Scientific opportunities in resilience research for cardiovascular health and wellness. Report from a National Heart, Lung, and Blood Institute workshop

Exposure of biological systems to acute or chronic insults triggers a host of molecular and physiological responses to either tolerate, adapt, or fully restore homeostasis; these responses constitute the hallmarks of resilience. Given the many facets, dimensions, and discipline-specific focus, gaining a shared understanding of "resilience" has been identified as a priority for supporting advances in cardiovascular health. This report is based on the working definition: "Resilience is the ability of living systems to successfully maintain or return to homeostasis in response to physical, molecular, individual, social, societal, or environmental stressors or challenges," developed after considering many factors contributing to cardiovascular resilience through deliberations of multidisciplinary experts convened by the National Heart, Lung, and Blood Institute during a workshop entitled: "Enhancing Resilience for Cardiovascular Health and Wellness." Some of the main emerging themes that support the possibility of enhancing resilience for cardiovascular health include optimal energy management and substrate diversity, a robust immune system that safeguards tissue homeostasis, and social and community support. The report also highlights existing research challenges, along with immediate and long-term opportunities for resilience research. Certain immediate opportunities identified are based on leveraging existing high-dimensional data from longitudinal clinical studies to identify vascular resilience measures, create a 'resilience index,' and adopt a life-course approach. Long-term opportunities include developing quantitative cell/organ/system/community models to identify resilience factors and mechanisms at these various levels, designing experimental and clinical interventions that specifically assess resilience, adopting global sharing of resilience-related data, and cross-domain training of next-generation researchers in this field.

The human body at cellular resolution: the NIH Human Biomolecular Atlas Program

Transformative technologies are enabling the construction of three-dimensional maps of tissues with unprecedented spatial and molecular resolution. Over the next seven years, the NIH Common Fund Human Biomolecular Atlas Program (HuBMAP) intends to develop a widely accessible framework for comprehensively mapping the human body at single-cell resolution by supporting technology development, data acquisition, and detailed spatial mapping. HuBMAP will integrate its efforts with other funding agencies, programs, consortia, and the biomedical research community at large towards the shared vision of a comprehensive, accessible three-dimensional molecular and cellular atlas of the human body, in health and under various disease conditions.

Emerging Concepts in Precision Medicine and Cardiovascular Diseases in Racial and Ethnic Minority Populations

Cardiovascular diseases remain the leading cause of mortality and a major contributor to preventable deaths worldwide. The dominant modifiable risk factors and the social and environmental determinants that increase cardiovascular risk are known, and collectively, are as important in racial and ethnic minority populations as they are in majority populations. Their prevention and treatment remain the foundation for cardiovascular health promotion and disease prevention. Genetic and epigenetic factors are increasingly recognized as important contributors to cardiovascular risk and provide an opportunity for advancing precision cardiovascular medicine. In this review, we explore emerging concepts at the interface of precision medicine and cardiovascular disease in racial and ethnic minority populations. Important among these are the lack of racial and ethnic diversity in genomics studies and biorepositories; the resulting misclassification of benign variants as pathogenic in minorities; and the importance of ensuring ancestry-matched controls in variant interpretation. We address the relevance of epigenetics, pharmacogenomics, genetic testing and counseling, and their social and cultural implications. We also examine the potential impact of precision medicine on racial and ethnic disparities. The National Institutes of Health's All of Us Research Program and the National Heart, Lung, and Blood Institute's Trans-Omics for Precision Medicine Initiative are presented as examples of research programs at the forefront of precision medicine and diversity to explore research implications in minorities. We conclude with an overview of implementation research challenges in precision medicine and the ethical implications in minority populations. Successful implementation of precision medicine in cardiovascular disease in minority populations will benefit from strategies that directly address diversity and inclusion in genomics research and go beyond race and ethnicity to explore ancestry-matched controls, as well as geographic, cultural, social, and environmental determinants of health.

NHLBI Cohort Studies: Opportunities for Nutrition Research (FS10-01-19)

Objectives

The recent release of the Strategic Plan for NIH Nutrition Research (SPNR) provides a unique opportunity for advancements in nutrition science and research through investigator-initiated efforts. This presentation provides a broad overview of the nutrition measures collected in NHLBI cohort studies and presents information on available resources through the NHLBI Biologic Specimen and Data Repository Information Coordinating Center (BioLINCC). Leveraging existing NHLBI cohort studies, which include diverse study populations, is a cost-effective approach for investigators, including early stage investigators, to develop new research questions.

Methods

A landscape analysis was conducted to evaluate the nutrition measures collected in eight, multi-site NHLBI-funded cohort studies including over 163,000 participants (ages 18 −100 y+). These datasets include the Coronary Artery Risk Development in Young Adults (CARDIA), the Framingham Heart Study, the Jackson Heart Study (JHS), the Women's Health Initiative (WHI), the Multi-Ethnic Study of Atherosclerosis (MESA), the Atherosclerosis Risk in Communities Study (ARIC), the Hispanics Community Health Study/Study of Latinos (SOL), and the Cardiovascular Health Study (CHS). Information from BioLINCC provided an additional resource to identify nutrition measures collected.

Results

Most of the cohort studies used food frequency questionnaires to assess diet, with a smaller number using 24-hr recall methodology. Concentration biomarkers largely varied by study, including carotenoid and vitamin D concentrations to serum calcium and potassium levels. Lipids and blood pressure measurements were consistently collected across all cohort studies and some studies collected inflammatory markers (e.g., C reactive protein, interleukin-6) and used more invasive and costly cardiac imaging outcomes (e.g., carotid IMT, coronary calcium).

Conclusions

This preliminary study identified variable nutrition measures and nutrition-related clinical outcomes in NHLBI-funded cohort studies, which are available on BioLINCC for future analysis by investigators. Additionally, these findings can help with implementation of the NIH SPNR by identifying key research gaps and possible focus areas for future research.

Funding Sources

National Institutes of Health.

Prevalence and risk factors of anemia among pregnant women attending a public-sector hospital in Bangalore, South India

Background:

Anemia affects almost two-thirds of pregnant women in developing countries and contributes to maternal mortality and low birthweight. According to the National Family Health Survey-4 reports, maternal anemia continues to be a public health problem.

Objective:

To study the prevalence of anemia and its risk factors among pregnant women attending a public-sector hospital.

Materials and Methods:

This study was nested within an ongoing cohort study “ÇASCADE” which is exploring the effect of prenatal exposure to maternal cortisol and psychological distress on infant development in Bangalore. The respondents were enrolled from the antenatal clinic at Jayanagar General Hospital, which is a sub-district hospital. A total of 280 women who fulfilled the eligibility criteria were enrolled.

Results:

The prevalence of anemia was observed to be 33.9%; proportion of mild and moderate anemia was almost similar (48.4 and 49.5%). The mean hemoglobin level of all the participants was 11.33 ± 1.460 g/dl. The mean hemoglobin level concentration was high during early gestation with a slight decrease by 21–24 weeks. Prenatal depression but not anxiety appeared to be a strong predictor of anemia on bivariate as well as multivariate analysis. No association was observed with socio-demographic and obstetric variables.

Conclusion:

The burden of maternal anemia was considerably high in the study population. Although iron-folic acid supplementation is available under the national health program to address this issue, it is important to consider and address other risk factors when designing and implementing target interventions for anemia control in selected populations.

Evaluation of the Prevalence of Oral Mucosal Lesions in a Population of Eastern Coast of South India

Objective/Aim

The aim of this study is to measure the association between oral mucosal lesions (OMLs) and habit of tobacco and alcohol in the population of Guntur city, Andhra Pradesh, South India.

Material and Method

A cross-sectional study was conducted on 300 participants in Guntur city with the habit of tobacco and alcohol consumption in various forms who were selected by stratified cluster random sampling technique. Guntur city was divided into four zones, that is, North, East, South, and West; and two administrative wards were randomly selected from each zone as clusters. Information was obtained by interviewing the participant regarding various tobacco-related habits followed by standardized clinical examination in the field. Clinical data were collected using a modified 1980 WHO Pro forma where the basis for diagnosis was established as per the criteria provided by the epidemiology guide for the diagnosis of oral mucosal diseases (WHO). Statistical tests such as Pearson Chi-square were exercised to test the significance, using SPSS version 19.0 with 0.05 as cutoff level of significance.

Results

Overall oral soft-tissue lesions were found in 42.4% of the study participants including nicotinic stomatitis, tobacco pouch keratosis, smokers melanosis, mild keratosis of the palate, and chewer's mucosa. In this study, nicotinic stomatitis was found to be the most common soft-tissue lesion among men, while leukoplakia was found to be the most common premalignant lesion with the prevalence being 5.7%. While oral submucous fibrosis was found to be the most common premalignant condition among women. It was found that 13.2% of illiterates (53) were having leukoplakia. In the present study, the lower labial mucosa and buccal mucosa were found to be the most common sites of occurrence of leukoplakia and oral submucous fibrosis.

Conclusion

This study gives information on the association of OML in smokers, chewers, alcoholics, and those with mixed habits. This study highlighted six habit-related OML which included potentially malignant disorders such as leukoplakia and oral submucous fibrosis. Future case-control or cohort studies for individual lesions and with larger sample size are necessary to evaluate the risk for OML including potentially malignant conditions and oral cancer resulting from smoking and chewing habits.

Fluoroquinolone-resistant Salmonella typhi infection: a report of two cases in South Africa

Typhoid and paratyphoid fever are acute, life-threatening febrile illnesses caused by systemic infection with the bacterium Salmonella enterica. Nineteen cases were reported in South Africa in 2016. We report on two cases of bacteraemic invasive S. typhi with fluoroquinolone resistance.

Investigation of propagation dynamics of truncated vector vortex beams

In this Letter, we experimentally investigate the propagation dynamics of truncated vector vortex beams generated using a Sagnac interferometer. Upon focusing, the truncated vector vortex beam is found to regain its original intensity structure within the Rayleigh range. In order to explain such behavior, the propagation dynamics of a truncated vector vortex beam is simulated by decomposing it into the sum of integral charge beams with associated complex weights. We also show that the polarization of the truncated composite vector vortex beam is preserved all along the propagation axis. The experimental observations are consistent with theoretical predictions based on previous literature and are in good agreement with our simulation results. The results hold importance as vector vortex modes are eigenmodes of the optical fiber.

Pattern of sexually transmitted infections: A profile from a rural- and tribal-based sexually transmitted infections clinic of a tertiary care hospital of Eastern India

Introduction:

Prevalence of Sexually transmitted infections (STI's) in developing nations is very high where the measures for STI treatment and prevention are limited. Enormous variation in clinical presentation make STI's very difficult to be studied epidemiologically. To know the exact prevalence of STI's is very important for a region or community for planning preventive strategies. The aim of the present study is to observe the pattern of sexually transmitted infections among the tribal and non-tribal population attending a rural and tribal base tertiary care Centre.

Method:

All the consecutive STI patients irrespective of age and sex attending the STI clinic were included. Thorough clinical examination and relevant investigations were done to know the different STI's present in them. They were divided into tribal and non-tribal group as per history and comparison of patterns of STI's done among the two groups.

Result:

Around 34% of STI patients were tribal. Majority of patients belong to 20-40 years of age. Sex ratio of tribal group was 1:0.86 and non-tribal group was 1:2.64. The difference is statistically significant. Commonest STI in both the group was Genital ulcer disease Herpetic but the occurrence of urethral discharge, genital scabies, and inguinal bubo were among the tribal group. Per vaginal discharge was the commonest STI among the female in both the groups. VDRL positivity was 1.16% and HIV positivity was 0.36% among STI clinic attendees.

Conclusion:

Tribal females need special attention for prevention of STI in tribal community.

Research on the human virome: where are we and what is next

The National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health convened a Working Group on the Microbiome in Cardiovascular, Pulmonary and Hematologic Health and Diseases from June 25, 2014, to June 26, 2014. The Working Group's central goal was to define what major microbiome research areas warranted additional study in the context of heart, lung, and blood (HLB) diseases. The Working Group identified studies of the human virome a key priority.

Zeolite Y-assisted nitration of aromatic and heterocyclic compounds and decarboxylative nitration of α,β-unsaturated acids under non-conventional conditions

The approach outlined in this paper is particularly appropriate for the conversion of unsaturated cinnamic acids into nitrostyrenes.

A phantom study on the behavior of Acuros XB algorithm in flattening filter free photon beams

To study the behavior of Acuros XB algorithm for flattening filter free (FFF) photon beams in comparison with the anisotropic analytical algorithm (AAA) when applied to homogeneous and heterogeneous phantoms in conventional and RapidArc techniques. Acuros XB (Eclipse version 10.0, Varian Medical Systems, CA, USA) and AAA algorithms were used to calculate dose distributions for both 6X FFF and 10X FFF energies. RapidArc plans were created on Catphan phantom 504 and conventional plans on virtual homogeneous water phantom 30 × 30 × 30 cm³, virtual heterogeneous phantom with various inserts and on solid water phantom with air cavity. Dose at various inserts with different densities were measured in both AAA and Acuros algorithms. The maximum % variation in dose was observed in (−944 HU) air insert and minimum in (85 HU) acrylic insert in both 6X FFF and 10X FFF photons. Less than 1% variation observed between −149 HU and 282 HU for both energies. At −40 HU and 765 HU Acuros behaved quite contrarily with 10X FFF. Maximum % variation in dose was observed in less HU values and minimum variation in higher HU values for both FFF energies. Global maximum dose observed at higher depths for Acuros for both energies compared with AAA. Increase in dose was observed with Acuros algorithm in almost all densities and decrease at few densities ranging from 282 to 643 HU values. Field size, depth, beam energy, and material density influenced the dose difference between two algorithms.

Oryzanol as natural antioxidant for improving sunflower oil stability

Sunflower oil is being made shelf stable by the incorporation of synthetic antioxidants such as tertiary butyl hydroquinone (TBHQ), while natural antioxidants like oryzanol and tocopherols can also be used. The aim of the current investigation was to evaluate the antioxidant effect of natural oryzanol (Oz) concentrate (15.5 % oryzanol) and purified Oz (80 % oryzanol) on oxidative and thermal stability of sunflower oil. Sunflower oil was incorporated with Oz concentrate to provide 0, 0.12, 0.25, 0.50, 0.84, 1.0, 1.60, 2.0, 2.5 and 3.20 % oryzanol in the oil, stored for 5 weeks at 37 °C and oxidative stability was evaluated. It was found that the oryzanol concentrate showed good antioxidant effect with increase in concentration of oryzanol. In another set of experiments, sunflower oil containing purified Oz at 1 % level individually and in combination with 0.1 % α- tocopherol (α-T) was heated at 120 °C for 24 h to evaluate thermal stability. Sunflower oil containing 1 % Oz (80 % purity) showed 98.40 % and sunflower oil containing 1 % Oz and 0.1 % α-T showed 108.75 % antioxidant effect compared to TBHQ taken as 100 %. The study indicated that sunflower oil containing 1 % Oz (80 % purity) and 0.1 % α-T combination provides a synergistic effect in inhibiting primary and secondary products and showed highest thermal stability. SFO containing 1 % Oz added as concentrate also showed good antioxidant effect during storage. Hence, instead of using synthetic antioxidants like TBHQ, we can add natural oryzanol (purified or as concentrate) to sunflower oil to increase its oxidative and thermal stability.

Integration of omics sciences to advance biology and medicine

In the past two decades, our ability to study cellular and molecular systems has been transformed through the development of omics sciences. While unlimited potential lies within massive omics datasets, the success of omics sciences to further our understanding of human disease and/or translating these findings to clinical utility remains elusive due to a number of factors. A significant limiting factor is the integration of different omics datasets (i.e., integromics) for extraction of biological and clinical insights. To this end, the National Cancer Institute (NCI) and the National Heart, Lung and Blood Institute (NHLBI) organized a joint workshop in June 2012 with the focus on integration issues related to multi-omics technologies that needed to be resolved in order to realize the full utility of integrating omics datasets by providing a glimpse into the disease as an integrated “system”. The overarching goals were to (1) identify challenges and roadblocks in omics integration, and (2) facilitate the full maturation of ‘integromics’ in biology and medicine. Participants reached a consensus on the most significant barriers for integrating omics sciences and provided recommendations on viable approaches to overcome each of these barriers within the areas of technology, bioinformatics and clinical medicine.

Prognostic significance of a multimarker strategy of biomarkers in acute heart failure

BACKGROUND

Heart failure (HF) is a growing public health problem. Patients often present to emergency department (ED) with acute onset dyspnea where a rapid triage is required to avoid misdiagnosis and to institute appropriate therapy. An objective risk-stratification in the ED is warranted to identify patients at high risk of adverse outcomes, so that more intensive therapy and vigilant follow-up after discharge are instituted.

METHODS AND RESULTS

Fifty two consecutive acute HF (AHF) patients in NYHA class III/IV were enrolled for the present study. N-terminal pro B-type natriuretic peptide (NT-proBNP), high-sensitivity cardiac troponin T (hsTropT), high-sensitivity C-reactive protein (hsCRP) and Uric acid (UA) were evaluated at admission; a second sample for NT-proBNP and hsTropT was obtained 48h later. The end-point of the study, a composite of cardiovascular death, rehospitalisation for worsening HF symptoms and refractory HF was reached in 32.7% of patients during a median follow-up of 4.8mnth. Although, hsTropT (>0.014ng/ml), hsCRP (>0.5mg/dl) and UA (>5.6mg/dl for females and >7 mg/dl for males) were elevated in the vast majority of patients (92.3%, 75% and 63.5% respectively), baseline and changing patterns of NT-proBNP following treatment were the only predictors of adverse outcomes on follow-up. A significant correlation between hsTropT, hsCRP and UA was observed suggesting a link between inflammation, myocyte injury and oxidative stress in AHF.

CONCLUSION

Baseline and changing patterns of NT-proBNP predicted adverse outcomes on follow-up suggesting that a strategy of serial measurement of NT-proBNP could prove invaluable in early risk stratification. Further research is needed to understand the link between inflammation, myocyte injury and oxidative stress in AHF which could provide potential therapeutic targets.

Incidence and patterns of valvular heart disease in a tertiary care high-volume cardiac center: a single center experience

BACKGROUND

Diseases of the heart valves constitute a major cause of cardiovascular morbidity and mortality worldwide with rheumatic heart disease (RHD) being the dominant form of valvular heart disease (VHD) in developing nations. The current study was undertaken at a tertiary care cardiac center with the objective of establishing the incidence and patterns of VHD by Echocardiography (Echo).

METHODS

Among the 136,098 first-time Echocardiograms performed between January 2010 and December 2012, an exclusion criterion of trivial and functional regurgitant lesions yielded a total of 13,289 cases of organic valvular heart disease as the study cohort.

RESULTS

In RHD, the order of involvement of valves was mitral (60.2%), followed by aortic, tricuspid and pulmonary valves. Mitral stenosis, predominantly seen in females, was almost exclusively of rheumatic etiology (97.4%). The predominant form of isolated MR was rheumatic (41.1%) followed closely by myxomatous or mitral valve prolapse (40.8%). Isolated AS, more common in males, was the third most common valve lesion seen in 7.3% of cases. Degenerative calcification was the commonest cause of isolated AS (65.0%) followed by bicuspid aortic valve (BAV) (33.9%) and RHD (1.1%). Multiple valves were involved in more than a third of all cases (36.8%). The order of involvement was MS + MR > MS + AR > MR + AR > AS + AR > MR + AS > MS + AS. Overall, 9.7% of cases had organic tricuspid valve disease.

CONCLUSION

RHD contributed most to the burden of VHD in the present study with calcific degeneration, myxomatous disease and BAV being the other major forms of VHD. Multiple valves were affected in more than a third of all cases.

Antibacterial and antimutagenic activities of novel zerumbone analogues

Zerumbone, the key constituent of Zingiber zerumbet Smith, is a very important bioactive phytochemical. Two new compounds viz. azazerumbone 1 and azazerumbone 2 were synthesised by ZnCl2-catalysed Beckmann rearrangement of the zerumbone oxime. The structure elucidation of these analogues of zerumbone was carried out by 1D ((1)H NMR and (13)C NMR) and 2D-NMR (COSY, HSQC and NOESY) spectral analysis. Studies on the antibacterial activity established that azazerumbone 2 had better activity than zerumbone. Among the tested bacteria, Bacillus cereus was the most sensitive and Yersinia enterocolitica was found to be the most resistant. These compounds exhibited strong protection against sodium azide induced mutagenicity of Salmonella typhimurium strains TA 98 and TA 1531. Azazerumbone 2 showed better antibacterial and antimutagenic activity than azazerumbone 1. The antibacterial and antimutagenic activities exhibited by zerumbone and its analogues demonstrate their potential for use as nutraceuticals and in food preservation.

Enzyme-assisted extraction of bioactive compounds from ginger (Zingiber officinale Roscoe)

Ginger (Zingiber officinale R.) is a popular spice used in various foods and beverages. 6-Gingerol is the major bioactive constituent responsible for the antiinflammatory, antitumour and antioxidant activities of ginger. The effect of application of α-amylase, viscozyme, cellulase, protease and pectinase enzymes to ginger on the oleoresin yield and 6-gingerol content has been investigated. Pre-treatment of ginger with α-amylase or viscozyme followed by extraction with acetone afforded higher yield of oleoresin (20%±0.5) and gingerol (12.2%±0.4) compared to control (15%±0.6 oleoresin, 6.4%±0.4 gingerol). Extraction of ginger pre-treated with enzymes followed by extraction with ethanol provided higher yield of gingerol (6.2-6.3%) than the control (5.5%) with comparable yields of the oleoresin (31-32%). Also, ethanol extract of cellulase pre-treated ginger had the maximum polyphenol content (37.5 mg/g). Apart from 6-gingerol, 6-paradol along with 6- and 8-methyl shogaols were the other important bio-active constituents in the oleoresin from cellulase-treated ginger.

Ag(I) Catalyzed Grafting of Acrylonitrile onto Gum Arabic by Ce(IV) in Medium: A Kinetic Study

Grafting of Acrylonitrile (AN) onto water-soluble polymer Gum arabic (GA) was carried out using ceric ammonium sulfate [Ce(IV)] as initiator in the presence and absence of Ag(I) in H2SO4 medium at 313 K. The rate of oxidation (), rate of grafting (), and grafting efficiency (GE) were determined for catalyzed and uncatalyzed grafting and suitable mechanism was proposed to explain the observed results. No homopolymerization in the absence of GA indicates that the polymer obtained is purely a graft copolymer. A probable mechanism involving the formation of Ag(I)-GA adduct followed by its oxidation with Ce(IV) to give Ag(II)-GA adduct, and its decomposition to give initiating radicals is proposed to explain the observed results. The graft polymer was characterized using Fourier-transform infrared (FTIR) spectroscopy, differential scanning calorimetry (DSC), X-ray diffraction, and scanning electron microscopy (SEM) considering GA as reference.

Structure-activity relationship studies of novel pyrazole and imidazole carboxamides as cannabinoid-1 (CB1) antagonists

The synthesis and biological evaluation of novel pyrazole and imidazole carboxamides as CB1 antagonists are described. As a part of eastern amide SAR, various chemically diverse motifs were introduced on rimonabant template. The central pyrazole core was also replaced with its conformationally constrained motif and imidazole moieties. In general, a range of modifications were well tolerated. Several molecules with low- and sub-nanomolar potencies were identified as potent CB1 receptor antagonists. The in vivo proof of principle for weight loss is demonstrated with a lead compound in DIO mice model.

The journey to regulation of protein-based multiplex quantitative assays

BACKGROUND

Clinical proteomics presents great promise in biology and medicine because of its potential for improving our understanding of diseases at the molecular level and for detecting disease-related biomarkers for diagnosis, prognosis, and prediction of therapeutic responses. To realize its full potential to improve clinical outcome for patients, proteomic studies have to be well designed, from biosample cohorts to data and statistical analyses. One key component in the biomarker development pipeline is the understanding of the regulatory science that evaluates diagnostic assay performance through rigorous analytical and clinical review criteria.

CONTENT

The National Cancer Institute's Clinical Proteomic Technologies for Cancer (CPTC) initiative has proposed an intermediate preclinical "verification" step to close the gap between protein-based biomarker discovery and clinical qualification. In collaboration with the US Food and Drug Administration (FDA), the CPTC network investigators recently published 2 mock submission review documents, first-of-their-kind educational materials that may help the scientific community interested in developing products for the clinic in understanding the likely analytical evaluation requirements for multiplex protein technology-based diagnostic tests.

CONCLUSIONS

Building on this momentum, the CPTC continues with this report its collaboration with the FDA, as well as its interactions with the AACC and the Centers for Medicare and Medicaid Services, to further the understanding of regulatory requirements for approving multiplex proteomic platform-based tests and analytically validating multiple analytes.

Novel pyrazole-3-carboxamide derivatives as cannabinoid-1 (CB1) antagonists: journey from non-polar to polar amides

The synthesis and biological evaluation of novel pyrazole-3-carboxamide derivatives as CB1 antagonists are described. As a part of eastern amide SAR, various chemically diverse motifs were introduced. In general, a range of modifications were well tolerated. Several molecules with high polar surface area were also identified as potent CB1 receptor antagonists. The in vivo proof of principle for weight loss is exemplified with a lead compound from this series.