Intranasal complications in women with osteoporosis under treatment with nasal calcitonin spray: case reports and review of the literature

Identification of a novel 'aggregation-prone'/'amyloidogenic determinant' peptide in the sequence of the highly amyloidogenic human calcitonin

Calcitonin is a 32-residue polypeptide hormone, which takes part in calcium metabolism in bones. It may form amyloid fibrils. Amyloid fibrils are related with serious diseases known as amyloidoses. The amyloid form of calcitonin takes part in medullary thyroid carcinoma. A novel hexapeptide ((6)TCMLGT(11)) of human calcitonin was predicted as a possible 'aggregation-prone' peptide, which may play a role in amyloid formation. We investigated experimentally the ability of an analog of this hexapeptide (cysteine replaced by alanine, TAMLGT) to form amyloid fibrils utilizing TEM, X-ray fiber diffraction, ATR FT-IR spectroscopy, and polarized light microscopy. This peptide self-assembles into amyloid-like fibrils and fibrillogenesis is mediated via nuclei of liquid crystalline nature, known as spherulites.

The role of intranasal estradiol spray in the management of moderate to severe vasomotor symptoms in menopausal women

Hormone therapy (HT) is the most effective treatment at present available for climacteric symptoms. As harmful effects were highlighted in recent randomized clinical trials, the risk-benefit ratio does not favor the use of HT for prevention of cardiovascular diseases and bone fractures in postmenopausal women. Nevertheless, experimental and clinical trials suggest that adverse effects of HT basically depend on the estrogen and progestin formulation, dosage, route of administration, patient's age, associated diseases, and duration of treatment. All estrogen formulations and routes of administration have comparable beneficial effects on vasomotor and urogenital symptoms and on bone structure. But adverse effects may differ. Thus, cardiovascular and invasive breast cancer risks are higher with oral estrogen than with transdermal estradiol. However, transdermal estradiol is not free of inconveniences such as differences among individuals in absorption rates, loss of patches due to poor adhesion, and skin irritation. HT requires careful adjustment to each individual patient and continuous monitoring of clinical evolution. In the future, this adjustment and maybe the use of alternative routes such as intranasal could benefit from genetic screening to maximize in each individual the ratio between positive and adverse effects of HT.