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Falcón Lincheta L, Saumell Nápoles Y, Gray Lovio OR, Viqueira Fuentesfría AM, Pérez Alonso T, Batista Romagoza M, Urquiza Rodríguez A, Mantecón Fernández B, Bautista Jerez HA, Fernández de Armas D, Martínez Matute ES, León García Y, Oramas Fernández DK, Marrero Chavez Y, Fernandez Lorente A, Valls Hung AR, Lorenzo-Luaces P, Valenzuela Silva C, Moreno E, Hernández-Casaña P. Long-term therapy with itolizumab is safe and effective for patients with moderate to severe psoriasis: Results from an expanded-access program. Int Immunopharmacol 2024; 134:112225. [PMID: 38759368 DOI: 10.1016/j.intimp.2024.112225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 04/22/2024] [Accepted: 05/05/2024] [Indexed: 05/19/2024]
Abstract
Itolizumab is a humanized monoclonal antibody that selectively targets the CD6-ALCAM pathway. This article reports on the safety and efficacy of itolizumab in the treatment of moderate-to-severe plaque psoriasis in a clinical study conducted in Cuba in the setting of an expanded-access program (EAP). The study included 84 patients who had previously received conventional anti-psoriatic systemic therapies but were either intolerant, had an inadequate response, or had contraindications to these therapies. It consisted of multiple phases, including a 12-week induction phase, a 40-week maintenance phase, and a 24-week off-treatment follow-up phase, using either a 0.4 or 1.6 mg/Kg dose. The results showed that itolizumab monotherapy was safe and effective during 52 weeks of continuous treatment and the subsequent 24 follow-up weeks. Itolizumab treatment resulted in a significant improvement (PASI 75) in 80 % of patients at the end of the induction phase, and this effect was sustained till week 52 during the maintenance phase. Moreover, 24 weeks after treatment stopped nearly two-thirds of patients still showed a PASI ≥ 75. The observed effects were dose-dependent, with 1.6 mg/kg being the most convenient dose. This study further supports the strategy of targeting the CD6-ALCAM signaling pathway for the treatment of psoriasis and the use of itolizumab as a valuable asset in the armamentarium of anti-psoriasis drugs.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Ana R Valls Hung
- Clinical Research Division, Center of Molecular Immunology, Havana, Cuba
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Eybpoosh S, Biglari A, Sorouri R, Ashrafian F, Sadat Larijani M, Verez-Bencomo V, Toledo-Romani ME, Valenzuela Silva C, Salehi-Vaziri M, Dahmardeh S, Doroud D, Banifazl M, Mostafavi E, Bavand A, Ramezani A. Immunogenicity and safety of heterologous boost immunization with PastoCovac Plus against COVID-19 in ChAdOx1-S or BBIBP-CorV primed individuals. PLoS Pathog 2023; 19:e1011744. [PMID: 37910480 PMCID: PMC10619776 DOI: 10.1371/journal.ppat.1011744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 10/10/2023] [Indexed: 11/03/2023] Open
Abstract
BACKGROUND This study aimed at evaluation and comparison of PastoCovac Plus protein-subunit vaccine in parallel with ChAdOx1-S (AstraZeneca) and BBIBP-CorV (Sinopharm) in primarily vaccinated volunteers with two doses of ChAdOx1-S or BBIBP-CorV. MATERIALS AND METHODS 194 volunteers enrolled the study who were previously primed with 2 doses of ChAdOx1-S or BBIBP-CorV vaccines. They were divided into two heterologous regimens receiving a third dose of PastoCovac Plus, and two parallel homologous groups receiving the third dose of BBIBP-CorV or ChAdOx1-S. Serum samples were obtained just before and 4 weeks after booster dose. Anti-spike IgG and neutralizing antibodies were quantified and the conventional live-virus neutralization titer, (cVNT50) assay was done against Omicron BA.5 variant. Moreover, the adverse events data were recorded after receiving booster doses. RESULTS ChAdOx1-S/PastoCovac Plus group reached 73.0 units increase in anti-Spike IgG rise compared to the ChAdOx1-S/ ChAdOx1-S (P: 0.016). No significant difference was observed between the two groups regarding neutralizing antibody rise (P: 0.256), indicating equivalency of both booster types. Adjusting for baseline titers, the BBIBP-CorV/PastoCovac Plus group showed 135.2 units increase (P<0.0001) in anti-Spike IgG, and 3.1 (P: 0.008) unit increase in mean rise of neutralizing antibodies compared to the homologous group. Adjustment for COVID-19 history, age, underlying diseases, and baseline antibody titers increased the odds of anti-Spike IgG fourfold rise both in the ChAdOx1-S (OR: 1.9; P: 0.199) and BBIBP CorV (OR: 37.3; P< 0.0001) heterologous groups compared to their corresponding homologous arms. The odds of neutralizing antibody fourfold rise, after adjustment for the same variables, was 2.4 (P: 0.610) for the ChAdOx1-S heterologous group and 5.4 (P: 0.286) for the BBIBP CorV heterologous groups compared to their corresponding homologous groups. All the booster types had the potency to neutralize BA.5 variant with no significant difference. The highest rate of adverse event incidence was recorded for ChAdOx1-S homologous group. CONCLUSIONS PastoCovac Plus booster application in primed individuals with BBIBP-CorV or ChAdOx1-S successfully increased specific antibodies' levels without any serious adverse events. This vaccine could be administrated in the heterologous regimen to effectively boost humoral immune responses.
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Affiliation(s)
- Sana Eybpoosh
- Department of Epidemiology and Biostatistics, Research Centre for Emerging and Reemerging Infectious Diseases, Pasteur Institute of Iran, Tehran, Iran
| | - Alireza Biglari
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Rahim Sorouri
- IPI Directorate, Pasteur Institute of Iran, Tehran, Iran
- Department of Microbiology, Faculty of Medicine, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Fatemeh Ashrafian
- Clinical Research Department, Pasteur Institute of Iran, Tehran, Iran
| | | | | | | | | | | | - Sarah Dahmardeh
- Vaccination Department, Pasteur Institute of Iran, Tehran, Iran
| | - Delaram Doroud
- Quality Control Department, Production and research Complex, Pasteur Institute of Iran, Tehran, Iran
| | - Mohammad Banifazl
- Iranian Society for Support of Patients with Infectious Disease, Tehran, Iran
| | - Ehsan Mostafavi
- Department of Epidemiology and Biostatistics, Research Centre for Emerging and Reemerging Infectious Diseases, Pasteur Institute of Iran, Tehran, Iran
| | - Anahita Bavand
- Clinical Research Department, Pasteur Institute of Iran, Tehran, Iran
| | - Amitis Ramezani
- Clinical Research Department, Pasteur Institute of Iran, Tehran, Iran
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Souza GB, Melo-Neto LF, Borges MS, Demartini KTM, Silva CV, Paes NF, Neves CTD, Costa JWG, Santos L, Salles MM. MANIPULAÇÃO MAGISTRAL DE MEDICAMENTOS EM ONCOLOGIA: REVISÃO DA LITERATURA E PESQUISA PARA O PREPARO DE FORMULAÇÃO ORAL LÍQUIDA DE INIBIDORES DA TIROSINA QUINASE (TKI): ERLOTINIBE, IMATINIBE, LAPATINIBE, SUNITINIBE. Hematol Transfus Cell Ther 2021. [DOI: 10.1016/j.htct.2021.10.797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Silva CV, Mantilla TF, Engel Y, Tavares JP, Freitas PM, Rechmann P. The effect of CO 2 9.3 μm short-pulsed laser irradiation in enamel erosion reduction with and without fluoride applications-a randomized, controlled in vitro study. Lasers Med Sci 2020; 35:1213-1222. [PMID: 32030555 DOI: 10.1007/s10103-020-02979-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Accepted: 01/31/2020] [Indexed: 10/25/2022]
Abstract
The aim of this in vitro study was to evaluate the protective effect of short-pulsed CO2 9.3 μm laser irradiation against erosion in human enamel without and combined with TiF4 and AmF/NaF/SnCl2 applications, respectively, as well as compared to the protective effect of these fluoride treatments alone. After polishing, ninety enamel samples (3 × 3mm) were used for 9 different treatment groups: 4% TiF4 gel (pH 1.5, 24,533 ppm F-); AmF/NaF/SnCl2 rinse (pH 4.5; 500 ppm F-, 800 ppm Sn2); CO2 laser (average power 0.58 W); CO2 laser (0.58 W) + TiF4; CO2 laser (0.58 W) + AmF/NaF/SnCl2; CO2 laser (0.69 W); CO2 laser (0.69 W) + TiF4; CO2 laser (0.69 W) + AmF/NaF/SnCl2; negative control (deionized water). TiF4 gel was brushed on only once before the first erosive cycling, while samples treated with AmF/NaF/SnCl2 were daily immersed in 5 ml of the solution before cycling. Laser treatment occurred with a CO2 laser (wavelength 9.3 μm, pulse repetition rate 100 Hz, pulse duration 14.6 μs/18 μs, average power 0.58 W/0.69 W, fluence 1.9 J/cm2/2.2 J/cm2, beam diameter 0.63 mm, irradiation time 10 s, air cooling). TiF4 was applied only once, while AmF/NaF/SnCl2 was applied once daily before the erosive challenge. Surface loss (in μm) was measured with optical profilometry immediately after treatment, and after 5 and 10 days of erosive cycling (0.5% citric acid, pH 2.3, 6 × 2 min/day). Additionally, scanning electron microscopy investigations were performed. All application measures resulted in loss of surface height immediately after treatment. After 5 days, significantly reduced surface loss was observed after applying laser irradiation (both power settings) followed by applications of TiF4 or AmF/NaF/SnCl2 solution (p < 0.05; 2-way ANOVA and Tukey test) compared to fluoride application alone. After 10 days, compared to after 5 days, a reduced tissue loss was observed in all groups treated with AmF/NaF/SnCl2 solution. This tissue gain occurred with the AmF/NaF/SnCl2 application alone and was significantly higher when the application was combined with the laser use (p < 0.05). Short-pulsed CO2 9.3 μm laser irradiation followed by additional application of AmF/NaF/SnCl2 solution significantly reduces the progression of dental enamel erosion in vitro.
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Affiliation(s)
- C V Silva
- Department of Restorative Dentistry, Faculdade de Odontologia, Universidade de São Paulo (USP), Av Prof. Lineu Prestes, 2227 - Cidade Universitária, São Paulo, SP, 05508-000, Brazil
| | - T F Mantilla
- Department of Restorative Dentistry, Faculdade de Odontologia, Universidade de São Paulo (USP), Av Prof. Lineu Prestes, 2227 - Cidade Universitária, São Paulo, SP, 05508-000, Brazil
| | - Y Engel
- Department of Restorative Dentistry, Faculdade de Odontologia, Universidade de São Paulo (USP), Av Prof. Lineu Prestes, 2227 - Cidade Universitária, São Paulo, SP, 05508-000, Brazil
| | - J P Tavares
- Department of Restorative Dentistry, Faculdade de Odontologia, Universidade de São Paulo (USP), Av Prof. Lineu Prestes, 2227 - Cidade Universitária, São Paulo, SP, 05508-000, Brazil
| | - P M Freitas
- Department of Restorative Dentistry, Faculdade de Odontologia, Universidade de São Paulo (USP), Av Prof. Lineu Prestes, 2227 - Cidade Universitária, São Paulo, SP, 05508-000, Brazil
| | - P Rechmann
- Department of Preventive and Restorative Dental Sciences, School of Dentistry, University of California at San Francisco, 707 Parnassus Avenue, San Francisco, CA, 94143, USA.
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Costa MB, Picon PD, Sander GB, Cuni HN, Silva CV, Meireles RP, Góes ACMA, Batoreu NM, Maia MDLDS, Albuquerque EM, Matos DCDS, Saura PL. Pharmacokinetics comparison of two pegylated interferon alfa formulations in healthy volunteers. BMC Pharmacol Toxicol 2018; 19:1. [PMID: 29301580 PMCID: PMC5755306 DOI: 10.1186/s40360-017-0192-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Accepted: 12/15/2017] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Several countries have used pegylation technology to improve the pharmacokinetic properties of essential drugs. Recently, a novel interferon alfa-2b protein conjugated to four-branched 12 kDa polyethylene glycol molecules was developed jointly between Cuba and Brazil. The aim of this study was to compare the pharmacokinetic properties of BIP48 (pegylated interferon alfa-2b from Bio-Manguinhos/Fiocruz, Brazil) to those of PEGASYS® (commercially available pegylated interferon alfa-2a from Roche Pharmaceutical). METHODS This phase I, single-centre, randomized, double-blind crossover trial enrolled 31 healthy male volunteers aged 19 to 35 who were allocated to two stages, either side of a 5-week wash-out period, with each arm lasting 14 consecutive days after subcutaneous administration of 180 μg of one formulation or the other (study or comparator). The main outcome variable was serum pegylated interferon concentrations in 15 samples collected during the course of the study and tested using an enzyme immunoassay. RESULTS There were no differences between formulations in terms of magnitude or absorption parameters. Analysis of time parameters revealed that BIP48 remained in the body significantly longer than PEGASYS® (Tmax: 73 vs. 54 h [p = 0.0010]; MRT: 133 vs. 115 h [p = 0.0324]; ke: 0.011 vs. 0.013 h(-1) [p = 0.0153]; t1/2: 192 vs. 108 h [p = 0.0218]). CONCLUSION BIP48 showed the expected pharmacokinetic profile for a pegylated product with a branched molecular structure. Compared to PEGASYS®, the magnitude absorption was similar, but time parameters were consistent with slower elimination. Further studies should be conducted to evaluate the clinical implications of these findings. A phase II-III repeated-dose clinical trial is ongoing to study these findings in patients with chronic hepatitis C virus infection. TRIAL REGISTRATION This study is registered on the ClinicalTrials.gov platform (accession number NCT01889849 ). This trial was retrospectively registered in June 2013.
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Affiliation(s)
- Marisa Boff Costa
- Center of Clinical Research, Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS Brazil
| | - Paulo Dornelles Picon
- Professor of Internal Medicine, Faculdade de Medicina do Rio Grande do Sul (UFRGS), Porto Alegre, RS Brazil
| | - Guilherme Becker Sander
- Professor of Internal Medicine, Faculdade de Medicina do Rio Grande do Sul (UFRGS), Porto Alegre, RS Brazil
| | - Hugo Nodarse Cuni
- Clinical Trials Division, Center for Biological Research, Havana, Cuba
| | | | | | | | | | | | | | | | - Pedro Lopez Saura
- Clinical Trials Division, Center for Biological Research, Havana, Cuba
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Iznaga Escobar NE, Luaces PL, Sanchez Valdes L, Valenzuela Silva C, Crombet Ramos T, Strumberg D, Schultheis B, Ebert MP, Kerkhoff A, Hofheinz R, Behringer DM, Schmidt WE, Goker E, De Dosso S, Kneba M, Yalcin S, Overkamp F, Schlegel F, Dommach M, Rohrberg R. Modified IPCW model: A method for adjusting for bias in the estimation of overall survival due to the use of second and third line therapies in locally advanced or metastatic pancreatic cancer patients. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.e15787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e15787 Background: Nimotuzumab, a unique and affinity differentiated anti-EGFR antibody had been used in combination with gemcitabine on the treatment of pancreatic cancer patients. The aim of the study was to evaluate overall survival. Methods: Patients with newly diagnosed, locally advanced or metastatic pancreatic cancer, KPS ≥ 70 %, 18-72 years old, with adequate renal and liver function were included. Pts received gemcitabine 1000 mg/m2and nimotuzumab or placebo fixed dose of 400 mg once a wk, for 3 wks, followed by a 1-wk rest (d1, 8, 15, q28) until disease progression or unacceptable toxicity. The primary endpoint was OS and secondary PFS, ORR, CBR, safety and QoL. For OS determination, a KM log-rank test was used and a modified IPCW with a cox regression as a secondary analysis. On this evaluation using a modified IPCW model, 41.7% of pts from treatment arm and 42.7% from control arm who received 2nd and 3rd line treatment were censored after progression, while pts that did not receive 2nd and 3rd line treatment were weighted to compensate for the bias created by censoring switchers to 2nd and 3rd line treatment. Results: 192 pancreatic cancer pts were recruited. Ninety-six pts (62 male and 34 female) with a median age of 67 years, range (31, 83) were randomized to treatment arm and 96 pts (57 male and 39 female) with a median age of 64 years, range (41, 82) were randomized to control arm. In the primary analysis, median OS [95% CI] in the treatment arm was 8.57 mo [5.93, 10.90] vs 6.03 mo [4.97, 7.60] in the control arm. The HR [95% CI], 0.83 [0.62, 1.12] and p = 0.23 and when a modified IPCW model as a secondary analysis was used to remove the effect of 2nd and 3rd line therapies, the median OS was statistically significant with a HR [95% CI], 0.81 [0.67, 0.98] and a p = 0.030. The median PFS [95% CI] was 4.43 mo [3.67, 6.00] in the treatment arm vs 3.47 mo [2.60, 4.03] in the control arm with a HR [95% CI] 0.68 [0.51, 0.92] and p = 0.012. Conclusions: A modified IPCW model had proven that addition of nimotuzumab to gemcitabine increases median overall survival of newly diagnosed chemotherapy-naïve locally advanced or metastatic pancreatic cancer patients. Clinical trial information: NCT00561990.
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Affiliation(s)
| | | | | | | | | | | | - Beate Schultheis
- Department of Hematology and Medical Oncology, University of Bochum (Marienhospital Herne), Herne, Germany
| | | | | | - Ralf Hofheinz
- University Medical Center Mannheim, Mannheim, Germany
| | | | | | | | - Sara De Dosso
- Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
| | - Michael Kneba
- University Medical Center Schleswig-Holstein, Kiel, Germany
| | - Suayib Yalcin
- Department of Medical Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | | | | | | | - Robert Rohrberg
- Gemeinschaftspraxis und Tagesklinik fuer Haematologie, Onkologie und Gastroenterologie, Halle, Germany
| | - Tilman Steinmetz, Dirk Reuter, Ferdinand Bach, Rikrik A. Ilyas, Budhi H. Simon, Group Practice Hematology/Oncology Cologne, Cologne, Germany; Oncoscience AG, Wedel, Germany, InnoCIMAb Pte Ltd, Singapore
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Anasagasti Angulo L, Garcia Vega Y, Collazo S, Jimenez Barban Y, Tijerino Arrieta E, Caballero YB, Linares VS, Guerra JM, Batista K, Roberts YD, Valenzuela Silva C, Iglesias AT, Alvarez Falcon L, Bello Rivero I. HeberFERON, formulation based on IFNs alpha2b and gamma for the treatment of non-melanoma skin cancer. Australas Med J 2017. [DOI: 10.21767/amj.2017.3013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Kawagoe JY, Toniolo AR, Santos CM, Silva CV, Menezes FG, Castagna HF, Cardoso MF, Gonçalves P, Pontes LG, Correa L. Multimodal hand hygiene program: twelve years of continuous improvement in the hospital. Antimicrob Resist Infect Control 2015. [PMCID: PMC4474875 DOI: 10.1186/2047-2994-4-s1-o21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Gonçalves P, Kawagoe JY, Cardoso MFDS, Silva CV, Toniolo ADR, Castagna HMF, dos Santos CM, de Menezes FG, Correa L. PDCA cycle reports: a quality tool to improve physician hand hygiene compliance. Antimicrob Resist Infect Control 2015. [PMCID: PMC4475168 DOI: 10.1186/2047-2994-4-s1-p280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
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Kawagoe JY, Toniolo AR, Silva CV, Menezes FG, Hutter M, Zimmer P, Barbosa L, Correa L, Santos C, Pontes L, Castagna H, Cardoso MF, Gonçalves P. Alcohol preparation compared to traditional surgical hand antisepsis: acceptance by surgical team at a private hospital in Brazil. Antimicrob Resist Infect Control 2015. [PMCID: PMC4475122 DOI: 10.1186/2047-2994-4-s1-p163] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Silva JM, Oliveira AM, Campos EV, Gomez DS, Ferreira MC, Giraud CS, Silva CV, Santos SRCJ. Vancomycin dose adjustment in severe burn patients based on trough level for drug effectiveness against pathogens at 1 mg/l minimum inhibitory concentration. Crit Care 2013. [PMCID: PMC3892205 DOI: 10.1186/cc12645] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Kawagoe JY, Silva CV, Cardoso MF, Gonçalves P, Ballalai MG, Toniolo AR, DalForno CB, Valerio ST, Reis EAA, Pontes LG, Cunha LB, Correa L. The challenges of hand hygiene improvement: a comparison between inpatient and outpatient units. BMC Proc 2011. [PMCID: PMC3239523 DOI: 10.1186/1753-6561-5-s6-p110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
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Ojeda Ojeda M, Larrondo Muguercia H, Magdariaga Figuerola A, Sánchez Valdivia A, Rodríguez Alonso I, Valenzuela Silva C, García Iglesias E, Domínguez Alonso E, Buurman WA, Araña Rosaínz MDJ. Temporal trends of circulating nitric oxide and pro-inflammatory cytokine responses ex vivo in intra-abdominal sepsis: results from a cohort study. Inflamm Res 2010; 60:289-97. [PMID: 20976525 DOI: 10.1007/s00011-010-0267-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2009] [Revised: 09/09/2010] [Accepted: 10/04/2010] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVE AND DESIGN To evaluate the association of pro-inflammatory mediators with organ dysfunction and adverse outcome in intra-abdominal sepsis patients. SUBJECTS Twenty-one patients admitted to the Intensive Care Unit (ICU) were prospectively included in the study. Only patients with surgical diagnosis of intra-abdominal sepsis were enrolled. RESULTS Tumor necrosis factor-α (TNFα) and interleukin (IL)-6 produced ex vivo were significantly lower in non-survivors on admission (p = 0.021) and day 2 (p = 0.013), respectively. Nitric oxide (NO(x)) levels were significantly higher in non-survivors from the onset of sepsis and until day 4 after diagnosis (p < 0.05). Circulating lymphocyte counts were lower in non-survivors after admission over time, but there was no association with impaired cytokine production in this group of patients during the entire follow-up. All non-survivors developed nosocomial pneumonia concomitantly with multiple organ dysfunction and septic shock. There was a significant correlation between nitric oxide (NO(x)) concentrations and the sequential organ failure assessment (SOFA) score at day 2 (r = 0.598, p = 0.009), and ICU stay (r = 0.605, p = 0.006). Continuously high NO(x) levels correlated with organ failure. The pro-inflammatory mediators TNFα, IL-6 and NO(x), and also the Simplified Acute Physiology Score II (SAPS-II), discriminate survivors from non-survivors. According to logistic regression models, although these parameters are independently associated with the outcome, they do not improve the predictive power of the SAPS-II score for mortality risk. CONCLUSIONS Disturbances in inflammatory responses and increase in NO(x) generation seem to characterize early intra-abdominal sepsis, in which immune suppression is associated with an increased susceptibility to nosocomial infections. Sequential NO(x) determinations could be a useful approach for improving the management of patients with intra-abdominal sepsis.
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Affiliation(s)
- Miriam Ojeda Ojeda
- Division of Pharmaceuticals, Center for Genetic Engineering and Biotechnology, Havana, Cuba.
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Bastos RKX, Bevilacqua PD, Silva CAB, Silva CV. Wastewater irrigation of salad crops: further evidence for the evaluation of the WHO guidelines. Water Sci Technol 2008; 57:1213-1219. [PMID: 18469392 DOI: 10.2166/wst.2008.244] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
This paper presents the results of an experiment on salad crop irrigation with waste stabilisation pond effluents, conducted in Southeast Brazil. Over about 18 months several trials were carried out using different effluent qualities to irrigate lettuce, kale, arugula, spinach, and green pepper. Equations for predicting the bacterial quality of irrigated crops (E.coli per gram) based on the irrigation water quality (E.coli per 100 mL) were derived for low and high growing crops. The quantitative microbial risk analysis (QMRA) technique, using pathogen-ingestion scenarios based on these field data and on official statistics of vegetables consumption in Brazil, was used to estimate infection risks arising from the consumption of wastewater irrigated crops. It is inferred that irrigation with effluents complying with the WHO guidelines for unrestricted irrigation should result in salad crops acceptable for consumption.
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Affiliation(s)
- R K X Bastos
- Universidade Federal de Viçosa, Departamento de Engenharia Civil, 36570-000, Viçosa-MG, Brasil.
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Estévez ZC, Betancourt AA, Muzio González V, Baile NF, Silva CV, Bernal FH, Arias EP, Delhanty Fernández A, Olazábal NM, del Río Martín A, Batista LL, Véliz Ríos G, Hernández HH, Hernández AB, Lugo EP, de la Torre Cruz J, Batista Marchec BL, Falcón LA, Brito JT, León DO, Saura PL. Immunogenicity and safety assessment of the Cuban recombinant hepatitis B vaccine in healthy adults. Biologicals 2006; 35:115-22. [PMID: 17056272 DOI: 10.1016/j.biologicals.2006.06.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2006] [Revised: 05/30/2006] [Accepted: 06/12/2006] [Indexed: 10/24/2022] Open
Abstract
Manufactures of biotechnological/biological products (including vaccines) frequently make changes to manufacturing processes of products both during development and after approval. In our case, a non-inferiority bridging study was carried out to demonstrate that changes in the production plant facilities of Cuban recombinant hepatitis B vaccine, Heberbiovac HB, did not affect the safety and immunogenicity of the vaccine. This controlled, randomized, doubled-blinded trial included 501 volunteers, aged between 20 and 64, who were given three doses of vaccine (20 microg HBsAg/mL) at month 0, 1, and 2. Four lots were evaluated (three corresponding to the new production facilities and a control one produced in the older facilities). One month after the third dose, were observed protective levels of anti-HBsAg in 97% of the subjects that concluded the study with a geometric mean antibody titer (GMT) of 931.18 IU/L. Normal values of body mass index (BMI), the younger ages, and being a female, were significantly related to a good antibody response. The vaccine was well tolerated. Pain at the injection site was the most commonly reported symptom. We conclude that Heberbiovac HB vaccine maintains its characteristics after the modifications carried out in the production plant facilities and both, lot obtained in previous facilities and in the new ones, are comparable in terms of safety and immunogenicity.
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Affiliation(s)
- Zurina Cinza Estévez
- Centre for Genetic Engineering and Biotechnology, Ave 31 e/158 y 190, P.O. Box 6162, 10600 Havana, Cuba.
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Hernández Valero E, Cabrera Gómez JA, Valenzuela Silva C. Características clínicas de la esclerosis múltiple en el Occidente de Cuba. Comparación con otras dos regiones del país. Rev Neurol 2004. [DOI: 10.33588/rn.3809.2003331] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Cabrera Gómez JA, Echazábal Santana N, Porrero Martín PJ, Valenzuela Silva C, Rodríguez CA, Fuentes Suárez I, Pérez Ruiz L, Ramos Cedeño AM, Cabrera Núñez JA. El Interferón-a2b recombinante mejora la disfunción cognitiva en pacientes con esclerosis múltiple. Rev Neurol 2003. [DOI: 10.33588/rn.3703.2003078] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Ojeda Ojeda M, Silva CV, de J Araña Rosaínz M, Fernández-Ortega C. TNFalpha production in whole blood cultures from healthy individuals. Biochem Biophys Res Commun 2002; 292:538-41. [PMID: 11906194 DOI: 10.1006/bbrc.2002.6688] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Tumor necrosis factor alpha (TNFalpha) is a major mediator of inflammatory responses and also plays a prominent role in bridging the innate and adaptive phases of immunity. In the present work we attempted to study TNFalpha production in endotoxin-stimulated blood of healthy individuals, and the inter-individual variability in TNFalpha production. For this study, we used diluted whole blood stimulated with lipopolysaccharide (LPS). The levels of the pro-inflammatory cytokine TNFalpha were measured by ELISA and by the L929 cytotoxicity bioassay in 16 and 18 healthy donors, respectively. There were highly significant inter-individual variations in the induced TNFalpha production. It is worth noting that there was no difference in sensitivity between ELISA and the cytotoxicity L929 bioassay. We concluded that whole blood culture is a sensitive method to determine the pro-inflammatory cytokine production in response to endotoxin stimuli in a relevant physiologic milieu. Our data indicate that this method provides appropriate information about the state of cellular immunity of the individual.
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Affiliation(s)
- Miriam Ojeda Ojeda
- Department of Cell Biology, Center for Genetic Engineering and Biotechnology, Havana, Cuba
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Laselva CR, Camargo LFA, Moura D, Yamashita MAA, Silva CV, Oliveira C, Bork AM, Knobel E. Quality improvement tools (PDCA cycle) enhances compliance to nosocomial infection preventive measures: experience of a medical-surgical ICU. Crit Care 2001. [PMCID: PMC3300964 DOI: 10.1186/cc1397] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Moura D, Camargo LFA, Laselva CR, Yamashita MAA, Silva CV, Oliveira C, Bork AM, Knobel E. Contact precautions for multidrug resistant bacteria: positive impact on handwashing compliance in an intensive care unit. Crit Care 2001. [PMCID: PMC3300963 DOI: 10.1186/cc1396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Kawagoe JY, Segre CA, Pereira CR, Cardoso MF, Silva CV, Fukushima JT. Risk factors for nosocomial infections in critically ill newborns: a 5-year prospective cohort study. Am J Infect Control 2001; 29:109-14. [PMID: 11287879 DOI: 10.1067/mic.2001.114162] [Citation(s) in RCA: 77] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND Nosocomial infections (NIs) are one of the most important causes of morbidity in neonatal intensive care units (NICUs). The aim of this study was to identify risk factors (RFs) for NIs among critically ill newborn patients in a Brazilian NICU. METHODS This 5-year prospective cohort study in an 8-bed NICU included all infants born in the hospital and admitted to the NICU from 1993 to 1997. Exposure variables were maternal and newborn data prospectively collected from patient records. Univariate and multivariate analyses were used to determine independent RFs associated with NIs. RESULTS Univariate analysis indicated gestational age, congenital abnormality, premature rupture of membranes, maternal illness, birth weight, mechanical ventilation, central venous catheter, total parenteral nutrition, peripheral venous catheter, and length of stay as possible RFs. Multivariate analysis identified 5 independent RFs for NIs: premature rupture of membranes (hazard ratio [HR] = 1.51 [95% CI, 1.15-1.99]), maternal disease (HR = 1.57 [95% CI, 1.18-2.07]), mechanical ventilation (HR = 2.43 [95% CI, 1.67-3.53]), central venous catheter (HR = 1.70 [95% CI, 1.21-2.41]), and total parenteral nutrition (HR = 4.04 [95% CI, 2.61-6.25]). CONCLUSION The recognition of RFs for NIs is an important tool for the identification and development of interventions to minimize such risks in the NICU.
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Affiliation(s)
- J Y Kawagoe
- Hospital Infection Control Service, Hospital Israelita Albert Einstein, São Paulo, Brazil
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Gilio AE, Stape A, Pereira CR, Cardoso MF, Silva CV, Troster EJ. Risk factors for nosocomial infections in a critically ill pediatric population: a 25-month prospective cohort study. Infect Control Hosp Epidemiol 2000; 21:340-2. [PMID: 10823571 DOI: 10.1086/501770] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
We studied risk factors for nosocomial infections among 500 critically ill children who were admitted to a pediatric intensive care unit from August 1994 through August 1996 and who were prospectively followed until death, transfer, or discharge. Age, gender, postoperative state, length of stay, device-utilization ratio, pediatric risk of mortality score, and total parenteral nutrition were the risk factors studied. Through multivariate analysis, we identified three independent risk factors for nosocomial infection: device-utilization ratio (odds ratio [OR], 1.6; 95% confidence interval [CI95], 1.10-2.34), total parenteral nutrition (OR, 2.5; CI95, 1.05 5.81) and length of stay (OR, 1.7; CI95, 1.31-2.21).
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Affiliation(s)
- A E Gilio
- Pediatric Intensive Care Unit, Hospital Israelita Albert Einstein-São Paulo, Brasil
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Tatsuo MA, Carvalho WM, Silva CV, Miranda AE, Ferreira SH, Francischi JN. Analgesic and antiinflammatory effects of dipyrone in rat adjuvant arthritis model. Inflammation 1994; 18:399-405. [PMID: 7982729 DOI: 10.1007/bf01534437] [Citation(s) in RCA: 45] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Dipyrone, a pirazolone derivative, is a known analgesic drug with minor toxic effects associated with its administration. The aim of the present study was to determine the analgesic and antiinflammatory effects of dipyrone in a model of chronic inflammation (adjuvant-induced arthritis in rats). Hind-paw hyperalgesia was detected in arthritic rats from the 10th to the 16th day of observation. Edema development was maximum (twofold increase) at the 14th day of observation compared to control animals and reduced at the 16th day of observation. Dipyrone (1-50 mg/kg) dose-dependently reduced both hind-paw hyperalgesia and edema from arthritic rats. However, it was shown to be more potent as analgesic than antiinflammatory in the present model. In contrast, indomethacin (2 mg/kg) and dexamethasone (0.4 mg/kg) completely inhibited hind-paw hyperalgesia and edema development. Our results indicate that dipyrone reduced the hyperalgesia and edema in arthritic rats by a mechanism not involving release of prostaglandin-like substances. The possibility of dipyrone inducing analgesia in arthritic rats through a peripheral action supports the use of dipyrone as an alternative choice drug for the treatment of pain associated with arthritislike diseases in selected cases.
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Affiliation(s)
- M A Tatsuo
- Department of Pharmacology, Biological Science Institute Federal University of Minas Gerais, Belo Horizonte, Brazil
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