1
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Kukla DA, Belair DG, Stresser DM. Evaluation and Optimization of a Microcavity Plate-Based Human Hepatocyte Spheroid Model for Predicting Clearance of Slowly Metabolized Drug Candidates. Drug Metab Dispos 2024; 52:797-812. [PMID: 38777596 DOI: 10.1124/dmd.124.001653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 05/13/2024] [Accepted: 05/14/2024] [Indexed: 05/25/2024] Open
Abstract
In vitro clearance assays are routinely conducted in drug discovery to predict in vivo clearance, but low metabolic turnover compounds are often difficult to evaluate. Hepatocyte spheroids can be cultured for days, achieving higher drug turnover, but have been hindered by limitations on cell number per well. Corning Elplasia microcavity 96-well microplates enable the culture of 79 hepatocyte spheroids per well. In this study, microcavity spheroid properties (size, hepatocyte function, longevity, culturing techniques) were assessed and optimized for clearance assays, which were then compared with microsomes, hepatocyte suspensions, two-dimensional-plated hepatocytes, and macrowell spheroids cultured as one per well. Higher enzyme activity coupled with greater hepatocyte concentrations in microcavity spheroids enabled measurable turnover of all 17 test compounds, unlike the other models that exhibited less drug turnover. Microcavity spheroids also predicted intrinsic clearance (CLint) and blood clearance (CLb) within threefold for 53% [9/17; average absolute fold error (AAFE), 3.9] and 82% (14/17; AAFE, 2.6) of compounds using a linear regression correction model, respectively. An alternate method incorporating mechanistic modeling that accounts for mass transport (permeability and diffusion) within spheroids demonstrated improved predictivity for CLint (12/17; AAFE, 4.0) and CLb (14/17; AAFE, 2.1) without the need for empirical scaling factors. The estimated fraction of drug metabolized by cytochrome P450 3A4 (fm,CYP3A4) using 3 μM itraconazole was within 25% of observed values for 6 of 8 compounds, with 5 of 8 compounds within 10%. In sum, spheroid cultures in microcavity plates permit the ability to test and predict clearance as well as fm,CYP3A4 of low metabolic turnover compounds and represent a valuable complement to conventional in vitro clearance assays. SIGNIFICANCE STATEMENT: Culturing multiple spheroids in ultralow attachment microcavities permits accurate quantitation of metabolically stable compounds in substrate depletion assays, overcoming limitations with singly cultured spheroids. In turn, this permits robust estimates of intrinsic clearance, which is improved with the consideration of mass transport within the spheroid. Incubations with 3 μM itraconazole enabled assessments of CYP3A4 involvement in hepatic clearance.
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Affiliation(s)
- David A Kukla
- Quantitative, Translational, and ADME Sciences, AbbVie Inc., North Chicago, Illinois
| | - David G Belair
- Quantitative, Translational, and ADME Sciences, AbbVie Inc., North Chicago, Illinois
| | - David M Stresser
- Quantitative, Translational, and ADME Sciences, AbbVie Inc., North Chicago, Illinois
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2
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Bollinger A, Jeiziner C, Meyer Zu Schwabedissen HE, Hersberger KE, Allemann SS, Stäuble CK. Severe systemic adverse reactions to ophthalmic timolol in a CYP2D6 homozygous *4 allele carrier: a case report. Pharmacogenomics 2023; 24:739-746. [PMID: 37712172 DOI: 10.2217/pgs-2023-0122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/16/2023] Open
Abstract
A woman with ocular hypertension suffered from severe bradycardia, hypotension and syncope attacks in temporal relation with ophthalmic timolol application. Topically applied timolol is nasally absorbed and has been shown to reach potentially relevant systemic concentrations. Timolol is mainly metabolized by CYP2D6, which exhibits interindividual metabolic capacity due to genetic variations. A reactive pharmacogenetic panel test identified the patient as a CYP2D6 homozygous *4 allele carrier, which has been associated with a poor metabolizer phenotype and lacking enzyme activity. Thus, the adverse drug reactions possibly resulted from increased systemic timolol exposure. This case report highlights that pharmacogenetic panel testing can contribute to safe and effective pharmacotherapy, even for topically applied drugs.
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Affiliation(s)
- Anna Bollinger
- Department of Pharmaceutical Sciences, University of Basel, 4056, Basel, Switzerland
| | - Chiara Jeiziner
- Department of Pharmaceutical Sciences, University of Basel, 4056, Basel, Switzerland
| | | | - Kurt E Hersberger
- Department of Pharmaceutical Sciences, University of Basel, 4056, Basel, Switzerland
| | - Samuel S Allemann
- Department of Pharmaceutical Sciences, University of Basel, 4056, Basel, Switzerland
| | - Céline K Stäuble
- Department of Pharmaceutical Sciences, University of Basel, 4056, Basel, Switzerland
- Institute of Hospital Pharmacy, Solothurner Spitäler AG, 4600, Olten, Switzerland
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3
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Kovács-Valasek A, Rák T, Pöstyéni E, Csutak A, Gábriel R. Three Major Causes of Metabolic Retinal Degenerations and Three Ways to Avoid Them. Int J Mol Sci 2023; 24:ijms24108728. [PMID: 37240082 DOI: 10.3390/ijms24108728] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 05/10/2023] [Accepted: 05/11/2023] [Indexed: 05/28/2023] Open
Abstract
An imbalance of homeostasis in the retina leads to neuron loss and this eventually results in a deterioration of vision. If the stress threshold is exceeded, different protective/survival mechanisms are activated. Numerous key molecular actors contribute to prevalent metabolically induced retinal diseases-the three major challenges are age-related alterations, diabetic retinopathy and glaucoma. These diseases have complex dysregulation of glucose-, lipid-, amino acid or purine metabolism. In this review, we summarize current knowledge on possible ways of preventing or circumventing retinal degeneration by available methods. We intend to provide a unified background, common prevention and treatment rationale for these disorders and identify the mechanisms through which these actions protect the retina. We suggest a role for herbal medicines, internal neuroprotective substances and synthetic drugs targeting four processes: parainflammation and/or glial cell activation, ischemia and related reactive oxygen species and vascular endothelial growth factor accumulation, apoptosis and/or autophagy of nerve cells and an elevation of ocular perfusion pressure and/or intraocular pressure. We conclude that in order to achieve substantial preventive or therapeutic effects, at least two of the mentioned pathways should be targeted synergistically. A repositioning of some drugs is considered to use them for the cure of the other related conditions.
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Affiliation(s)
- Andrea Kovács-Valasek
- Department of Experimental Zoology and Neurobiology, University of Pécs, Ifjúság útja 6, 7624 Pécs, Hungary
| | - Tibor Rák
- Department of Ophthalmology, Medical School, University of Pécs, Szigeti út 12, 7624 Pécs, Hungary
| | - Etelka Pöstyéni
- Department of Experimental Zoology and Neurobiology, University of Pécs, Ifjúság útja 6, 7624 Pécs, Hungary
| | - Adrienne Csutak
- Department of Ophthalmology, Medical School, University of Pécs, Szigeti út 12, 7624 Pécs, Hungary
| | - Robert Gábriel
- Department of Experimental Zoology and Neurobiology, University of Pécs, Ifjúság útja 6, 7624 Pécs, Hungary
- János Szentágothai Research Centre, University of Pécs, Ifjúság útja 20, 7624 Pécs, Hungary
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4
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Andorfer KEC, Zeman F, Koller M, Zeller J, Fischer R, Seebauer CT, Vielsmeier V, Bohr C, Kühnel TS. TIMolol Nasal Spray as a Treatment for Epistaxis in Hereditary Hemorrhagic Telangiectasia (TIM-HHT)—A Prospective, Randomized, Double-Blind, Controlled, Cross-Over Trial. Pharmaceutics 2022; 14:pharmaceutics14112335. [PMID: 36365152 PMCID: PMC9692661 DOI: 10.3390/pharmaceutics14112335] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 10/25/2022] [Accepted: 10/27/2022] [Indexed: 12/03/2022] Open
Abstract
To date, there is no approved local therapeutic agent for the treatment of epistaxis due to hereditary hemorrhagic telangiectasia (HHT). Several case reports suggest the topical use of timolol. This monocentric, prospective, randomized, placebo-controlled, double-blinded, cross-over study investigated whether the effectiveness of the standard treatment with a pulsed diode laser can be increased by also using timolol nasal spray. The primary outcome was severity of epistaxis after three months, while the main secondary outcome was severity of epistaxis and subjective satisfaction after one month. Twenty patients were allocated and treated, of which 18 patients completed both 3-month treatment sequences. Timolol was well tolerated by all patients. Epistaxis Severity Score after three months, the primary outcome measure, showed a beneficial, but statistically nonsignificant (p = 0.084), effect of additional timolol application. Epistaxis Severity Score (p = 0.010) and patients’ satisfaction with their nosebleeds after one month (p = 0.050) showed statistically significant benefits. This placebo-controlled, randomized trial provides some evidence that timolol nasal spray positively impacts epistaxis severity and subjective satisfaction in HHT patients when additively applied to standard laser therapy after one month. However, the effect of timolol was observed to diminish over time. Trials with larger sample sizes are warranted to confirm these findings.
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Affiliation(s)
- Kornelia E. C. Andorfer
- Department of Otorhinolaryngology, University Hospital Regensburg, Franz-Josef-Strauss-Allee 11, D-93053 Regensburg, Germany
- Correspondence: ; Tel.: +49-941-944-9410
| | - Florian Zeman
- Center for Clinical Studies, University Hospital Regensburg, Franz-Josef-Strauss-Allee 11, D-93053 Regensburg, Germany
| | - Michael Koller
- Center for Clinical Studies, University Hospital Regensburg, Franz-Josef-Strauss-Allee 11, D-93053 Regensburg, Germany
| | - Judith Zeller
- Department of Internal Medicine II, University Hospital Regensburg, Franz-Josef-Strauss-Allee 11, D-93053 Regensburg, Germany
| | - René Fischer
- Department of Otorhinolaryngology, University Hospital Regensburg, Franz-Josef-Strauss-Allee 11, D-93053 Regensburg, Germany
| | - Caroline T. Seebauer
- Department of Otorhinolaryngology, University Hospital Regensburg, Franz-Josef-Strauss-Allee 11, D-93053 Regensburg, Germany
| | - Veronika Vielsmeier
- Department of Otorhinolaryngology, University Hospital Regensburg, Franz-Josef-Strauss-Allee 11, D-93053 Regensburg, Germany
| | - Christopher Bohr
- Department of Otorhinolaryngology, University Hospital Regensburg, Franz-Josef-Strauss-Allee 11, D-93053 Regensburg, Germany
| | - Thomas S. Kühnel
- Department of Otorhinolaryngology, University Hospital Regensburg, Franz-Josef-Strauss-Allee 11, D-93053 Regensburg, Germany
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5
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Silva-Alarcon S, Valencia C, Newball L, Saldarriaga W, Castillo A. Molecular Variants in Genes related to the Response to Ocular Hypotensive Drugs in an Afro-Colombian Population. Open Ophthalmol J 2022. [DOI: 10.2174/18743641-v16-e2205250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Aims:
This study aimed to conduct an exploratory analysis of the pharmacogenomic variants involved in ocular hypotensive drugs to understand the individual differential response in an Afro-descendant population.
Background:
Glaucoma is the leading cause of irreversible blindness worldwide. The pharmacologic treatment available consists of lowering intraocular pressure by administering topical drugs. In Asian and Caucasian people, pharmacogenomic variants associated with the efficacy of these treatments have been identified. However, in Afro-descendant populations, there is a profound gap in this knowledge.
Objective:
This study identified the pharmacogenomic variants related to ocular hypotensive efficacy treatment in Afro-descendant individuals from the Archipelago of San Andres and Providence, Colombia.
Methods:
An analysis of whole-exome sequencings (WES), functional annotation, and clinical significance was performed for pharmacogenomic variants reported in PharmGKB databases; in turn, an in silico available prediction analysis was carried out for the novel variants.
Results:
We identified six out of 18 non-synonymous variants with a clinical annotation in PharmGKB. Five were classified as level three evidence for the hypotensive drugs; rs1801252 and rs1801253 in the ADRB1 gene and rs1042714 in the ADRB2 gene. These pharmacogenomic variants have been involved in a lack of efficacy of topical beta-blockers and higher systolic and diastolic pressure under treatment with ophthalmic timolol drug. The rs1045642 in the ABCB1 gene was associated with greater efficacy of treatments with latanoprost drug. Also, we found the haplotypes *17 for CYP2D6 and *10 for CYP2C19; both related to reducing the enzyme activity to timolol drug metabolization. In addition, we observed 50 novel potentially actionable variants; 36 synonymous, two insertion variants that caused frameshift mutations, and 12 non-synonymous, where five were predicted to be pathogenic based on several pathogenicity predictions.
Conclusion:
Our results suggested that the pharmacogenomic variants were found to decrease the ocular hypotensive efficacy treatment in a Colombian Afro-descendant population and revealed a significant proportion of novel variants with a potential to influence drug response.
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6
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Lopez-Campos JL, Almagro P, Gómez JT, Chiner E, Palacios L, Hernández C, Navarro MD, Molina J, Rigau D, Soler-Cataluña JJ, Calle M, Cosío BG, Casanova C, Miravitlles M. Spanish COPD Guideline (GesEPOC) Update: Comorbidities, Self-Management and Palliative Care. Arch Bronconeumol 2022; 58:334-344. [PMID: 35315327 DOI: 10.1016/j.arbres.2021.08.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 08/09/2021] [Accepted: 08/09/2021] [Indexed: 12/20/2022]
Abstract
The current health care models described in GesEPOC indicate the best way to make a correct diagnosis, the categorization of patients, the appropriate selection of the therapeutic strategy and the management and prevention of exacerbations. In addition, COPD involves several aspects that are crucial in an integrated approach to the health care of these patients. The evaluation of comorbidities in COPD patients represents a healthcare challenge. As part of a comprehensive assessment, the presence of comorbidities related to the clinical presentation, to some diagnostic technique or to some COPD-related treatments should be studied. Likewise, interventions on healthy lifestyle habits, adherence to complex treatments, developing skills to recognize the signs and symptoms of exacerbation, knowing what to do to prevent them and treat them within the framework of a self-management plan are also necessary. Finally, palliative care is one of the pillars in the comprehensive treatment of the COPD patient, seeking to prevent or treat the symptoms of a disease, the side effects of treatment, and the physical, psychological and social problems of patients and their caregivers. Therefore, the main objective of this palliative care is not to prolong life expectancy, but to improve its quality. This chapter of GesEPOC 2021 presents an update on the most important comorbidities, self-management strategies, and palliative care in COPD, and includes a recommendation on the use of opioids for the treatment of refractory dyspnea in COPD.
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Affiliation(s)
- José Luis Lopez-Campos
- Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío, Universidad de Sevilla, Sevilla, España; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, España.
| | - Pere Almagro
- Servicio de Medicina Interna, Hospital Universitario Mutua de Tarrasa, Tarrasa, Barcelona, España
| | | | - Eusebi Chiner
- Servicio de Neumología, Hospital Universitario San Juan de Alicante, Alicante, España
| | - Leopoldo Palacios
- Unidad de Gestión Clínica El Torrejón, Distrito Sanitario Huelva-Costa y Condado-Campiña, Huelva, España
| | - Carme Hernández
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, España; Dispositivo transversal hospitalización a domicilio, Dirección Médica y Enfermera, Hospital Clínic, Universidad de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, España
| | | | - Jesús Molina
- Centro de Salud Francia, Dirección Asistencial Oeste, Fuenlabrada, Madrid, España
| | - David Rigau
- Centro Cochrane Iberoamericano, Barcelona, España
| | | | - Myriam Calle
- Servicio de Neumología, Hospital Clínico San Carlos, Departamento de Medicina, Facultad de Medicina, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, España
| | - Borja G Cosío
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, España; Servicio de Neumología, Hospital Universitario Son Espases-IdISBa, Palma de Mallorca, Baleares, España
| | - Ciro Casanova
- Unidad de Investigación, Servicio de Neumología, Hospital Universitario de La Candelaria, Universidad de La Laguna, Santa Cruz de Tenerife, Tenerife, España
| | - Marc Miravitlles
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, España; Servicio de Neumología, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, España
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7
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Lopez-Campos JL, Almagro P, Gómez JT, Chiner E, Palacios L, Hernández C, Navarro MD, Molina J, Rigau D, Soler-Cataluña JJ, Calle M, Cosío BG, Casanova C, Miravitlles M. [Translated article] Spanish COPD Guideline (GesEPOC) Update: Comorbidities, Self-Management and Palliative Care. ARCHIVOS DE BRONCONEUMOLOGÍA 2022. [DOI: 10.1016/j.arbres.2021.08.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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8
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Yang HY, Fierro F, Yoon DJ, Gallegos A, Osborn SL, Nguyen AV, Peavy TR, Ferrier W, Talken L, Ma BW, Galang KG, Medina Lopez A, Fregoso DR, Stewart H, Kurzrock EA, Soulika AM, Nolta JA, Isseroff RR. Combination product of dermal matrix, preconditioned human mesenchymal stem cells and timolol promotes wound healing in the porcine wound model. J Biomed Mater Res B Appl Biomater 2022; 110:1615-1623. [PMID: 35099112 DOI: 10.1002/jbm.b.35022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 12/13/2021] [Indexed: 01/13/2023]
Abstract
A combination product of human mesenchymal stem/stromal cells (MSCs) embedded in an extracellular matrix scaffold and preconditioned with hypoxia and the beta-adrenergic receptor antagonist, timolol, combined with sustained timolol application post implantation, has shown promising results for improving wound healing in a diabetic mouse model. In the present study, we extend those findings to the more translatable large animal porcine wound model and show that the combined treatment promotes wound reepithelialization in these excisional wounds by 40.2% and increases the CD31 immunostaining marker of angiogenesis compared with the matrix control, while maintaining an accumulated timolol plasma concentration below the clinically safe level of 0.3 ng/mL after the 15-day course of topical application. Human GAPDH was not elevated in the day 15 wounds treated with MSC-containing device relative to wounds treated with matrix alone, indicating that the xenografted human MSCs in the treatment do not persist in these immune-competent animals after 15 days. The work demonstrates the efficacy and safety of the combined treatment for improving healing in the clinically relevant porcine wound model.
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Affiliation(s)
- Hsin-Ya Yang
- Department of Dermatology, School of Medicine, University of California Davis Health System, Sacramento, California, USA
| | - Fernando Fierro
- Department of Cell Biology and Human Anatomy, University of California Davis Health System, Sacramento, California, USA.,Stem Cell Program, Department of Internal Medicine, University of California Davis Health System, Sacramento, California, USA
| | - Daniel J Yoon
- Department of Dermatology, School of Medicine, University of California Davis Health System, Sacramento, California, USA
| | - Anthony Gallegos
- Department of Dermatology, School of Medicine, University of California Davis Health System, Sacramento, California, USA
| | - Stephanie L Osborn
- Stem Cell Program, Department of Internal Medicine, University of California Davis Health System, Sacramento, California, USA.,Department of Urologic Surgery, School of Medicine, University of California Davis Health System, Sacramento, California, USA
| | - Alan V Nguyen
- Department of Dermatology, School of Medicine, University of California Davis Health System, Sacramento, California, USA.,Institute for Pediatric Regenerative Medicine, Shriners Hospital for Children Northern California, Sacramento, California, USA
| | - Thomas R Peavy
- Department of Biological Sciences, California State University, Sacramento, Sacramento, California, USA
| | - William Ferrier
- Large Animal Survival Surgery Facility, Stem Cell Program, University of California Davis Health System, Sacramento, California, USA
| | - Linda Talken
- Large Animal Survival Surgery Facility, Stem Cell Program, University of California Davis Health System, Sacramento, California, USA
| | - Betty W Ma
- Campus Veterinary Services Clinic, Office of Research, University of California, Davis, Davis, California, USA
| | - Kristopher G Galang
- Campus Veterinary Services Clinic, Office of Research, University of California, Davis, Davis, California, USA.,Residency Program in Laboratory Animal/Primate Medicine, School of Veterinary Medicine, University of California, Davis, Davis, California, USA
| | - Andrea Medina Lopez
- Department of Dermatology, School of Medicine, University of California Davis Health System, Sacramento, California, USA
| | - Daniel R Fregoso
- Department of Dermatology, School of Medicine, University of California Davis Health System, Sacramento, California, USA
| | - Heather Stewart
- Stem Cell Program, Department of Internal Medicine, University of California Davis Health System, Sacramento, California, USA
| | - Eric A Kurzrock
- Stem Cell Program, Department of Internal Medicine, University of California Davis Health System, Sacramento, California, USA.,Department of Urologic Surgery, School of Medicine, University of California Davis Health System, Sacramento, California, USA
| | - Athena M Soulika
- Department of Dermatology, School of Medicine, University of California Davis Health System, Sacramento, California, USA.,Institute for Pediatric Regenerative Medicine, Shriners Hospital for Children Northern California, Sacramento, California, USA
| | - Jan A Nolta
- Stem Cell Program, Department of Internal Medicine, University of California Davis Health System, Sacramento, California, USA
| | - R Rivkah Isseroff
- Department of Dermatology, School of Medicine, University of California Davis Health System, Sacramento, California, USA.,Dermatology Section, VA Northern California Health Care System, Mather, California, USA
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9
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Wang H, Masselos K, Kalloniatis M, Phu J. Headaches related to latanoprost in open-angle glaucoma. Clin Exp Optom 2021; 104:625-633. [PMID: 33689660 DOI: 10.1080/08164622.2021.1878846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Clinical relevance: The existing notion that topical latanoprost can lead to symptoms of headaches by reporting three cases of headache symptoms that developed following instillation of latanoprost prescribed as first-line therapy for newly diagnosed primary open-angle glaucoma (POAG) is explored in this case series.Background: Prostaglandin analogues (PGAs) are often used as first-line treatment in the treatment of POAG. An uncommon and infrequently reported side effect of PGAs is headaches.Methods: A retrospective review of patient records was conducted on patients seen at the Centre for Eye Health between April 2016 and August 2017. Clinical findings, including outcomes following interventions such a punctal occlusion, as well as the proposed pharmacological mechanism underlying this phenomenon are presented and discussed.Results: Case 1 is a 62-year-old Caucasian male diagnosed with POAG and prescribed latanoprost in both eyes. At the follow-up visit, he reported waking up in with a dull throbbing headache following instillation of the eye drops the night before. Case 2 is a 58-year-old Asian male with POAG prescribed latanoprost to both eyes. Within a week, he developed symptoms of recurrent progressively worsening headaches post-instillation which persisted into the morning. Case 3 is a 75-year-old Caucasian male with POAG prescribed latanoprost for both eyes. He developed latanoprost sensitivity as well as headache symptoms associated with the eye drops which resolved followed its cessation. All patients reported initial symptoms of headaches associated with latanoprost use however the headaches were not persistent with intermittent punctal occlusion (cases 1 and 2) or intra-class drug rechallenge (case 3).Conclusion: Although there may be a yet-undiscovered link between a headache response and latanoprost, these cases call to question the pharmacological relationship between latanoprost and headache symptoms. A systemic approach to critically examine the pathophysiological link between pharmacological therapy and potential adverse effects is proposed.
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Affiliation(s)
- Henrietta Wang
- Centre for Eye Health, University of New South Wales, Kensington, NSW, Australia.,School of Optometry and Vision Science, University of New South Wales, Kensington, NSW, Australia
| | - Katherine Masselos
- Centre for Eye Health, University of New South Wales, Kensington, NSW, Australia.,Ophthalmology Department, Prince of Wales Hospital, Randwick, NSW, Australia
| | - Michael Kalloniatis
- Centre for Eye Health, University of New South Wales, Kensington, NSW, Australia.,School of Optometry and Vision Science, University of New South Wales, Kensington, NSW, Australia
| | - Jack Phu
- Centre for Eye Health, University of New South Wales, Kensington, NSW, Australia.,School of Optometry and Vision Science, University of New South Wales, Kensington, NSW, Australia
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10
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Hammid A, Fallon JK, Lassila T, Salluce G, Smith PC, Tolonen A, Sauer A, Urtti A, Honkakoski P. Carboxylesterase Activities and Protein Expression in Rabbit and Pig Ocular Tissues. Mol Pharm 2021; 18:1305-1316. [PMID: 33595329 PMCID: PMC8023712 DOI: 10.1021/acs.molpharmaceut.0c01154] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Hydrolytic reactions constitute an important pathway of drug metabolism and a significant route of prodrug activation. Many ophthalmic drugs and prodrugs contain ester groups that greatly enhance their permeation across several hydrophobic barriers in the eye before the drugs are either metabolized or released, respectively, via hydrolysis. Thus, the development of ophthalmic drug therapy requires the thorough profiling of substrate specificities, activities, and expression levels of ocular esterases. However, such information is scant in the literature, especially for preclinical species often used in ophthalmology such as rabbits and pigs. Therefore, our aim was to generate systematic information on the activity and expression of carboxylesterases (CESs) and arylacetamide deacetylase (AADAC) in seven ocular tissue homogenates from these two species. The hydrolytic activities were measured using a generic esterase substrate (4-nitrophenyl acetate) and, in the absence of validated substrates for rabbit and pig enzymes, with selective substrates established for human CES1, CES2, and AADAC (d-luciferin methyl ester, fluorescein diacetate, procaine, and phenacetin). Kinetics and inhibition studies were conducted using these substrates and, again due to a lack of validated rabbit and pig CES inhibitors, with known inhibitors for the human enzymes. Protein expression levels were measured using quantitative targeted proteomics. Rabbit ocular tissues showed significant variability in the expression of CES1 (higher in cornea, lower in conjunctiva) and CES2 (higher in conjunctiva, lower in cornea) and a poor correlation of CES expression with hydrolytic activities. In contrast, pig tissues appear to express only CES1, and CES3 and AADAC seem to be either low or absent, respectively, in both species. The current study revealed remarkable species and tissue differences in ocular hydrolytic enzymes that can be taken into account in the design of esterase-dependent prodrugs and drug conjugates, the evaluation of ocular effects of systemic drugs, and in translational and toxicity studies.
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Affiliation(s)
- Anam Hammid
- School of Pharmacy, University of Eastern Finland, Yliopistonranta 1 C, 70210 Kuopio, Finland
| | - John K Fallon
- Division of Pharmacoengineering and Molecular Pharmaceutics, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Campus Box 7355, Chapel Hill, North Carolina 27599-7355, United States
| | | | - Giulia Salluce
- Centro Singular de Investigación en Química Biolóxica e Materiais Moleculares (CiQUS), Departamento de Química Orgánica, Universidade de Santiago de Compostela, 15782 Santiago de Compostela, Spain
| | - Philip C Smith
- Division of Pharmacoengineering and Molecular Pharmaceutics, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Campus Box 7355, Chapel Hill, North Carolina 27599-7355, United States
| | - Ari Tolonen
- Admescope Ltd, Typpitie 1, 90620 Oulu, Finland
| | - Achim Sauer
- Department of Drug Discovery Sciences, Boehringer Ingelheim Pharma GmbH & Co. KG, 88397 Biberach, Germany
| | - Arto Urtti
- School of Pharmacy, University of Eastern Finland, Yliopistonranta 1 C, 70210 Kuopio, Finland.,Institute of Chemistry, Saint Petersburg State University, Universitetskii pr. 26, 198584 Saint Petersburg, Russia.,Faculty of Pharmacy, University of Helsinki, Viikinkaari 5 E, 00790 Helsinki, Finland
| | - Paavo Honkakoski
- School of Pharmacy, University of Eastern Finland, Yliopistonranta 1 C, 70210 Kuopio, Finland.,Division of Pharmacotherapy and Experimental Therapeutics, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Campus Box 7569, Chapel Hill, North Carolina 27599-7569, United States
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Mirzaev K, Abdullaev S, Akmalova K, Sozaeva J, Grishina E, Shuev G, Bolieva L, Sozaeva M, Zhuchkova S, Gimaldinova N, Sidukova E, Serebrova S, Asoskova A, Shein A, Poptsova M, Suleymanov S, Burashnikova I, Shikaleva A, Kachanova A, Fedorinov D, Sychev D. Interethnic differences in the prevalence of main cardiovascular pharmacogenetic biomarkers. Pharmacogenomics 2020; 21:677-694. [DOI: 10.2217/pgs-2020-0005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Background: The aim of this study was to determine the prevalence of CYP2C9, VKORC1, CYP2C19, ABCB1, CYP2D6 and SLCO1B1 genes polymorphisms among residents of the Volga region (Chuvash and Mari) and northern Caucasus (Kabardins and Ossetians). Materials & methods: The study involved 845 apparently healthy volunteers of both sexes of the four different ethnic groups living in the Russian Federation: 238 from the Chuvash ethnic group, 206 Mari, 157 Kabardins and 244 Ossetians. Results: Significant differences were identified in allele frequency of CYP2C9, VKORC1, CYP2C19, ABCB1, CYP2D6 and SLCO1B1 genes polymorphisms between the Chuvash and Kabardins, Chuvash and Ossetians, Mari and Kabardians, Mari and Ossetians.
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Affiliation(s)
- Karin Mirzaev
- Federal State Budgetary Educational Institution of Further Professional Education “Russian Medical Academy of Continuous Professional Education” of The Ministry of Healthcare of The Russian Federation, Barrikadnaya Str., 2/1, Bldg. 1, Moscow, 125993, Russian Federation
| | - Sherzod Abdullaev
- Federal State Budgetary Educational Institution of Further Professional Education “Russian Medical Academy of Continuous Professional Education” of The Ministry of Healthcare of The Russian Federation, Barrikadnaya Str., 2/1, Bldg. 1, Moscow, 125993, Russian Federation
| | - Kristina Akmalova
- Federal State Budgetary Educational Institution of Further Professional Education “Russian Medical Academy of Continuous Professional Education” of The Ministry of Healthcare of The Russian Federation, Barrikadnaya Str., 2/1, Bldg. 1, Moscow, 125993, Russian Federation
| | - Jeannette Sozaeva
- Federal State Budgetary Educational Institution of Further Professional Education “Russian Medical Academy of Continuous Professional Education” of The Ministry of Healthcare of The Russian Federation, Barrikadnaya Str., 2/1, Bldg. 1, Moscow, 125993, Russian Federation
| | - Elena Grishina
- Federal State Budgetary Educational Institution of Further Professional Education “Russian Medical Academy of Continuous Professional Education” of The Ministry of Healthcare of The Russian Federation, Barrikadnaya Str., 2/1, Bldg. 1, Moscow, 125993, Russian Federation
| | - Gregory Shuev
- Federal State Budgetary Educational Institution of Further Professional Education “Russian Medical Academy of Continuous Professional Education” of The Ministry of Healthcare of The Russian Federation, Barrikadnaya Str., 2/1, Bldg. 1, Moscow, 125993, Russian Federation
| | - Laura Bolieva
- Federal State Budgetary Educational Institution of Higher Education “North Ossetia State Medical Academy” of The Ministry of Healthcare of the Russian Federation, Pushkinskaya Str., 40, Vladikavkaz, Republic of North Ossetia–Alania, 362019, Russian Federation
| | - Mariam Sozaeva
- State Budgetary Healthcare Institution “Republican Clinical Hospital” of The Ministry of Healthcare of The Russian Federation, Nogmova Str., 91, Nalchik, Kabardino–Balkarian Republic, 360003, Russian Federation
| | - Svetlana Zhuchkova
- Autonomous Institution “Republican Clinical Oncology Center” of the Ministry of Health of The Chuvash Republic, Gladkov Str., 31, Cheboksary, Chuvash Republic, 428020, Russian Federation
| | - Natalya Gimaldinova
- Federal State Budgetary Educational Institution of Higher Education “I. N. Ulianov Chuvash State University”, Moskovskiy Pr., 15, Cheboksary, Chuvash Republic, 428015, Russian Federation
| | - Elena Sidukova
- State Budgetary Institution of The Republic of Mari El ‘Kozmodemyansk interdistrict hospital”, 3rd microdistrict, 25, Kozmodemyansk, Republic of Mari El, 425350, Russian Federation
| | - Svetlana Serebrova
- Department of Clinical Pharmacology & Propaedeutic of Internal Diseases of The Faculty of General Medicine of Sechenov First Moscow State Medical University of The Ministry of Health of The Russian Federation, Trubetskaya Str., 8, bld., Moscow, 2119991, Russian Federation
| | - Anastasia Asoskova
- Federal State Budgetary Educational Institution of Further Professional Education “Russian Medical Academy of Continuous Professional Education” of The Ministry of Healthcare of The Russian Federation, Barrikadnaya Str., 2/1, Bldg. 1, Moscow, 125993, Russian Federation
| | - Alexander Shein
- Laboratory of Bioinformatics, Big Data & Information Retrieval School, Faculty of Computer Science, National Research University Higher School of Economics, 3 Kochnovsky Proezd, Moscow, 109028, Russian Federation
| | - Maria Poptsova
- Laboratory of Bioinformatics, Big Data & Information Retrieval School, Faculty of Computer Science, National Research University Higher School of Economics, 3 Kochnovsky Proezd, Moscow, 109028, Russian Federation
| | - Salavat Suleymanov
- Russian–Japanese Medical Center “SAIKO”, Komsomolskaya St., 104, Khabarovsk, Khabarovsk Territory, 680000, Russian Federation
| | - Irina Burashnikova
- Kazan State Medical Academy, Kazan State Medical University, Mushtari st., 11, Kazan, Republic of Tatarstan, 420012, Russian Federation
| | - Anastasia Shikaleva
- Kazan State Medical Academy, Kazan State Medical University, Mushtari st., 11, Kazan, Republic of Tatarstan, 420012, Russian Federation
| | - Anastasia Kachanova
- Federal State Budgetary Educational Institution of Further Professional Education “Russian Medical Academy of Continuous Professional Education” of The Ministry of Healthcare of The Russian Federation, Barrikadnaya Str., 2/1, Bldg. 1, Moscow, 125993, Russian Federation
| | - Denis Fedorinov
- Federal State Budgetary Educational Institution of Further Professional Education “Russian Medical Academy of Continuous Professional Education” of The Ministry of Healthcare of The Russian Federation, Barrikadnaya Str., 2/1, Bldg. 1, Moscow, 125993, Russian Federation
| | - Dmitry Sychev
- Federal State Budgetary Educational Institution of Further Professional Education “Russian Medical Academy of Continuous Professional Education” of The Ministry of Healthcare of The Russian Federation, Barrikadnaya Str., 2/1, Bldg. 1, Moscow, 125993, Russian Federation
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12
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Albiñana V, Cuesta AM, de Rojas-P I, Gallardo-Vara E, Recio-Poveda L, Bernabéu C, Botella LM. Review of Pharmacological Strategies with Repurposed Drugs for Hereditary Hemorrhagic Telangiectasia Related Bleeding. J Clin Med 2020; 9:E1766. [PMID: 32517280 PMCID: PMC7356836 DOI: 10.3390/jcm9061766] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 05/28/2020] [Accepted: 06/03/2020] [Indexed: 12/18/2022] Open
Abstract
The diagnosis of hereditary hemorrhagic telangiectasia (HHT) is based on the Curaçao criteria: epistaxis, telangiectases, arteriovenous malformations in internal organs, and family history. Genetically speaking, more than 90% of HHT patients show mutations in ENG or ACVRL1/ALK1 genes, both belonging to the TGF-β/BMP9 signaling pathway. Despite clear knowledge of the symptoms and genes of the disease, we still lack a definite cure for HHT, having just palliative measures and pharmacological trials. Among the former, two strategies are: intervention at "ground zero" to minimize by iron and blood transfusions in order to counteract anemia. Among the later, along the last 15 years, three different strategies have been tested: (1) To favor coagulation with antifibrinolytic agents (tranexamic acid); (2) to increase transcription of ENG and ALK1 with specific estrogen-receptor modulators (bazedoxifene or raloxifene), antioxidants (N-acetylcysteine, resveratrol), or immunosuppressants (tacrolimus); and (3) to impair the abnormal angiogenic process with antibodies (bevacizumab) or blocking drugs like etamsylate, and propranolol. This manuscript reviews the main strategies and sums up the clinical trials developed with drugs alleviating HHT.
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Affiliation(s)
- Virginia Albiñana
- Centro de Investigaciones Biológicas Margarita Salas, Consejo Superior de Investigaciones Científicas (CSIC), 9 Ramiro de Maeztu Street, 28040 Madrid, Spain; (V.A.); (A.M.C.); (I.d.R.-P.); (L.R.-P.); (C.B.)
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Institute of Health Carlos III, 28040 Madrid, Spain
| | - Angel M. Cuesta
- Centro de Investigaciones Biológicas Margarita Salas, Consejo Superior de Investigaciones Científicas (CSIC), 9 Ramiro de Maeztu Street, 28040 Madrid, Spain; (V.A.); (A.M.C.); (I.d.R.-P.); (L.R.-P.); (C.B.)
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Institute of Health Carlos III, 28040 Madrid, Spain
| | - Isabel de Rojas-P
- Centro de Investigaciones Biológicas Margarita Salas, Consejo Superior de Investigaciones Científicas (CSIC), 9 Ramiro de Maeztu Street, 28040 Madrid, Spain; (V.A.); (A.M.C.); (I.d.R.-P.); (L.R.-P.); (C.B.)
| | - Eunate Gallardo-Vara
- Yale Cardiovascular Research Center, Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, 300 George Street, New Haven, CT 06511, USA;
| | - Lucía Recio-Poveda
- Centro de Investigaciones Biológicas Margarita Salas, Consejo Superior de Investigaciones Científicas (CSIC), 9 Ramiro de Maeztu Street, 28040 Madrid, Spain; (V.A.); (A.M.C.); (I.d.R.-P.); (L.R.-P.); (C.B.)
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Institute of Health Carlos III, 28040 Madrid, Spain
| | - Carmelo Bernabéu
- Centro de Investigaciones Biológicas Margarita Salas, Consejo Superior de Investigaciones Científicas (CSIC), 9 Ramiro de Maeztu Street, 28040 Madrid, Spain; (V.A.); (A.M.C.); (I.d.R.-P.); (L.R.-P.); (C.B.)
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Institute of Health Carlos III, 28040 Madrid, Spain
| | - Luisa María Botella
- Centro de Investigaciones Biológicas Margarita Salas, Consejo Superior de Investigaciones Científicas (CSIC), 9 Ramiro de Maeztu Street, 28040 Madrid, Spain; (V.A.); (A.M.C.); (I.d.R.-P.); (L.R.-P.); (C.B.)
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Institute of Health Carlos III, 28040 Madrid, Spain
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Allium cepa exerts neuroprotective effect on retinal ganglion cells of pterygopalatine artery (PPA) ligated mice. J Ayurveda Integr Med 2020; 11:489-494. [PMID: 32088091 PMCID: PMC7772493 DOI: 10.1016/j.jaim.2019.08.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2018] [Revised: 07/24/2019] [Accepted: 08/16/2019] [Indexed: 01/19/2023] Open
Abstract
Background Repeated failure to rescue the damaged retinal ganglion cells (RGCs) by various drugs has warranted the need to screen common herbal compounds available in the form of various eye formulations for their efficacy. Objective We aimed to investigate the neuroprotective effect of pretreatment with aqueous extract of A. cepa in Ischemia/Reperfusion (I/R) induced retinal injury. Methods Ischemia was induced for 2 h by pterygopalatine artery (PPA) ligation in C57BL/6J mice, followed by reperfusion. The neuroprotective role of oral pretreatment with aqueous extract of A. cepa (300 mg/kg) was analyzed with respect to control and injury only group at 7, 14, and 28 day after the surgery for expression of different genes in the retina by Real-Time PCR. Results Molecular analysis at different time points showed increased expression of BCl-2, GDNF, GFAP, and Brn3b in the retina at 14 and 28 day after A. cepa treatment in comparison to the injury alone group. However, at shorter time point (7th day), the expression of these genes was pronounced in the injury only group in comparison to the injury and pretreated group. Conclusion Pretreatment with aqueous extract of A. cepa may protect from the neuronal damage in I/R-induced retinal injury in mice by altering the expression of neurotrophic factor.
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Efficacy of TIMOLOL nasal spray as a treatment for epistaxis in hereditary hemorrhagic telangiectasia. A double-blind, randomized, placebo-controlled trial. Sci Rep 2019; 9:11986. [PMID: 31427745 PMCID: PMC6700077 DOI: 10.1038/s41598-019-48502-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 08/07/2019] [Indexed: 12/13/2022] Open
Abstract
Hereditary hemorrhagic telangiectasia is a rare vascular genetic disease. Epistaxis is the most frequent and disabling manifestation, and timolol appears to be a new therapeutic option as non-selective beta-blockers have in vitro and in vivo anti-angiogenic properties. Our main objective was to evaluate the efficacy of TIMOLOL nasal spray as a treatment for epistaxis in hereditary hemorrhagic telangiectasia. This study is a single-center, randomized, phase 2, double-blind placebo-controlled study with an allocation ratio of 1:1. It was proposed to patients with hereditary hemorrhagic telangiectasia monitored at the French Reference Center, and we included patients aged over 18 years, diagnosed with hereditary hemorrhagic telangiectasia and epistaxis. The treatment was self-administered by the patient with a posology of one spray (50 µL) of timolol 0.5% or placebo in each nostril twice a day for 28 consecutive days. The primary efficacy endpoint was mean monthly epistaxis duration, assessed by monitoring epistaxis grids. A total of 58 patients were randomized and treated. The baseline characteristics were similar in the 2 groups. Mean monthly epistaxis duration measured at 3 months was not significantly different in the 26 patients receiving the drug in comparison with the placebo group (p = 0.54). Toxicity was low and no severe adverse events were reported. One limitation is that we included all HHT patients with nosebleeds and did not take into account history of nasal surgery or nasal crusts. Timolol, administered by nasal spray at a dose of 0.25 mg in each nostril twice a day for 28 consecutive days, did not improve epistaxis in patients with hereditary hemorrhagic telangiectasia at 4 months after the beginning of the treatment.
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Abstract
In recent years, β-adrenergic blockers have become the first choice drugs for glaucoma treatment. Timolol holds the main position among them, being a part of most combined antiglaucoma preparations. The use of timolol maleate in clinical practice may be accompanied by severe side effects affecting different organs and systems. The fact that cells with β-adrenergic receptors are widely common within the human body explains pharmacodynamic effects of timolol maleate. Because of these undesirable side effects, timolol maleate often evokes negative reaction from doctors and patients, which to certain extent limits its usage in ophthalmological practice. Obviously, efficacy and safety of timolol administration depends on individual characteristics making personalized approach necessary for every patient. Such particular approach, being the foundation of personalized medicine, increases efficacy and safety of timolol while reducing costs by using targeted doses.
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Affiliation(s)
- L K Moshetova
- Russian Medical Academy of Continuous Professional Education, Department of Ophthalmology, 2/1 Barricadnaya St., Moscow, Russian Federation, 125993
| | - M M Soshina
- Russian Medical Academy of Continuous Professional Education, Department of Ophthalmology, 2/1 Barricadnaya St., Moscow, Russian Federation, 125993
| | - D A Sychev
- Russian Medical Academy of Continuous Professional Education, Department of Clinical Pharmacology and Therapy, 2/1 Barricadnaya St., Moscow, Russian Federation, 125993
| | - K I Turkina
- Russian Medical Academy of Continuous Professional Education, Department of Ophthalmology, 2/1 Barricadnaya St., Moscow, Russian Federation, 125993
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16
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Survey of Pharmacological Activity and Pharmacokinetics of Selected β-Adrenergic Blockers in Regard to Their Stereochemistry. APPLIED SCIENCES-BASEL 2019. [DOI: 10.3390/app9040625] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
The present survey concentrates on pharmacodynamics and pharmacokinetics of selected β-adrenergic blockers from the point of view of their stereochemistry. It could be shown that the activity in the arylaminoethanol and aryloxyaminopropanol group of β-blockers is higher in their (–)-enantiomers as compared with the (+)-enantiomers. The stereoisomers differ also in other types of bioactivity as well as in toxicity. The particular pharmacokinetic stages such as resorption, distribution, and metabolism are discussed in regard to their stereochemistry.
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Laser speckle flowgraphy derived characteristics of optic nerve head perfusion in normal tension glaucoma and healthy individuals: a Pilot study. Sci Rep 2018; 8:5343. [PMID: 29593269 PMCID: PMC5871884 DOI: 10.1038/s41598-018-23149-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Accepted: 02/27/2018] [Indexed: 11/08/2022] Open
Abstract
The purpose of this prospective, case control study was to investigate the differences in optic nerve head blood flow measured with Laser Speckle Flowgraphy (LSFG) between Caucasian patients with normal tension glaucoma and healthy subjects. It included 20 eyes from 20 Caucasian patients with diagnosis of normal tension glaucoma and 20 eyes from age- and sex-matched healthy individuals. In the glaucoma group the antiglaucomatous therapy was paused 3 weeks prior to the investigations. Measurement of optic nerve head blood flow was performed with LSFG. The mean blur rate was obtained for different vascular compartments of the optic nerve head. Parameters for the characterization of pulse-waveform of the mean blur rate were calculated. It was shown that the mean blur rate was significantly lower in the glaucoma group compared to the control group (P < 0.001). The significant differences in the pulse-waveform parameters blow out time (P = 0.028) and flow acceleration time index (P < 0.001) indicate a flatter curve in NTG patients. In conclusion, LSFG can detect differences in optic nerve head blood flow between eyes with normal tension glaucoma and healthy eyes.
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Prediction of regioselectivity and preferred order of metabolisms on CYP1A2-mediated reactions. Part 2: Solving substrate interactions of CYP1A2 with non-PAH substrates on the template system. Drug Metab Pharmacokinet 2017; 32:229-247. [DOI: 10.1016/j.dmpk.2017.05.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Revised: 04/19/2017] [Accepted: 05/17/2017] [Indexed: 01/02/2023]
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Esteves R, Freitas T, Teixeira P, Napoleão P, Neves C, Saldanha C. Erythrocyte nitric oxide in glaucoma patients - ex vivo study. Clin Hemorheol Microcirc 2017; 64:989-994. [PMID: 27814293 DOI: 10.3233/ch-168049] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Glaucoma is an optic neuropathy associated with vascular dysregulation and increased intra-ocular pressure (IOP). Timolol is used as treatment for reducing IOP, by limiting aqueous humour production. Increased NOS expression as well as decreased levels of nitric oxide (NO) metabolites, and high activity of erythrocyte acetylcholinesterase (AChE) were observed in primary open angle glaucoma patients. OBJECTIVE This ex vivo study aims to evaluate timolol effect in NO efflux and its derivatives in glaucoma patient's erythrocytes. METHODS Venous blood from 15 glaucoma patients was collected. Erythrocyte suspensions were incubated with the AChE modulators acetylcholine (ACh) and timolol at 10 μM. Erythrocyte NO efflux and S-nitrosoglutathione (GSNO) concentration were measured. RESULTS No significant differences were obtained in erythrocyte NO efflux and GSNO concentration in response to ACh or timolol when compared with the untreated erythrocytes of glaucoma patients. When comparing the same incubation conditions for erythrocyte suspensions between glaucoma patients and healthy subjects, those from glaucoma patients showed higher NO efflux in presence and absence of timolol, and higher values of GSNO in the presence of timolol. CONCLUSIONS We demonstrated that erythrocytes from glaucoma patients have similar availability to release NO both in absence and presence of timolol, and have higher GSNO values in presence of timolol.
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Affiliation(s)
- Rita Esteves
- Carlota Saldanha Lab, Instituto de Medicina Molecular, Instituto de Bioquímica, Faculdade de Medicina, Universidade de Lisboa. Lisboa, Portugal
| | - Teresa Freitas
- Carlota Saldanha Lab, Instituto de Medicina Molecular, Instituto de Bioquímica, Faculdade de Medicina, Universidade de Lisboa. Lisboa, Portugal
| | - Pedro Teixeira
- Carlota Saldanha Lab, Instituto de Medicina Molecular, Instituto de Bioquímica, Faculdade de Medicina, Universidade de Lisboa. Lisboa, Portugal
| | - Patrícia Napoleão
- Carlota Saldanha Lab, Instituto de Medicina Molecular, Instituto de Bioquímica, Faculdade de Medicina, Universidade de Lisboa. Lisboa, Portugal
| | - Carlos Neves
- Faculdade de Medicina, Universidade de Lisboa, ISAMB, CECU Coordenator, ALM Clinical Director
| | - Carlota Saldanha
- Carlota Saldanha Lab, Instituto de Medicina Molecular, Instituto de Bioquímica, Faculdade de Medicina, Universidade de Lisboa. Lisboa, Portugal
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Couto AH, Siqueira H, Brasileiro PP, Cavalcanti IL, Videira RLDR. Severe Intraoperative Shock Related to Mesenteric Traction Syndrome. ACTA ACUST UNITED AC 2017; 8:51-54. [PMID: 27898550 DOI: 10.1213/xaa.0000000000000422] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Mesenteric traction syndrome is defined as arterial hypotension, facial flushing, and tachycardia related to mesenteric traction. We describe a case of mesenteric traction syndrome refractory to catecholamine and vasopressin infusions. The patient, who had Crohn disease, developed severe distributive shock after mesenteric traction while undergoing resection of an intestinal inflammatory mass, accompanied by facial flushing and unaltered readings for pulse oximetry, capnography, and bispectral index monitoring. The absence of tachycardia in this case was attributed to long-term use of timolol. Arterial pressure returned to baseline level after approximately 30 minutes, and the postoperative period was uneventful.
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Affiliation(s)
- Alfredo Haack Couto
- From the *Division of Anesthesiology, Antonio Pedro University Hospital, Fluminense Federal University, Niterói, Brazil; and †Department of Surgery, Fluminense Federal University Medical School, Niterói, Brazil
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He A, Zampella JG, Kwatra SG. Genotyping for CYP2D6 in Patients with Infantile Hemangiomas Refractory to Topical Timolol. Pediatr Dermatol 2016; 33:686. [PMID: 27882672 DOI: 10.1111/pde.12942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Alice He
- Department of Dermatology, School of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - John G Zampella
- Department of Dermatology, School of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Shawn G Kwatra
- Department of Dermatology, School of Medicine, Johns Hopkins University, Baltimore, Maryland
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Abstract
INTRODUCTION It is generally believed that topical administration of eye drops safeguards against harmful systemic effects. However, about 80% of the drug in the ophthalmic products is systemically absorbed and the first-pass metabolism is avoided. Ophthalmic timolol is widely prescribed in the treatment of glaucoma either alone or in the combination eye drop products, many of which have been launched fairly recently. Ophthalmic timolol may cause serious adverse effects such as symptomatic bradycardia, various conduction disorders in the heart, orthostatic hypotension, syncope and falls. Areas covered: In this review we document a number of factors associated with the properties of ophthalmic timolol and specific features of a patient, which may jeopardize patient's cardiac safety even after topical treatment. Expert opinion: Plasma timolol levels are correlated with cardiovascular adverse effects in patients, since timolol is mainly metabolized by cytochrome P450 2D6 (CYP2D6) enzyme in the liver. Patients who are lacking the functional CYP2D6 or who are concomitantly using potent CYP2D6 inhibitor drugs (e.g. paroxetine or fluoxetine) or verapamil or other beta-blockers are at risk of getting serious cardiac adverse effects. Prior to treatment initiation, ECG should be always performed and CYP2D6 genotyping should be considered, if routinely available.
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Affiliation(s)
- Jukka Mäenpää
- a AstraZeneca, Research and Development, Patient Safety, Respiratory, Inflammation, Autoimmunity, Infections and Vaccines Therapeutic Area , Gothenburg , Sweden
| | - Olavi Pelkonen
- b Department of Pharmacology and Toxicology, Institute of Biomedicine , University of Oulu , Oulu , Finland
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Kölln C, Reichl S. Expression of glutathione transferases in corneal cell lines, corneal tissues and a human cornea construct. Int J Pharm 2016; 506:371-81. [DOI: 10.1016/j.ijpharm.2016.04.053] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Revised: 04/18/2016] [Accepted: 04/19/2016] [Indexed: 10/21/2022]
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Liu XL, Jia QJ, Wang LN, Liu ZM, Liu H, Duan XC, Lyu XM. Roles of CYP2C19 Gene Polymorphisms in Susceptibility to POAG and Individual Differences in Drug Treatment Response. Med Sci Monit 2016; 22:310-5. [PMID: 26822491 PMCID: PMC4737058 DOI: 10.12659/msm.894868] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background The aim of this study was to investigate the roles of cytochrome P450 2C19 (CYP2C19) polymorphisms in primary open-angle glaucoma (POAG) susceptibility and individual responses to drug treatment. Material/Methods This case-control study consisted of 93 cases with POAG and 125 controls. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was used to analyze CYP2C19 single-nucleotide polymorphisms (SNPs). After timolol treatment, patients were classified into side effect (SE) group and non-side effect (NSE) group. According to drug treatment responses, patients were divided into 3 groups: excellent group (Ex) (IOP ≥8 mm Hg); utility group (Ut) (5 <IOP ≤8 mm Hg), and ineffective group (In) (IOP ≤5 mm Hg). Data analysis was performed using SPSS software. Results We found no statistical differences in the alleles and genotypes frequencies of CYP2C19 between the case group and the control group (both P>0.05). Frequencies of extensive metabolizer phenotype and poor metabolizer phenotype or poor metabolizer phenotype and intermediate metabolizer phenotype were significantly different between the SE group and NSE group (both P<0.05). The distribution of intermediate metabolizer phenotype and extensive metabolizer phenotype were significantly different among Ex group, Ut group, and In group (all P<0.05). Conclusions We found no evidence that CYP2C19 polymorphisms are associated with susceptibility to POAG. However, different CYP2C19 metabolizer phenotypes were identified and observed to have important effects on the individual differences in drug treatment response.
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Affiliation(s)
- Xiang-Long Liu
- Department of Ophthalmology, Affiliated Hospital of Beihua University, Jilin City, Jilin, China (mainland)
| | - Qiu-Ju Jia
- Department of Ophthalmology, Central Hospital of Jilin, Jilin City, Jilin, China (mainland)
| | - Li-Na Wang
- Department of Ophthalmology, China-Japan Union Hospital of Jilin University, Jilin City, Jilin, China (mainland)
| | - Zong-Ming Liu
- Department of Anesthesiology, Jilin Cancer Hospital, Changchun, Jilin, China (mainland)
| | - Hai Liu
- Department of Ophthalmology, The First People's Hospital of Yueyang, Yueyang, Hunan, China (mainland)
| | - Xuan-Chu Duan
- Department of Ophthalmology, The First People's Hospital of Yueyang, Yueyang, Hunan, China (mainland)
| | - Xue-Man Lyu
- Department of Ophthalmology, China-Japan Union Hospital of Jilin University, Jilin City, Jilin, China (mainland)
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Alario AF, Strong TD, Pizzirani S. Medical Treatment of Primary Canine Glaucoma. Vet Clin North Am Small Anim Pract 2015; 45:1235-59, vi. [DOI: 10.1016/j.cvsm.2015.06.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Qin F, Zeng L, Zhu Y, Cao J, Wang X, Liu W. Preparation and evaluation of a timolol maleate drug–resin ophthalmic suspension as a sustained-release formulation in vitro and in vivo. Drug Dev Ind Pharm 2015; 42:535-45. [PMID: 26368660 DOI: 10.3109/03639045.2015.1085872] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Fuhong Qin
- Department of Pharmacy, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Li Zeng
- School of Pharmaceutical Sciences, Zhengzhou University, Zhengzhou, Henan, China
| | - Yongtao Zhu
- School of Pharmaceutical Sciences, Zhengzhou University, Zhengzhou, Henan, China
| | - Jingjing Cao
- Department of Pharmacy, Henan Provincial People’s Hospital, Zhengzhou, Henan, China, and
| | - Xiaohui Wang
- Department of Pharmacy, Luohe Central Hospital, Luohe, Henan, China
| | - Wei Liu
- School of Pharmaceutical Sciences, Zhengzhou University, Zhengzhou, Henan, China
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Pelkonen O. Drug Metabolism - FromIn VitrotoIn Vivo, From Simple to Complex. Basic Clin Pharmacol Toxicol 2015; 117:147-55. [DOI: 10.1111/bcpt.12429] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2015] [Accepted: 06/09/2015] [Indexed: 11/26/2022]
Affiliation(s)
- Olavi Pelkonen
- Centre of Biomedical Research; Department of Pharmacology and Toxicology; University of Oulu; Oulu Finland
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Abstract
BACKGROUND Medication use is a potentially modifiable risk factor for falling; psychotropic and cardiovascular drugs have been indicated as main drug groups that increase fall risk. However, evidence is mainly based on studies that recorded falls retrospectively and/or did not determine medication use at the time of the fall. Therefore, we investigated the associations indicated in the literature between medication use and falls, using prospectively recorded falls and medication use determined at the time of the fall. METHODS Data from the B-PROOF (B-vitamins for the prevention of osteoporotic fractures) study were used, concerning community-dwelling elderly aged ≥65 years. We included 2,407 participants with pharmacy dispensing records. During the 2- to 3-year follow-up, participants recorded falls using a fall calendar. Cox proportional hazard models were applied, adjusting for potential confounders including age, sex, health status variables and concomitant medication use. RESULTS During follow-up, 1,147 participants experienced at least one fall. Users of anti-arrhythmic medication had an increased fall risk (hazard ratio [HR] 1.61; 95% confidence interval [CI] 1.12-2.32) compared with non-users. Similarly, non-selective beta-blocker use was associated with an increased fall risk (HR 1.41 [95% CI 1.12-1.78]), while statin use was associated with a lower risk (HR 0.81 [95% CI 0.71-0.94]). Benzodiazepine use (HR 1.32 [95% CI 1.02-1.71]), and antidepressant use (HR 1.40 [95% CI 1.07-1.82]) were associated with an increased fall risk. Use of other cardiovascular and psychotropic medication was not associated with fall risk. CONCLUSION Our results strengthen the evidence for an increased fall risk in community-dwelling elderly during the use of anti-arrhythmics, non-selective beta-blockers, benzodiazepines, and antidepressant medication. Clinicians should prescribe these drugs cautiously and if possible choose safer alternatives for older patients.
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Anand A, Modgil S, Sharma VL, Shri R, Kaushik S. Preserving neural retina through re-emerging herbal interventions. J Cell Biochem 2015; 115:1659-68. [PMID: 24819477 DOI: 10.1002/jcb.24840] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2014] [Accepted: 05/08/2014] [Indexed: 01/19/2023]
Abstract
Eye related diseases such as glaucoma, diabetic retinopathy, cataract, conjunctivitis are very common worldwide. With the current scenario India will be among the top five countries in the number of glaucoma cases. Limited discovery of successful drugs for the treatment of such diseases led scientists to look towards the use of conventional sources for treatment. Herbal extracts from Ayurveda have remained an important part of treatment regime in many parts of world even today. For this reason, local herbs possessing curative properties are still being used by local inhabitants due to its anti-inflammatory and antioxidant properties. Because retinal damage involves alterations in oxidative enzymes, blood flow changes and increase in apoptotic signals, herbal extracts are being tested for their ability to moderate antioxidant machinery and trigger neuroprotective pathways. The present review summarizes some of such herbal extracts which have been tested for their neuroprotective role in eye related diseases. The active components that exert neuroprotective effects have also been discussed along with possible mechanisms of action.
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Affiliation(s)
- Akshay Anand
- Department of Neurology, Neuroscience Research Lab, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India
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Abstract
Timolol maleate is a non-selective beta-adrenergic receptor blocking agent with demonstrated efficacy in the treatment of open-angle glaucoma. A 76 year old female who presented with productive cough, progressive dyspnea and hypoxia after starting timolol maleate opthalamic drops following glaucoma surgery. The patient was diagnosed with interstitial lung disease secondary to timolol treatment and after cessation of the offending agent along with corticosteroid treatment, symptoms improved drastically. Elimination of other possible causes of disease along with evolution of radiological and functional signs left us with a diagnosis of timolol-induced interstitial lung disease. To our knowledge, this is the second reported case of timolol-induced interstitial lung disease.
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Affiliation(s)
- Hetain Patel
- Division of Critical Care and Pulmonary Diseases, Florida Hospital Orlando, Orlando, FL, USA
| | - Lina Vanessa Wilches
- Division of Critical Care and Pulmonary Diseases, Florida Hospital Orlando, Orlando, FL, USA
| | - Jorge Guerrero
- Division of Critical Care and Pulmonary Diseases, Florida Hospital Orlando, Orlando, FL, USA
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Mäenpää J, Volotinen-Maja M, Kautiainen H, Neuvonen M, Niemi M, Neuvonen PJ, Backman JT. Paroxetine markedly increases plasma concentrations of ophthalmic timolol; CYP2D6 inhibitors may increase the risk of cardiovascular adverse effects of 0.5% timolol eye drops. Drug Metab Dispos 2014; 42:2068-76. [PMID: 25261563 DOI: 10.1124/dmd.114.059576] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Although ophthalmic timolol is generally well tolerated, a significant fraction of topically administered timolol can be systemically absorbed. We investigated the effect of the strong CYP2D6 inhibitor paroxetine on the pharmacokinetics of timolol after ophthalmic administration. In a four-phase crossover study, 12 healthy volunteers ingested either paroxetine (20 mg) or placebo daily for 3 days. In phases 1-2, timolol 0.1% gel, and in phases 3-4, timolol 0.5% drops were administered to both eyes. Paroxetine increased the plasma concentrations of timolol with both timolol formulations to a similar degree. The geometric mean ratio (95% confidence interval) of timolol peak concentration was 1.53-fold (1.23-1.91) with 0.1% timolol and 1.49-fold (0.94-2.36) with 0.5% timolol, and that of timolol area under the plasma concentration-time curve (AUC) from time 0 to 12 hours was 1.61-fold (1.26- to 2.06-fold) and 1.78-fold (1.21-2.62), respectively. During paroxetine administration, six subjects on 0.5% timolol drops, but none on 0.1% timolol gel, had plasma timolol concentrations exceeding 0.7 ng/ml, which can cause systemic adverse effects in patients at risk. There was a positive correlation between the AUC from time 0 to 13 hours of paroxetine and the placebo phase AUC from time 0 to infinity of timolol after timolol 0.5% drops (P < 0.05), and a nonsignificant trend after timolol 0.1% gel, consistent with the role of CYP2D6 in the metabolism of both agents. In the orthostatic test, heart rate immediately after upright standing was significantly lower (P < 0.05) during the paroxetine phase than during the placebo phase at 1 and 3 hours after 0.5% timolol dosing. In conclusion, paroxetine and other CYP2D6 inhibitors can have a clinically important interaction with ophthalmic timolol, particularly when patients are using 0.5% timolol formulations.
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Affiliation(s)
- Jukka Mäenpää
- Santen Oy, Tampere, Finland (J.M., M.V.-M.); Medcare Oy, Äänekoski, Finland (H.K.); and Department of Clinical Pharmacology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland (M.Ne., M.Ni., P.J.N., J.T.B.)
| | - Marjo Volotinen-Maja
- Santen Oy, Tampere, Finland (J.M., M.V.-M.); Medcare Oy, Äänekoski, Finland (H.K.); and Department of Clinical Pharmacology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland (M.Ne., M.Ni., P.J.N., J.T.B.)
| | - Hannu Kautiainen
- Santen Oy, Tampere, Finland (J.M., M.V.-M.); Medcare Oy, Äänekoski, Finland (H.K.); and Department of Clinical Pharmacology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland (M.Ne., M.Ni., P.J.N., J.T.B.)
| | - Mikko Neuvonen
- Santen Oy, Tampere, Finland (J.M., M.V.-M.); Medcare Oy, Äänekoski, Finland (H.K.); and Department of Clinical Pharmacology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland (M.Ne., M.Ni., P.J.N., J.T.B.)
| | - Mikko Niemi
- Santen Oy, Tampere, Finland (J.M., M.V.-M.); Medcare Oy, Äänekoski, Finland (H.K.); and Department of Clinical Pharmacology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland (M.Ne., M.Ni., P.J.N., J.T.B.)
| | - Pertti J Neuvonen
- Santen Oy, Tampere, Finland (J.M., M.V.-M.); Medcare Oy, Äänekoski, Finland (H.K.); and Department of Clinical Pharmacology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland (M.Ne., M.Ni., P.J.N., J.T.B.)
| | - Janne T Backman
- Santen Oy, Tampere, Finland (J.M., M.V.-M.); Medcare Oy, Äänekoski, Finland (H.K.); and Department of Clinical Pharmacology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland (M.Ne., M.Ni., P.J.N., J.T.B.)
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Lorenz K, Pfeiffer N. Efficacy and safety of tafluprost 0.0015% and timolol maleate 0.5% fixed combination in patients with ocular hypertension or open-angle glaucoma. Expert Opin Pharmacother 2014; 15:2255-62. [DOI: 10.1517/14656566.2014.955471] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Wang C, Han Y, Wu A, Sólyom S, Niu L. Mechanism and site of inhibition of AMPA receptors: pairing a thiadiazole with a 2,3-benzodiazepine scaffold. ACS Chem Neurosci 2014; 5:138-47. [PMID: 24313227 DOI: 10.1021/cn400193u] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
2,3-Benzodiazepine compounds are synthesized as drug candidates for treatment of various neurological disorders involving excessive activity of AMPA receptors. Here we report that pairing a thiadiazole moiety with a 2,3-benzodiazepine scaffold via the N-3 position yields an inhibitor type with >28-fold better potency and selectivity on AMPA receptors than the 2,3-benzodiazepine scaffold alone. Using whole-cell recording, we characterized two thiadiazolyl compounds, that is, one contains a 1,3,4-thiadiazole moiety and the other contains a 1,2,4-thiadiazole-3-one moiety. These compounds exhibit potent, equal inhibition of both the closed-channel and the open-channel conformations of all four homomeric AMPA receptor channels and two GluA2R-containing complex AMPA receptor channels. Furthermore, these compounds bind to the same receptor site as GYKI 52466 does, a site we previously termed as the "M" site. A thiadiazole moiety is thought to occupy more fully the side pocket of the receptor site or the "M" site, thereby generating a stronger, multivalent interaction between the inhibitor and the receptor binding site. We suggest that, as a heterocycle, a thiadiazole can be further modified chemically to produce a new class of even more potent, noncompetitive inhibitors of AMPA receptors.
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Affiliation(s)
- Congzhou Wang
- Department of Chemistry, and Center for Neuroscience Research, University at Albany, SUNY, Albany, New York 12222, United States
| | - Yan Han
- Department of Chemistry, and Center for Neuroscience Research, University at Albany, SUNY, Albany, New York 12222, United States
| | - Andrew Wu
- Department of Chemistry, and Center for Neuroscience Research, University at Albany, SUNY, Albany, New York 12222, United States
| | - Sándor Sólyom
- CF Pharma Pharmaceutical Manufacturing Co., Ltd, H-1097 Budapest, Kén
utca 5, Hungary
| | - Li Niu
- Department of Chemistry, and Center for Neuroscience Research, University at Albany, SUNY, Albany, New York 12222, United States
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Byrom L, Zappala T, Muir J. Dermatological reactions to ophthalmic preparations: More than meets the eye. Australas J Dermatol 2014; 55:95-8. [DOI: 10.1111/ajd.12152] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2013] [Accepted: 01/12/2014] [Indexed: 12/01/2022]
Affiliation(s)
- Lisa Byrom
- Department of Dermatology; Mater Hospital; Brisbane Australia
| | - Tania Zappala
- Department of Dermatology; Mater Childrens Hospital; Brisbane Australia
| | - Jim Muir
- Department of Dermatology; Mater Hospital and Belmont Specialist Centre; Brisbane Australia
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Epperla N, Brilliant MH, Vidaillet H. Topical timolol for treatment of epistaxis in hereditary haemorrhagic telangiectasia associated with bradycardia: a look at CYP2D6 metabolising variants. BMJ Case Rep 2014; 2014:bcr-2013-203056. [PMID: 24518395 DOI: 10.1136/bcr-2013-203056] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
A 59-year-old man presented to the emergency department with lightheadedness. He had started intranasal administration of ophthalmic timolol for the prevention of epistaxis associated with hereditary haemorrhagic telangiectasia approximately 3 weeks earlier with excellent response. His heart rate was about half its normal rate, an ECG revealed sinus bradycardia, and it was determined he had significant cardiac issues in his family history. Essentially all other tests were normal. The discontinuation of the intranasal use of timolol resolved any further episodes of lightheadedness and bradycardia. It was determined through genetic testing that he is an intermediate metaboliser of CYP2D6, the main enzyme contributing to the metabolism of timolol. This explains the development of the bradycardia after intranasal timolol use. The metabolising variants of CYP2D6 need to be considered when prescribing medications metabolised by this enzyme, so possible adverse effects can be avoided.
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Affiliation(s)
- Narendranath Epperla
- Department of Internal Medicine and Clinical Research, Marshfield Clinic, Marshfield, Wisconsin, USA
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Semkova K, Kazandjieva J. Rapid complete regression of an early infantile hemangioma with topical timolol gel. Int J Dermatol 2013; 53:241-2. [DOI: 10.1111/j.1365-4632.2011.05441.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Correspondence. Retina 2013; 33:2185. [DOI: 10.1097/iae.0b013e31829f731e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Martínez-Jacobo L, Córdova-Fletes C, Ortiz-López R, Rivas F, Saucedo-Carrasco C, Rojas-Martínez A. Delineation of a de novo 7q21.3q31.1 Deletion by CGH-SNP Arrays in a Girl with Multiple Congenital Anomalies Including Severe Glaucoma. Mol Syndromol 2013; 4:285-91. [PMID: 24167464 DOI: 10.1159/000353510] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
In this study, we present a female patient with a constitutional de novo deletion in 7q21.3q31.1 as determined by G-banding and CGH-SNP arrays. She exhibited, among other features, psychomotor retardation, congenital severe bilateral glaucoma, a cleft palate, and heart defect. Microarray assay disclosed a deleted 12.5-Mb region roughly 88 kb downstream the ectrodactyly critical region; thus, the patient's final karyotype was 46,XX.arr 7q21.3q31.1(96,742,140-109,246,085)×1 dn. This girl represents the fourth patient described so far with congenital glaucoma and a deletion encompassing or overlapping the 7q21.3q31.1 region, and confirms the presence of a locus or loci related to such a clinical feature. According to our results, the proneness to ocular defects secondary to 7q intermediate deletions could be caused by co-deletion of TAC1, HBP1, and a small cluster of cytochrome P450 genes (subfamily 3A). This conclusion is supported by their functional roles and expression locations as well as because TAC1 is related to the functional pathway of the MYOC gene whose mutations are linked to glaucoma. Moreover, given that this girl is clinically reminiscent of several phenotypes related to diverse deletions within 7q21q32, our results and observations offer a general overview of the gene content of deletions/phenotypes overlapping 7q21.3q31.1 and confirm that loci distal to DLX genes including the CUX1 gene and potential regulatory elements downstream from DLX5 are unrelated to ectrodactyly.
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Affiliation(s)
- L Martínez-Jacobo
- Departamento de Bioquímica y Medicina Molecular, Facultad de Medicina, Monterrey, Mexico
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Abstract
PURPOSE Timolol is an effective and safe medication that is widely used in glaucoma treatment. Although it is known that it is quickly taken up by the cornea following topical administration and that the cornea exhibits -adrenergic receptors, there are few studies available on the clinical impact of timolol on central corneal thickness (CCT). METHODS Twenty healthy subjects were tested in a double-blind, prospective, and randomized study. Intraocular pressure (IOP) and CCT were measured before and during administration of timolol 0.5% eyedrops over 28 days. RESULTS Administration of timolol 0.5% resulted in a reduction of IOP from an initial value of 16 ± 2 mm Hg to 13 ± 0 mm Hg (p<0.001, R2 = 0.7033) as well as an increase in CCT from 555 ± 11 µm from the time of the baseline examination to 567 ± 9 µm (p = 0.005, R2 = 0.8754), an increase of epithelial thickness from 53 ± 2 µm to 59 ± 3 µm (p<0.001, R2 = 0.5063), and an increase of stromal thickness from 494 ± 4 µm to 498 ± 9 µm (p = 0.045, R2 = 0.4352) after 9 days each. From day 10 on, a decrease in CCT (R2 = 0.6164), epithelial thickness (R2 = 0.2216), and stromal thickness (R2 = 0.2092) was observed. At the end, the values had returned toward the initial values measured (CCT 553 ± 8 µm, p = 0.391; epithelial thickness, 50 ± 2 µm, p = 0.214; and stromal thickness, 493 ± 8 µm, p = 0.483). In contrast, endothelial thickness did not vary following administration of timolol 0.5% (p = 0.727, R2 = 0.009). CONCLUSIONS Topical administration of timolol 0.5% results in a reversible increase in CCT. These modest changes are unlikely to influence tonometry or clinical decision-making.
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