Identification of amides derived from 1H-pyrazolo[3,4-b]pyridine-5-carboxylic acid as potent inhibitors of human nicotinamide phosphoribosyltransferase (NAMPT)

Potent, 1H-pyrazolo[3,4-b]pyridine-containing inhibitors of the human nicotinamide phosphoribosyltransferase (NAMPT) enzyme were identified using structure-based design techniques. Many of these compounds exhibited nanomolar antiproliferation activities against human tumor lines in in vitro cell culture experiments, and a representative example (compound 26) demonstrated encouraging in vivo efficacy in a mouse xenograft tumor model derived from the A2780 cell line. This molecule also exhibited reduced rat retinal exposures relative to a previously studied imidazo-pyridine-containing NAMPT inhibitor. Somewhat surprisingly, compound 26 was only weakly active in vitro against mouse and monkey tumor cell lines even though it was a potent inhibitor of NAMPT enzymes derived from these species. The compound also exhibited only minimal effects on in vivo NAD levels in mice, and these changes were considerably less profound than those produced by an imidazo-pyridine-containing NAMPT inhibitor. The crystal structures of compound 26 and the corresponding PRPP-derived ribose adduct in complex with NAMPT were also obtained.

Structure-based discovery of novel amide-containing nicotinamide phosphoribosyltransferase (nampt) inhibitors

Crystal structures of several urea- and thiourea-derived compounds in complex with the nicotinamide phosphoribosyltransferase (Nampt) protein were utilized to design a potent amide-containing inhibitor bearing an aza-indole moiety (7, Nampt BC IC50 = 9.0 nM, A2780 cell proliferation IC50 = 10 nM). The Nampt-7 cocrystal structure was subsequently obtained and enabled the design of additional amide-containing inhibitors which incorporated various other fused 6,5-heterocyclic moieties and biaryl sulfone or sulfonamide motifs. Additional modifications of these molecules afforded many potent biaryl sulfone-containing Nampt inhibitors which also exhibited favorable in vitro ADME properties (microsomal and hepatocyte stability, MDCK permeability, plasma protein binding). An optimized compound (58) was a potent inhibitor of multiple cancer cell lines (IC50 <10 nM vs U251, HT1080, PC3, MiaPaCa2, and HCT116 lines), displayed acceptable mouse PK properties (F = 41%, CL = 52.4 mL/min/kg), and exhibited robust efficacy in a U251 mouse xenograft model.

Structure-based identification of ureas as novel nicotinamide phosphoribosyltransferase (Nampt) inhibitors

Nicotinamide phosphoribosyltransferase (Nampt) is a promising anticancer target. Virtual screening identified a thiourea analogue, compound 5, as a novel highly potent Nampt inhibitor. Guided by the cocrystal structure of 5, SAR exploration revealed that the corresponding urea compound 7 exhibited similar potency with an improved solubility profile. These studies also indicated that a 3-pyridyl group was the preferred substituent at one inhibitor terminus and also identified a urea moiety as the optimal linker to the remainder of the inhibitor structure. Further SAR optimization of the other inhibitor terminus ultimately yielded compound 50 as a urea-containing Nampt inhibitor which exhibited excellent biochemical and cellular potency (enzyme IC50 = 0.007 μM; A2780 IC50 = 0.032 μM). Compound 50 also showed excellent in vivo antitumor efficacy when dosed orally in an A2780 ovarian tumor xenograft model (TGI of 97% was observed on day 17).

Genetic testing in patients with acute coronary syndrome undergoing percutaneous coronary intervention: a cost-effectiveness analysis

BACKGROUND

The CYP2C19 genotype is a predictor of adverse cardiovascular events in acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI) treated with clopidogrel.

OBJECTIVES

We aimed to evaluate the cost-effectiveness of a CYP2C19*2 genotype-guided strategy of antiplatelet therapy in ACS patients undergoing PCI, compared with two 'no testing' strategies (empiric clopidogrel or prasugrel).

METHODS

We developed a Markov model to compare three strategies. The model captured adverse cardiovascular events and antiplatelet-related complications. Costs were expressed in 2010 US dollars and estimated using diagnosis-related group codes and Medicare reimbursement rates. The net wholesale price for prasugrel was estimated as $5.45 per day. A generic estimate for clopidogrel of $1.00 per day was used and genetic testing was assumed to cost $500.

RESULTS

Base case analyses demonstrated little difference between treatment strategies. The genetic testing-guided strategy yielded the most QALYs and was the least costly. Over 15 months, total costs were $18 lower with a gain of 0.004 QALY in the genotype-guided strategy compared with empiric clopidogrel, and $899 lower with a gain of 0.0005 QALY compared with empiric prasugrel. The strongest predictor of the preferred strategy was the relative risk of thrombotic events in carriers compared with wild-type individuals treated with clopidogrel. Above a 47% increased risk, a genotype-guided strategy was the dominant strategy. Above a clopidogrel cost of $3.96 per day, genetic testing was no longer dominant but remained cost-effective.

CONCLUSIONS

Among ACS patients undergoing PCI, a genotype-guided strategy yields similar outcomes to empiric approaches to treatment, but is marginally less costly and more effective.

OA01.11. Toxicity study and testicular regeneration property of swarna vanga

Purpose:

Method:

Result:

Conclusion:

The dominant functional nicotinic receptor in progenitor cells in the rostral migratory stream is the α3β4 subtype

Addition of newly generated neurons into mature neural circuits in the adult CNS responds to changes in neurotransmitter levels and is tightly coupled to the activity of specific brain regions. This postnatal neurogenesis contributes to plasticity of the olfactory bulb and hippocampus and is thought to play a role in learning and memory, context and odor discrimination, as well as perceptual learning. While acetylcholine plays an important role in odor discrimination and perceptual learning, its role in adult neurogenesis in the olfactory bulb has not been elucidated. In this study, I have examined the functional expression of nAChRs in progenitor cells of the rostral migratory stream (RMS) in the adult olfactory bulb of mice. I show that most of these cells in the RMS exhibit large nAChR-mediated calcium transients upon application of acetylcholine (ACh). Unlike in the hippocampus, the predominant functional nAChRs on progenitor cells are of α3β4 subtype. Interestingly, functional receptor expression is lost once progenitor cells mature, and are incorporated into the granule cell layer. Instead, nAChRs are now expressed on some presynaptic terminals and modulate glutamate release onto granule cells. My results imply that ACh is a part of the permissive niche and likely plays a role in development of progenitor cells.

Health-care seeking among people with cough of 2 weeks or more in India. Is passive TB case finding sufficient?

SETTING

Thirty districts of India.

OBJECTIVES

To estimate 1) the proportion of people with cough of ≥2 weeks, 2) those who did not seek care from a health care provider for cough, and 3) their characteristics.

METHODOLOGY

A cross-sectional community-based survey in which 4562 people (aged ≥18 years) were interviewed.

RESULTS

Of the 4562 individuals interviewed, 437 (9.5%, 95%CI 7.2-11.8) had cough ≥2 weeks; this was more frequent in those >55 years of age (14%) and in those from districts in eastern (12%) and northern (11%) states of India. Of those with cough, 300 (69%, 95%CI 60-77) had not sought care from any health care provider. Not seeking care was more frequent in people residing in rural areas (73%) compared with urban areas (53%), and in the districts of eastern (82%) and northern (74%) states compared to districts from the southern (46%) and western (54%) states.

CONCLUSIONS

Nearly a tenth of those interviewed aged ≥18 years had cough of ≥2 weeks. About two thirds, especially those from rural areas, had not visited a health care provider for the cough. This finding has huge implications for India's current mostly passive case-finding strategy for detecting and controlling tuberculosis.

Fractures of angle of mandible - A retrospective study

AIMS

This retrospective study was done to evaluate the efficacy of single miniplate osteosynthesis at superior border of angle of mandible.

MATERIAL AND METHODS

In this study 50 patients were treated by single miniplate osteosynthesis according to Champy's principle. Bite force generated was used as a parameter for judging the efficacy of internal fixation. In this article we present our experience over the years in the management of the fractures of angle of mandible based on this model.

RESULTS

Most patients were of 21-30 yrs of age with unilateral angle fracture of mandible except one patient who had isolated bilateral angle fracture. The patients were treated successfully according to Champy's principle of osteosynthesis. There was a progressive improvement in the bite force generated after osteosynthesis.

CONCLUSIONS

The angle of the mandible is an anatomically weak and an area susceptible to fracture. The presence of an impacted or partially erupted third molar tooth further weakens it. Angle of mandible is the most common site for fracture however, bilateral angle fracture is very rare and uncommon. Osteosynthesis according to Champy's model led to an early functional improvement as demonstrated by the bite force generated.

Carrier density dependence of the nonlinear absorption of intense THz radiation in GaAs

We study the carrier density dependence of nonlinear terahertz (THz) absorption due to field-induced intervalley scattering in photoexcited GaAs using the optical-pump/THz-probe technique. The intervalley scattering in GaAs is strongly dependent on the photo-carrier density. As the carrier density is increased from 1 × 10(17) to 4.7 × 10(17) cm(-3), the nonlinear absorption bleaching increases. However, if the carrier density is increased further above 4.7 × 10(17) cm(-3), the trend reverses and the bleaching is reduced. The initial increase in absorption bleaching is because, unlike low THz field, high THz field experiences intervalley scattering and nonparabolicity of the conduction band. On the other hand, a simple electron transport model shows that the reduction in intervalley scattering is mainly due to the increase in the electron-hole scattering rate with the increase in the carrier density. This increase in the electron-hole scattering rate limits the maximum kinetic energy attainable by the electrons and thus reduces the observed nonlinear absorption.

Ipsilateral shoulder and elbow dislocation: a case report

ABSTRACT

Simultaneous ipsilateral shoulder and elbow joint dislocation is a rare injury. In most reported cases, shoulder joint dislocation was missed and diagnosed at a later time. We present the case of a 30-year-old male who dislocated his ipsilateral shoulder and elbow joint following a motor vehicle accident. Keeping a high index of suspicion, radiographs of both joints were obtained. Under general anaesthesia, the elbow joint was reduced before the shoulder joint. In the final follow up after 1.5 years, the patient had returned to his occupation and enjoyed a full range of motion. The purpose of this report is to describe a very rare injury and to emphasise the importance of maintaining a high index of suspicion in such cases.

KEY WORDS

Dislocation, shoulder, elbow, ipsilateral.