells. In both cell lines, phosphorylation of P-glycoprotein (Pgp), which is known as a drug efflux pump, was induced by PKC not only with Ca2+-dependent, but also with Ca2+-independent reactions. These results indicate that the expression of one or more specific isoform(s) of PKC, particularly the Ca2+-independent type, may be necessary for expression as well as activation of the function of Pgp.

Stromal cells expressing hedgehog-interacting protein regulate the proliferation of myeloid neoplasms

Aberrant reactivation of hedgehog (Hh) signaling has been described in a wide variety of human cancers including cancer stem cells. However, involvement of the Hh-signaling system in the bone marrow (BM) microenvironment during the development of myeloid neoplasms is unknown. In this study, we assessed the expression of Hh-related genes in primary human CD34⁺ cells, CD34⁺ blastic cells and BM stromal cells. Both Indian Hh (Ihh) and its signal transducer, smoothened (SMO), were expressed in CD34⁺ acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS)-derived cells. However, Ihh expression was relatively low in BM stromal cells. Remarkably, expression of the intrinsic Hh-signaling inhibitor, human Hh-interacting protein (HHIP) in AML/MDS-derived stromal cells was markedly lower than in healthy donor-derived stromal cells. Moreover, HHIP expression levels in BM stromal cells highly correlated with their supporting activity for SMO⁺ leukemic cells. Knockdown of HHIP gene in stromal cells increased their supporting activity although control cells marginally supported SMO⁺ leukemic cell proliferation. The demethylating agent, 5-aza-2′-deoxycytidine rescued HHIP expression via demethylation of HHIP gene and reduced the leukemic cell-supporting activity of AML/MDS-derived stromal cells. This indicates that suppression of stromal HHIP could be associated with the proliferation of AML/MDS cells.

Improvement of Large Intestinal Absorption of Insulin by Chemical Modification with Palmitic Acid in Rats

The intestinal absorption of 125I-labelled palmitoyl insulin was examined following administration into in-situ closed large intestinal loops of rats. When mono- and dipalmitoyl insulins (Palins-1 and Palins-2, respectively) were administered in polyoxyethylene hydrogenated castor oil (HCO 60) micellar system into intestinal loops, a marked increase in plasma radioactivity and a corresponding disappearance of residual radioactivity in the intestinal lumen were observed in the following rank order: Palins-2 &gt; Palins-1 &gt; native insulin. In addition, the derivatives were more stable than native insulin in the mucosal tissue homogenates of the large intestine. These results suggest that chemical modification of insulin with palmitic acid may not only increase the lipophilicity of insulin but also reduce its degradation, resulting in the increased transfer of insulin across the large intestinal mucous membrane. The linoleic acid-HCO 60 mixed micelles system did not have a significant effect on the large intestinal absorption of radioactivity associated with the lipophilic insulin analogues.

Improvement of Intestinal Absorption of Thyrotropin-releasing Hormone by Chemical Modification with Lauric Acid

Intestinal absorption of 125I-labelled lauryl thyrotropin-releasing hormone (Lau-TRH), a novel lipophilic derivative of TRH, was examined by rat in-situ closed intestinal loops. At a dose of 1 μmol per rat into the small intestine, a significant increase in percent of dose in plasma radioactivity of Lau-TRH was observed in comparison with that of TRH. A dose-dependent decrease in percent of dose in plasma radioactivity of TRH was noted, suggesting a saturable process of TRH transport. In contrast, the percent of dose in plasma radioactivity of Lau-TRH increased with increasing dose of Lau-TRH. The stability of TRH and Lau-TRH was studied in plasma and rat small intestinal homogenates. Lau-TRH was more stable than TRH in rat plasma. These results suggest that chemical modification of TRH with lauric acid may not only increase the lipophilicity of TRH but also reduce the degradation of TRH, resulting in the increased plasma radioactivity of TRH. On the other hand, Lau-TRH was gradually converted to TRH in the intestinal mucosal homogenate. These findings indicate that chemical modification of TRH with lauric acid might be a useful approach for improving the intestinal absorption of this peptide.

Ursolic acid and oleanolic acid, members of pentacyclic triterpenoid acids, suppress TNF-α-induced E-selectin expression by cultured umbilical vein endothelial cells

E-selectin is an early response adhesion molecule expressed on the surface of endothelial cells during inflammatory responses. We examined the effects of two pentacyclic triterpenoid acids, ursolic acid (UA) and oleanolic acid (OA), on the expression of E-selectin by cultured human umbilical vein endothelial cells (HUVECs). Treatment of the cells with UA or OA alone did not influence expression of E-selectin. Expression of E-selectin mRNA and surface antigen by HUVECs was induced by treatment with tumor necrosis factor-α (TNF-α) in a dose- and time-dependent manner. TNF-α-induced up-regulation of E-selectin was abrogated by pre-treatment of the cells with UA or OA which decreased expression of E-selectin mRNA. The repression of E-selectin mRNA expression caused by the pentacyclic triterpenoid acids paralleled the inhibition of NF-κB activation and nuclear translocation, as evaluated by electrophoretic mobility shift assays, although the degree of repression by UA was approximately two times more effective than that of OA. The results suggest that UA and OA suppress the inflammatory cytokine-induced expression of E-selectin in endothelial cells by decreasing E-selectin transcription via inhibition of NF-κB activation. Thus, UA and OA function as anti-inflammatory agents. The differences in the inhibitory efficacy between UA and OA may be due to conformational differences in ring-E of the two pentacyclic triterpenoid acids.

Corticofugal direct projections to primary afferent neurons in the trigeminal mesencephalic nucleus of rats

Little is known about projections from the cerebral cortex to the trigeminal mesencephalic nucleus (Vmes) which contains the cell bodies of primary sensory afferents innervating masticatory muscle spindles and periodontal ligaments of the teeth. To address this issue, we employed retrograde (Fluorogold, FG) and anterograde (biotinylated dextranamine, BDA) tracing techniques in the rat. After injections of FG into the Vmes, a large number of neurons were retrogradely labeled in the prefrontal cortex including the medial agranular cortex, anterior cingulate cortex, prelimbic cortex, infralimbic cortex, deep peduncular cortex and insular cortex; the labeling was bilateral, but with an ipsilateral predominance to the injection site. Almost no FG-labeled neurons were found in the somatic sensorimotor cortex. After BDA injections into the prefrontal cortex, anterogradely labeled axon fibers and boutons were distributed bilaterally in a topographic pattern within the Vmes, but with an ipsilateral predominance to the injection site. The rostral Vmes received more preferential projections from the medial agranular cortex, while the deep peduncular cortex and insular cortex projected more preferentially to the caudal Vmes. Several BDA-labeled axonal boutons made close associations (possible synaptic contacts) with the cell bodies of Vmes neurons. The present results have revealed the direct projections from the prefrontal cortex to the primary sensory neurons in the Vmes and their unique features, suggesting that deep sensory inputs conveyed by the Vmes neurons from masticatory muscle spindles and periodontal ligaments are regulated with specific biological significance in terms of the descending control by the cerebral cortex.