[Therapeutic approach to epilepsy from the nutritional view: current status of dietary treatment]

Approximately 20%-30% of epilepsy patient do not respond adequately to drug treatment. In this population, a dietary treatment has been posed as a therapeutic alternative or coadjuvant tool. This present work has aimed to carry out a review on the dietary alternatives currently available to treat epilepsy (ketogenic diet, Atkins' diet, etc.). The ketogenic diet has been used and studied the most in this neurological disorder. That is why it is also the one that has undergone the greatest change. Furthermore, this diet has caused the most controversy about its action mechanism, efficacy and adverse effects as well as about what would be the best protocol to carry it out. Many observational studies and reviews on this subject that support the beneficial effect of the ketogenic diet have been conducted. However, controlled, randomized clinical trials with larger population samples are needed to confirm these results in order to achieve an optimum and individualized dietary treatment in refractory epilepsy.

Sumecton reinforced gelatin-based scaffolds for cell-free bone regeneration

Bone tissue engineering has risen to tackle the challenges of the current clinical need concerning bone fractures that is already considered a healthcare system problem. Scaffold systems for the repair of this tissue have yielded different combinations including biomaterials with nanotechnology or biological agents. Herein, three-dimensional porous hydrogels were engineered based on gelatin as a natural biomaterial and reinforced with synthetic saponite nanoclays. Scaffolds were biocompatible and shown to enhance the inherent properties of pristine ones, in particular, proved to withstand pressures similar to load-bearing tissues. Studies with murine mesenchymal stem cells found that scaffolds had the potential to proliferate and promote cell differentiation. In vivo experiments were conducted to gain insight about the ability of these cell-free scaffolds to regenerate bone, as well as to determine the role that these nanoparticles in the scaffold could play as a drug delivery system. SDF-1 loaded scaffolds showed the highest percentage of bone formation, which was corroborated by osteogenic markers and new blood vessels. Albeit a first attempt in the field of synthetic nanosilicates, these results suggest that the designed constructs may serve as delivery platforms for biomimetic agents to mend bony defects, circumventing high doses of therapeutics and cell-loading systems.

[Treatment adherence with levetiracetam: a non-interventionist retrospective observation-based study]

INTRODUCTION

Treatment adherence is a factor that is affecting the effectiveness of antiepileptic drugs. Levetiracetam is a drug whose effectiveness and safety is well established and is available in different oral formulations (granulates in sachets, tablets, oral solution), but information on treatment adherence/compliance with these oral formulations is limited.

AIM

To determine treatment adherence with levetiracetam formulations (granulates in sachets, tablets) in adult and elderly people.

PATIENTS AND METHODS

Retrospective observational non-interventionist study. During the three months before the study patients should be treated with levetiracetam (granulates in sachets or tablets), either alone or in combination. Compliance tests (Green-Morisky modified test) as well as a satisfaction questionnaire investigator and patient/caregiver is assessed. Data were analyzed using SPSS v. 21.0 program.

RESULTS

A total of 466 patients completed the study. The average age was 52.75 ± 19.17 years old and the average over 65 years of 72.79 ± 6.15. 55.4% were men. Compliance is related to the variable 'pharmaceutical formulation' and with age (p = 0.031). The risk of non-compliance was 86.4% higher among those taking tablets versus granulates in sachets of levetiracetam (odds ratio: 1.864). Likewise, the non-compliance was greater among patients over 65 years. The non-compliance was related to attributing of memory failures.

CONCLUSIONS

Patients older are more difficult to compliance. The granulates levetiracetam in sachets improves compliance.

Harnessing extracellular vesicle membrane for gene therapy: EVs-biomimetic nanoparticles

One of the main concerns in oligonucleotide-based therapeutics is achieving a successful cell targeting while avoiding drug degradation and clearance. Nanoparticulated drug delivery systems have emerged as a way of overcoming these issues. Among them, membrane-coated nanoparticles are of increasing relevance mainly due to their enhanced cellular uptake, immune evasion and biocompatibility. In this study, we designed and elaborated a simple and highly tuneable biomimetic drug delivery nanosystem based on a polymeric core surrounded by extracellular vesicles (EVs)-derived membranes. This strategy should allow the nanosystems to benefit from the properties conferred by the membrane proteins present in EVs membrane, key paracrine mediators. The developed systems were able to successfully encapsulate the required oligonucleotides. Also, their characterisation through already well standardised methods (dynamic light scattering, transmission electron microscopy and nanoparticle tracking analysis) and by fluorescence cross-correlation spectroscopy (FCCS) showed the desired core-shell structure. The cellular uptake using different cell types further confirmed the coating though an enhancement in cell internalisation of the developed biomimetic nanoparticles. This study brings up new possibilities for GapmeR delivery as it might be a base for the development of new delivery systems for gene therapy.

SFRP1-Silencing GapmeR-Loaded Lipid-Polymer Hybrid Nanoparticles for Bone Regeneration in Osteoporosis: Effect of Dosing and Targeting Strategy

Introduction

Osteoporosis is a metabolic disorder characterized by the loss of bone mass and density. Nucleic acid-based therapies are among the most innovative approaches for osteoporosis management, although their effective delivery to bone tissue remains a challenge. In this work, SFRP1-silencing GampeR loaded-nanoparticles were prepared and functionalized with specific moieties to improve bone targeting and, consequently, therapeutic efficacy. SFRP1-silencing would promote osteoblastic differentiation by enhancing the WNT/β-catenin pathway and thus diminishing the progression of osteoporosis.

Methods

A nucleic acid-based delivery system consisting of lipid-polymer hybrid nanoparticles (LPNPs) loading a GapmeR for SFRP1 silencing was developed and further functionalized with two bone-targeting moieties: a specific aptamer (Apt) for murine mesenchymal stem cells and an antiresorptive drug, namely alendronate (ALD). These systems were tested in vivo in osteoporotic mice at different dosage regimens to analyze dose dependence in bone-forming activity and potential toxicity. The quality of trabecular and cortical bone was assessed by both micro computed tomography (micro-CT) and histological and histomorphometric analyses. Early and late osteogenesis were quantified by immunohistochemistry.

Results

Results showed that functionalizing LPNPs loaded with an SFRP1-silencing GapmeR using both Apt and ALD improved bone quality and enhanced osteogenesis following a dose-effect relationship, as revealed by micro-CT, histological and immunohistochemical analyses. In contrast, non-functionalized LPNPs did not produce these effects.

Conclusion

These findings highlight the relevance of proper targeting and dosage in nucleic acid-based therapeutics, proving to be crucial for exerting their therapeutic effect: a deficient targeting strategy and/or dosage may result in the therapeutic failure of an adequate gene therapy agent.

[The virtue of that precious balsam...: approach to Don Quixote from the psychopharmacological perspective]

The most outstanding novel of the Spanish literature, Don Quixote, represents the source to which the different specialists who intend to deepen their knowledge of the late Renaissance society usually address. This masterpiece of Miguel de Cervantes has been frequently approached from the psychopathological perspective to obtain a psychiatric diagnosis of its main character, Alonso Quijano. Also, other clinical approaches from the traumatological and general therapeutical view (oils, ointments, balms and other pharmacy preparations) have been frequent. We have tackled Don Quixote from the psychopharmacological perspective, a barely explored field. In this work, we intend to study the therapeutical cures used during the Cervantine time for the treatment of insane and mentally disturbed people (sedatives like opium, laxatives like hellebore, tonics, irritants and surgical techniques like bloodlettings and <<fuentes>>) and we analyze the limited and unspecific therapies, mainly of herbal origin (balms, purgatives and emetics), which Cervantes reveals to us in his novel. Among them, rhubarb root (Rumex alpinus), seeds of spurge (Euphorbia lathyris), St. John's Wort (Hypericum perforatum), main ingredient of Aparicio's oil, and rosemary (Rosmarinus officinalis), primary component of the famous balsam of Fierabras, should be highlighted. We have also examined the possible scientific influences which might have inspired Cervantes in this field, mainly the works of Juan Huarte de San Juan The examination of men's wits and the one of Andres Laguna Dioscorides' materia medica.

Nanoclay-reinforced HA/alginate scaffolds as cell carriers and SDF-1 delivery-platforms for bone tissue engineering

Bone tissue engineering has come on the scene to overcome the difficulties of the current treatment strategies. By combining biomaterials, active agents and growth factors, cells and nanomaterials, tissue engineering makes it possible to create new structures that enhance bone regeneration. Herein, hyaluronic acid and alginate were used to create biologically active hydrogels, and montmorillonite nanoclay was used to reinforce and stabilize them. The developed scaffolds were found to be biocompatible and osteogenic with mMSCs in vitro, especially those reinforced with the nanoclay, and allowed mineralization even in the absence of differentiation media. Moreover, an in vivo investigation was performed to establish the potential of the hydrogels to mend bone and act as cell-carriers and delivery platforms for SDF-1. Scaffolds embedded with SDF-1 exhibited the highest percentages of bone regeneration as well as of angiogenesis, which confirms the suitability of the scaffolds for bone. Although there are a number of obstacles to triumph over, these bioengineered structures showed potential as future bone regeneration treatments.