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Bach MS, de Vries CR, Khosravi A, Sweere JM, Popescu MC, Chen Q, Demirdjian S, Hargil A, Van Belleghem JD, Kaber G, Hajfathalian M, Burgener EB, Liu D, Tran QL, Dharmaraj T, Birukova M, Sunkari V, Balaji S, Ghosh N, Mathew-Steiner SS, El Masry MS, Keswani SG, Banaei N, Nedelec L, Sen CK, Chandra V, Secor PR, Suh GA, Bollyky PL. Filamentous bacteriophage delays healing of Pseudomonas-infected wounds. Cell Rep Med 2022; 3:100656. [PMID: 35732145 PMCID: PMC9244996 DOI: 10.1016/j.xcrm.2022.100656] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [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: 11/21/2019] [Revised: 03/29/2022] [Accepted: 05/17/2022] [Indexed: 01/09/2023]
Abstract
Chronic wounds infected by Pseudomonas aeruginosa (Pa) are characterized by disease progression and increased mortality. We reveal Pf, a bacteriophage produced by Pa that delays healing of chronically infected wounds in human subjects and animal models of disease. Interestingly, impairment of wound closure by Pf is independent of its effects on Pa pathogenesis. Rather, Pf impedes keratinocyte migration, which is essential for wound healing, through direct inhibition of CXCL1 signaling. In support of these findings, a prospective cohort study of 36 human patients with chronic Pa wound infections reveals that wounds infected with Pf-positive strains of Pa are more likely to progress in size compared with wounds infected with Pf-negative strains. Together, these data implicate Pf phage in the delayed wound healing associated with Pa infection through direct manipulation of mammalian cells. These findings suggest Pf may have potential as a biomarker and therapeutic target in chronic wounds.
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Affiliation(s)
- Michelle S Bach
- Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University, Stanford, CA 94305, USA; Stanford Immunology, Stanford University, Stanford, CA 94305, USA
| | - Christiaan R de Vries
- Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University, Stanford, CA 94305, USA
| | - Arya Khosravi
- Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University, Stanford, CA 94305, USA
| | - Johanna M Sweere
- Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University, Stanford, CA 94305, USA; Stanford Immunology, Stanford University, Stanford, CA 94305, USA
| | - Medeea C Popescu
- Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University, Stanford, CA 94305, USA; Stanford Immunology, Stanford University, Stanford, CA 94305, USA
| | - Qingquan Chen
- Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University, Stanford, CA 94305, USA
| | - Sally Demirdjian
- Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University, Stanford, CA 94305, USA
| | - Aviv Hargil
- Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University, Stanford, CA 94305, USA
| | - Jonas D Van Belleghem
- Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University, Stanford, CA 94305, USA
| | - Gernot Kaber
- Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University, Stanford, CA 94305, USA
| | - Maryam Hajfathalian
- Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University, Stanford, CA 94305, USA; Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA
| | - Elizabeth B Burgener
- Center for Excellence in Pulmonary Biology, Department of Pediatrics, Stanford University, Stanford, CA 94305, USA
| | - Dan Liu
- Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University, Stanford, CA 94305, USA
| | - Quynh-Lam Tran
- Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University, Stanford, CA 94305, USA
| | - Tejas Dharmaraj
- Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University, Stanford, CA 94305, USA; Stanford Immunology, Stanford University, Stanford, CA 94305, USA
| | - Maria Birukova
- Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University, Stanford, CA 94305, USA; Stanford Immunology, Stanford University, Stanford, CA 94305, USA
| | - Vivekananda Sunkari
- Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University, Stanford, CA 94305, USA; Stanford Immunology, Stanford University, Stanford, CA 94305, USA
| | - Swathi Balaji
- Division of Pediatric Surgery, Department of Surgery, Baylor College of Medicine, Houston, TX 77030, USA
| | - Nandini Ghosh
- Department of Surgery, Indiana University, Indianapolis, IN 46202, USA
| | | | | | - Sundeep G Keswani
- Division of Pediatric Surgery, Department of Surgery, Baylor College of Medicine, Houston, TX 77030, USA
| | - Niaz Banaei
- Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University, Stanford, CA 94305, USA; Division of Pathology, Department of Medicine, Stanford University, Stanford, CA 94305, USA
| | - Laurence Nedelec
- Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University, Stanford, CA 94305, USA
| | - Chandan K Sen
- Department of Surgery, Indiana University, Indianapolis, IN 46202, USA
| | - Venita Chandra
- Department of Surgery, Division of Vascular Surgery, Stanford University, Stanford, CA 94305, USA
| | - Patrick R Secor
- Division of Biological Sciences, University of Montana, Missoula, MT 59812, USA
| | - Gina A Suh
- Division of Infectious Diseases, Mayo Clinic, Rochester, MN 55902, USA
| | - Paul L Bollyky
- Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University, Stanford, CA 94305, USA.
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Garcia LC, Shanafelt TD, West CP, Sinsky CA, Trockel MT, Nedelec L, Maldonado YA, Tutty M, Dyrbye LN, Fassiotto M. Burnout, Depression, Career Satisfaction, and Work-Life Integration by Physician Race/Ethnicity. JAMA Netw Open 2020; 3:e2012762. [PMID: 32766802 PMCID: PMC7414389 DOI: 10.1001/jamanetworkopen.2020.12762] [Citation(s) in RCA: 60] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
IMPORTANCE Previous research suggests that the prevalence of occupational burnout varies by demographic characteristics, such as sex and age, but the association between physician race/ethnicity and occupational burnout is less well understood. OBJECTIVE To investigate possible differences in occupational burnout, depressive symptoms, career satisfaction, and work-life integration by race/ethnicity in a sample of US physicians. DESIGN, SETTING, AND PARTICIPANTS In this cross-sectional study, data for this secondary analysis of 4424 physicians were originally collected from a cross-sectional survey of US physicians between October 12, 2017, and March 15, 2018. The dates of analysis were March 8, 2019, to May 21, 2020. Multivariable logistic regression, including statistical adjustment for physician demographic and clinical practice characteristics, was performed to examine the association between physician race/ethnicity and occupational burnout, depressive symptoms, career satisfaction, and work-life integration. EXPOSURES Physician demographic and clinical practice characteristics included race/ethnicity, sex, age, clinical specialty, hours worked per week, primary practice setting, and relationship status. MAIN OUTCOMES AND MEASURES Physicians with a high score on the emotional exhaustion or depersonalization subscale of the Maslach Burnout Inventory were classified as having burnout. Depressive symptoms were measured using the Primary Care Evaluation of Mental Disorders instrument. Physicians who marked "strongly agree" or "agree" in response to the survey items "I would choose to become a physician again" and "My work schedule leaves me enough time for my personal/family life" were considered to be satisfied with their career and work-life integration, respectively. RESULTS Data were available for 4424 physicians (mean [SD] age, 52.46 [12.03] years; 61.5% [2722 of 4424] male). Most physicians (78.7% [3480 of 4424]) were non-Hispanic White. Non-Hispanic Asian, Hispanic/Latinx, and non-Hispanic Black physicians comprised 12.3% (542 of 4424), 6.3% (278 of 4424), and 2.8% (124 of 4424) of the sample, respectively. Burnout was observed in 44.7% (1540 of 3447) of non-Hispanic White physicians, 41.7% (225 of 540) of non-Hispanic Asian physicians, 38.5% (47 of 122) of non-Hispanic Black physicians, and 37.4% (104 of 278) of Hispanic/Latinx physicians. The adjusted odds of burnout were lower in non-Hispanic Asian physicians (odds ratio [OR], 0.77; 95% CI, 0.61-0.96), Hispanic/Latinx physicians (OR, 0.63; 95% CI, 0.47-0.86), and non-Hispanic Black physicians (OR, 0.49; 95% CI, 0.30-0.79) compared with non-Hispanic White physicians. Non-Hispanic Black physicians were more likely to report satisfaction with work-life integration compared with non-Hispanic White physicians (OR, 1.69; 95% CI, 1.05-2.73). No differences in depressive symptoms or career satisfaction were observed by race/ethnicity. CONCLUSIONS AND RELEVANCE Physicians in minority racial/ethnic groups were less likely to report burnout compared with non-Hispanic White physicians. Future research is necessary to confirm these results, investigate factors contributing to increased rates of burnout among non-Hispanic White physicians, and assess factors underlying the observed patterns in measures of physician wellness by race/ethnicity.
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Affiliation(s)
- Luis C. Garcia
- Office of Faculty Development and Diversity, Stanford University School of Medicine, Stanford, California
| | - Tait D. Shanafelt
- Department of Medicine, Stanford University School of Medicine, Stanford, California
- WellMD Center, Stanford University School of Medicine, Stanford, California
| | - Colin P. West
- Department of Medicine, Mayo Clinic, Rochester, Minnesota
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota
| | | | - Mickey T. Trockel
- Department of Psychiatry, Stanford University School of Medicine, Stanford, California
| | - Laurence Nedelec
- WellMD Center, Stanford University School of Medicine, Stanford, California
| | - Yvonne A. Maldonado
- Office of Faculty Development and Diversity, Stanford University School of Medicine, Stanford, California
- Department of Pediatrics, Stanford University School of Medicine, Stanford, California
| | | | | | - Magali Fassiotto
- Office of Faculty Development and Diversity, Stanford University School of Medicine, Stanford, California
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3
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Abstract
IMPORTANCE The prevalence of physician burnout is well documented, and resilience training has been proposed as an option to support physician well-being. However, the resilience of physicians compared with that of the US working population is not established, and the association between resilience and physician burnout is not well understood. OBJECTIVES To evaluate resilience among physicians and US workers, and to determine the association between resilience and burnout among US physicians. DESIGN, SETTING, AND PARTICIPANTS A cross-sectional national survey study of 5445 US physicians and a probability-based sample of 5198 individuals in the US working population was conducted between October 12, 2017, and March 15, 2018. MAIN OUTCOMES AND MEASURES Resilience was measured using the 2-item Connor-Davidson Resilience Scale (total scores range from 0-8; higher scores indicate greater resilience); burnout was measured using the full Maslach Burnout Inventory with overall burnout indicated by a score of at least 27 on the 0 to 54 emotional exhaustion subscale and/or at least 10 on the depersonalization subscale (higher scores indicate greater burnout). RESULTS Of 30 456 physicians who received an invitation to participate, 5445 (17.9%) completed surveys (2995 men [62.1%]; median [IQR] age of 53 [42-62] years). In multivariable analysis, mean (SD) resilience scores were higher among physicians than the general employed population (6.49 [1.30] vs 6.25 [1.37]; adjusted mean difference, 0.25 points; 95% CI, 0.19-0.32; P < .001). Among physicians, resilience was associated with burnout. Physicians without overall burnout had higher mean (SD) resilience scores than physicians with burnout (6.82 [1.15] vs 6.13 [1.36]; adjusted mean difference, 0.68 points, 95% CI, 0.61-0.76; P < .001). Each 1-point increase in resilience score was associated with 36% lower odds of overall burnout (odds ratio, 0.64; 95% CI, 0.60-0.67; P < .001). However, 392 of 1350 physicians (29%) with the highest possible resilience score had burnout. CONCLUSIONS AND RELEVANCE The findings of this national survey study suggest that physicians exhibited higher levels of resilience than the general working population in the US. Resilience was inversely associated with burnout symptoms, but burnout rates were substantial even among the most resilient physicians. Additional solutions, including efforts to address system issues in the clinical care environment, are needed to reduce burnout and promote physician well-being.
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Affiliation(s)
- Colin P. West
- Division of General Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, Minnesota
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota
| | - Liselotte N. Dyrbye
- Division of Community Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, Minnesota
| | | | - Mickey Trockel
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, California
| | | | - Laurence Nedelec
- Department of Primary Care and Population Health, Department of Medicine, Stanford University, Palo Alto, California
| | | | - Tait D. Shanafelt
- Division of Hematology, Department of Medicine, Stanford University, Palo Alto, California
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Melnick ER, Sinsky CA, Dyrbye LN, Trockel M, West CP, Nedelec L, Shanafelt T. Association of Perceived Electronic Health Record Usability With Patient Interactions and Work-Life Integration Among US Physicians. JAMA Netw Open 2020; 3:e207374. [PMID: 32568397 PMCID: PMC7309439 DOI: 10.1001/jamanetworkopen.2020.7374] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
This cross-sectional survey assesses the association of perceived electronic health record usability with patient interaction and work-life integration among US physicians.
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Affiliation(s)
- Edward R. Melnick
- Department of Emergency Medicine, Yale University School of Medicine, New Haven, Connecticut
| | | | | | - Mickey Trockel
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, California
| | - Colin P. West
- Department of Medicine, Mayo Clinic, Rochester, Minnesota
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota
| | - Laurence Nedelec
- Department of Medicine, Stanford University School of Medicine, Palo Alto, California
| | - Tait Shanafelt
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota
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Melnick ER, Dyrbye LN, Sinsky CA, Trockel M, West CP, Nedelec L, Tutty MA, Shanafelt T. The Association Between Perceived Electronic Health Record Usability and Professional Burnout Among US Physicians. Mayo Clin Proc 2020; 95:476-487. [PMID: 31735343 DOI: 10.1016/j.mayocp.2019.09.024] [Citation(s) in RCA: 174] [Impact Index Per Article: 43.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 09/17/2019] [Accepted: 09/25/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To describe and benchmark physician-perceived electronic health record (EHR) usability as defined by a standardized metric of technology usability and evaluate the association with professional burnout among physicians. PARTICIPANTS AND METHODS This cross-sectional survey of US physicians from all specialty disciplines was conducted between October 12, 2017, and March 15, 2018, using the American Medical Association Physician Masterfile. Among the 30,456 invited physicians, 5197 (17.1%) completed surveys. A random 25% (n=1250) of respondents in the primary survey received a subsurvey evaluating EHR usability, and 870 (69.6%) completed it. EHR usability was assessed using the System Usability Scale (SUS; range 0-100). SUS scores were normalized to percentile rankings across more than 1300 previous studies from other industries. Burnout was measured using the Maslach Burnout Inventory. RESULTS Mean ± SD SUS score was 45.9±21.9. A score of 45.9 is in the bottom 9% of scores across previous studies and categorized in the "not acceptable" range or with a grade of F. On multivariate analysis adjusting for age, sex, medical specialty, practice setting, hours worked, and number of nights on call weekly, physician-rated EHR usability was independently associated with the odds of burnout with each 1 point more favorable SUS score associated with a 3% lower odds of burnout (odds ratio, 0.97; 95% CI, 0.97-0.98; P<.001). CONCLUSION The usability of current EHR systems received a grade of F by physician users when evaluated using a standardized metric of technology usability. A strong dose-response relationship between EHR usability and the odds of burnout was observed.
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Affiliation(s)
- Edward R Melnick
- Department of Emergency Medicine, Yale University School of Medicine, New Haven, CT.
| | | | - Christine A Sinsky
- Professional Satisfaction and Practice Sustainability, American Medical Association, Chicago, IL
| | - Mickey Trockel
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, CA
| | - Colin P West
- Department of Medicine, Mayo Clinic, Rochester, MN; Department of Health Sciences Research, Mayo Clinic, Rochester, MN
| | - Laurence Nedelec
- Department of Medicine, Stanford School of Medicine, Palo Alto, CA
| | - Michael A Tutty
- Professional Satisfaction and Practice Sustainability, American Medical Association, Chicago, IL
| | - Tait Shanafelt
- Department of Medicine, Stanford School of Medicine, Palo Alto, CA
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Burgener EB, Sweere JM, Bach MS, Secor PR, Haddock N, Jennings LK, Marvig RL, Johansen HK, Rossi E, Cao X, Tian L, Nedelec L, Molin S, Bollyky PL, Milla CE. Filamentous bacteriophages are associated with chronic Pseudomonas lung infections and antibiotic resistance in cystic fibrosis. Sci Transl Med 2019; 11:eaau9748. [PMID: 30996083 PMCID: PMC7021451 DOI: 10.1126/scitranslmed.aau9748] [Citation(s) in RCA: 64] [Impact Index Per Article: 12.8] [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: 08/07/2018] [Revised: 01/14/2019] [Accepted: 03/27/2019] [Indexed: 12/31/2022]
Abstract
Filamentous bacteriophage (Pf phage) contribute to the virulence of Pseudomonas aeruginosa infections in animal models, but their relevance to human disease is unclear. We sought to interrogate the prevalence and clinical relevance of Pf phage in patients with cystic fibrosis (CF) using sputum samples from two well-characterized patient cohorts. Bacterial genomic analysis in a Danish longitudinal cohort of 34 patients with CF revealed that 26.5% (n = 9) were consistently Pf phage positive. In the second cohort, a prospective cross-sectional cohort of 58 patients with CF at Stanford, sputum qPCR analysis showed that 36.2% (n = 21) of patients were Pf phage positive. In both cohorts, patients positive for Pf phage were older, and in the Stanford CF cohort, patients positive for Pf phage were more likely to have chronic P. aeruginosa infection and had greater declines in pulmonary function during exacerbations than patients negative for Pf phage presence in the sputum. Last, P. aeruginosa strains carrying Pf phage exhibited increased resistance to antipseudomonal antibiotics. Mechanistically, in vitro analysis showed that Pf phage sequesters these same antibiotics, suggesting that this mechanism may thereby contribute to the selection of antibiotic resistance over time. These data provide evidence that Pf phage may contribute to clinical outcomes in P. aeruginosa infection in CF.
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Affiliation(s)
- Elizabeth B Burgener
- Center for Excellence in Pulmonary Biology, Department of Pediatrics, Stanford University, Stanford, CA 94305, USA.
| | - Johanna M Sweere
- Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University, Stanford, CA 94305, USA
- Stanford Immunology, Stanford University, Stanford, CA 94305, USA
| | - Michelle S Bach
- Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University, Stanford, CA 94305, USA
| | - Patrick R Secor
- Division of Biological Sciences, University of Montana, Missoula, MT 59812, USA
| | - Naomi Haddock
- Stanford Immunology, Stanford University, Stanford, CA 94305, USA
| | - Laura K Jennings
- Division of Biological Sciences, University of Montana, Missoula, MT 59812, USA
| | - Rasmus L Marvig
- Center for Genomic Medicine, Rigshospitalet-Copenhagen University Hospital, Copenhagen, Denmark
| | - Helle Krogh Johansen
- Department of Clinical Microbiology, Rigshospitalet, Copenhagen Ø, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen N, Denmark
| | - Elio Rossi
- Department of Clinical Microbiology, Rigshospitalet, Copenhagen Ø, Denmark
| | - Xiou Cao
- Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University, Stanford, CA 94305, USA
| | - Lu Tian
- Biomedical Data Science Administration and Statistics, Stanford University, Stanford, CA 94305, USA
| | - Laurence Nedelec
- Primary Care and Population Health, Stanford University, Stanford, CA 94305, USA
| | - Søren Molin
- Primary Care and Population Health, Stanford University, Stanford, CA 94305, USA
| | - Paul L Bollyky
- Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University, Stanford, CA 94305, USA
- Stanford Immunology, Stanford University, Stanford, CA 94305, USA
| | - Carlos E Milla
- Center for Excellence in Pulmonary Biology, Department of Pediatrics, Stanford University, Stanford, CA 94305, USA
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Abstract
Fluorescent spirolactone derivatives are obtained by coupling 3-carboxylic coumarins to a spirolactone bearing a 3-hydroxypropyl chain in the 7 alpha position. The two esters prepared by this method are highly fluorescent (emission 383 and 408 nm).
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Affiliation(s)
- G Auzou
- INSERM U 300, Montpellier, France
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Nedelec L, Pierdet A, Fauveau P, Euvrard C, Proulx-Ferland L, Dumont C, Labrie F, Boissier JR. Synthesis and central dopaminergic activities of (+/-)-hexahydro-7H-indolo[3,4-gh][1,4]benzoxazine derivatives [(+/-)-9-oxaergolines]. J Med Chem 1983; 26:522-7. [PMID: 6834383 DOI: 10.1021/jm00358a012] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
The synthesis and biological activities of a series of (+/-)-hexahydro-7H-indolo[3,4-gh][1,4]benzoxazine derivatives [(+/-)-trans-9-oxaergolines] with central dopamine (DA) agonist properties are described. The compounds were prepared from [2aRS-(2a alpha,4 beta,5 alpha)]-4-amino-1,2,2a,3,4, 5-hexahydro-1-(phenylmethyl)benz[cd]indol-5-ol (6b) by alkaline cyclization of the corresponding N-chloracetamide 7b, followed by reduction of the amido group [5aRS-(5a alpha, 6a beta, 10a alpha)]-4,5,5a,6,6a,7,9, 10a-octahydro-4-(phenylmethyl)-7H-indolo[3,4-gh][1,4]benzoxazin-8-one (8b) with LiAlH4. After debenzylation of the resulting amine 9a, the indoline ring of [5aRS-(5a alpha, 6a beta, 10a alpha)]-4,5,5a,6,6a,8,9, 10a-octahydro-7H-indolo[3,4-gh][1,4 ]benzoxazine (10a) was dehydrogenated with MnO2 to give (+/-)-trans-9-oxaergoline (11a), which can be alkylated on the nitrogen (11b,c and 12) and brominated in position 2 (13a,b). The compounds were examined in vitro for their ability to bind to DA receptors and to inhibit prolactin (PRL) secretion in pituitary cells in culture, in vivo both for their DA stimulant effects at the striatal level (circling in 6-OHDA-lesioned animals, DA turnover, and stereotypy) and inhibitory effects on plasma PRL levels in rats, and for their emetic effects in dogs. Most of the tested compounds were active in these tests, and the potency of (+/-)-trans-6-n-propyl-9-oxaergoline (11c) was comparable to that of pergolide mesylate.
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9
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Bourgoin S, Hamon M, Bruxelle J, Oliveras JL, Besson JM, Pratt J, Jenner P, Reynolds EH, Marsden CD, Leger L, McRae-Degueurce A, Pujol JF, Wiklund L, Joseph MH, Kadam BV, Whitaker PM, Marsden CA, Tricklebank MD, Hutson PH, Curzon G, Herbet A, Nelson DL, Glowinski J, Hamon M, Petitjean F, Buda C, Janin M, Touret M, Salvert D, Jouvet M, Bobillier P, Maj J, Przegaliński E, Ashkenazi R, Youdim MBH, Nicolaou NM, Garcia-Munoz M, Arbuthnott GW, Eccleston D, Araneda S, Gamrani A, Font C, Calas A, Bobillier P, Pujol JF, Hutson PH, Knott PJ, Curzon G, Petitjean F, Chiang CY, Buda C, Janin M, Jouvet M, Soubrié P, Héry F, Bourgoin S, Montastruc JL, Artaud F, Glowinski J, Nicolaou NM, Eccleston D, Fillion G, Rousselle JC, Fillion MP, Jacob J, Curzon G, Kantamaneni BD, van Boxel P, Gillman PK, Holder GE, Bartlett JR, Bridges PK, Hunt P, Euvrard C, Brown N, Nedelec L, Joseph MH, Gamble SJ, Harris MJ, Johnstone EC, Risby D. Abstracts. Advances in Experimental Medicine and Biology 1981. [DOI: 10.1007/978-1-4684-3860-4_43] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Delaroff V, Dupuy N, Nedelec L, Legrand M. Circular dichroism, proton magnetic resonance and conformation of steroid 4-en-3-ones, 4, 9-dien-3-ones and 4, 9, 11-trien-3-ones. Tetrahedron 1979. [DOI: 10.1016/0040-4020(79)87050-7] [Citation(s) in RCA: 5] [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: 10/17/2022]
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11
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Nedelec L, Torelli V, Rousseau G, Allais A, Philibert D, Fournex R, Azadian-Boulanger G. 10. Sultine analogues of spirolactones. ACTA ACUST UNITED AC 1978. [DOI: 10.1016/0022-4731(78)90710-0] [Citation(s) in RCA: 2] [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: 11/26/2022]
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12
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Nedelec L, Gasc J, Delaroff V, Bucourt R, Nomine G. Les dimethyl-2ξ, 17α,δ9 et δ9,11 nor-19-testosterones. Conformation du cycle a et equilibres en solution. Tetrahedron 1978. [DOI: 10.1016/0040-4020(78)88411-7] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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