Inhibition of post-transcriptional gene silencing of chalcone synthase genes in petunia picotee petals by fluacrypyrim

In petals of picotee petunia (Petunia hybrida) cultivars, margin-specific post-transcriptional gene silencing (PTGS) of chalcone synthase A (CHSA) inhibits anthocyanin biosynthesis, resulting in marginal white tissue formation. In this study, we found that a low molecular mass compound, fluacrypyrim, inhibits PTGS of CHSA, and we explored the site-specific PTGS mechanism of operation. Fluacrypyrim treatment abolished the picotee pattern and eliminated site-specific differences in the levels of anthocyanin-related compounds, CHSA expression, and CHSA small interfering RNA (siRNA). In addition, fluacrypyrim abolished the petunia star-type pattern, which is also caused by PTGS of CHSA. Fluacrypyrim treatment was effective only at the early floral developmental stage and predominantly eliminated siRNA derived from CHS genes; i.e. siRNA derived from other genes remained at a comparable level. Fluacrypyrim probably targets the induction of PTGS that specifically operates for CHS genes in petunia picotee flowers, rather than common PTGS maintenance mechanisms that degrade mRNAs and generate siRNA. Upon treatment, the proportion of colored tissue increased due to a shift of the border between white and colored sites toward the margin in a time- and dose-dependent manner. These findings imply that the fluacrypyrim-targeted PTGS induction is completed gradually and its strength is attenuated from the margins to the center of petunia picotee petals.

An adjuvant compound that enhances immunogenicity at fractional doses of the Sabin-inactivated poliovirus vaccine (sIPV) with a long duration of protection in a rat model

BACKGROUND

At the same dosage, the new generation of Sabin-inactivated poliovirus vaccine (sIPV) is less immunogenic than the traditional oral polio vaccine (OPV) dosage in China. The useful adjuvant might be a necessary strategy to strengthen the immune protective effects.

METHODS

In this study, we produced an adjuvant compound (named KML05) that could promote immunogenicity and fractional doses of sIPV with a long duration of protection in a rat model. The compound adjuvant had both advantages and a function of MF59 and carbopol971P.

RESULTS

The effect seroconversion of experimental animals immunized with KML05 could be extended to one-eighth of the dose. According to the result of the geometric mean titers (GMTs), KML05 adjuvant could save eight times the amount of sIPV D-antigen usage, but aluminum hydroxide adjuvant could save twice at the same titers. Additionally, it was found that there was a significant difference in the GMT titer of poliovirus type 2 between animals immunized by KML05 and alum adjuvant (P < 0.05). At 12th-month postvaccination, the neutralization titers stimulated by IPV-KML05 were maintained over a longer time period in immunized animals.

CONCLUSION

Our research team developed KML05 adjuvant, which combined carbopol971P with MF59, increased antibody responses to sIPV for a longer duration of protection in a rat model.

Critical evaluation of 2-ethylhexyl acrylate dermal carcinogenicity studies using contemporary criteria

Skin tumors have been observed in C3H/HeJ mice following treatment with high and strongly irritating concentrations of 2-ethylhexyl acrylate (2-EHA). Dermal carcinogenicity studies performed with 2-EHA are reviewed, contrasting the results in two mouse strains (C3H/HeJ and NMRI) under different dosing regimens. Application of contemporary evaluation criteria to the existing dermal carcinogenicity dataset demonstrates that 2-EHA induces skin tumors only at concentrations exceeding an maximum tolerated dose (MTD) and in the immune-dysregulated C3H/HeJ mouse model. Overall, the available chronic toxicity and genotoxicity data on 2-EHA support a non-genotoxic chemical irritant mechanism, whereby chronic irritation leads to inflammation, tissue injury, and wound repair, the latter of which is disrupted in C3H/HeJ mice and leads to tumor formation. Tumor response information in excess of an MTD should not be considered in a human hazard or risk assessment paradigm. For the purposes of an appropriate hazard assessment, 2-EHA did not cause or initiate dermal carcinogenesis in an immune competent (NMRI) mouse model, and, even in the immune compromised C3H/HeJ model, did not induce skin tumors at doses which did not exceed the MTD.

Nose-to-brain delivery of insulin enhanced by a nanogel carrier

Recent evidences suggest that insulin delivery to the brain can be an important pharmacological therapy for some neurodegenerative pathologies, including Alzheimer disease (AD). Due to the presence of the Blood Brain Barrier, a suitable carrier and an appropriate route of administration are required to increase the efficacy and safety of the treatment. Here, poly(N-vinyl pyrrolidone)-based nanogels (NG), synthetized by e-beam irradiation, alone and with covalently attached insulin (NG-In) were characterized for biocompatibility and brain delivery features in a mouse model. Preliminarily, the biodistribution of the "empty" nanocarrier after intraperitoneal (i.p.) injection was investigated by using a fluorescent-labeled NG. By fluorescence spectroscopy, SEM and dynamic light scattering analyses we established that urine clearance occurs in 24h. Histological liver and kidneys inspections indicated that no morphological alterations of tissues occurred and no immunological response was activated after NG injection. Furthermore, after administration of the insulin-conjugated nanogels (NG-In) through the intranasal route (i.n.) no alteration or immunogenic response of the nasal mucosa was observed, suggesting that the formulation is well tolerated in mouse. Moreover, an enhancement of NG-In delivery to the different brain areas and of its biological activity, measured as Akt activation levels, with reference to free insulin administration was demonstrated. Taken together, these results indicate that the synthesized NG-In enhances brain insulin delivery upon i.n. administration and strongly encourage its further evaluation as therapeutic agent against some neurodegenerative diseases.

MCT1 Inhibitor AZD3965 Increases Mitochondrial Metabolism, Facilitating Combination Therapy and Noninvasive Magnetic Resonance Spectroscopy

Monocarboxylate transporters (MCT) modulate tumor cell metabolism and offer promising therapeutic targets for cancer treatment. Understanding the impact of MCT blockade on tumor cell metabolism may help develop combination strategies or identify pharmacodynamic biomarkers to support the clinical development of MCT inhibitors now in clinical trials. In this study, we assessed the impact of the MCT1 inhibitor AZD3965 on cancer cell metabolism in vitro and in vivo Exposing human lymphoma and colon carcinoma cells to AZD3965 increased MCT4-dependent accumulation of intracellular lactate, inhibiting monocarboxylate influx and efflux. AZD3965 also increased the levels of TCA cycle-related metabolites and 13C-glucose mitochondrial metabolism, enhancing oxidative pyruvate dehydrogenase and anaplerotic pyruvate carboxylase fluxes. Increased mitochondrial metabolism was necessary to maintain cell survival under drug stress. These effects were counteracted by coadministration of the mitochondrial complex I inhibitor metformin and the mitochondrial pyruvate carrier inhibitor UK5099. Improved bioenergetics were confirmed in vivo after dosing with AZD3965 in mouse xenograft models of human lymphoma. Our results reveal new metabolic consequences of MCT1 inhibition that might be exploited for therapeutic and pharmacodynamic purposes. Cancer Res; 77(21); 5913-24. ©2017 AACR.

Inhibition of the Nuclear Export Receptor XPO1 as a Therapeutic Target for Platinum-Resistant Ovarian Cancer

Purpose: The high fatality-to-case ratio of ovarian cancer is directly related to platinum resistance. Exportin-1 (XPO1) is a nuclear exporter that mediates nuclear export of multiple tumor suppressors. We investigated possible clinicopathologic correlations of XPO1 expression levels and evaluated the efficacy of XPO1 inhibition as a therapeutic strategy in platinum-sensitive and -resistant ovarian cancer.Experimental Design: XPO1 expression levels were analyzed to define clinicopathologic correlates using both TCGA/GEO datasets and tissue microarrays (TMA). The effect of XPO1 inhibition, using the small-molecule inhibitors KPT-185 and KPT-330 (selinexor) alone or in combination with a platinum agent on cell viability, apoptosis, and the transcriptome was tested in immortalized and patient-derived ovarian cancer cell lines (PDCL) and platinum-resistant mice (PDX). Seven patients with late-stage, recurrent, and heavily pretreated ovarian cancer were treated with an oral XPO1 inhibitor.Results: XPO1 RNA overexpression and protein nuclear localization were correlated with decreased survival and platinum resistance in ovarian cancer. Targeted XPO1 inhibition decreased cell viability and synergistically restored platinum sensitivity in both immortalized ovarian cancer cells and PDCL. The XPO1 inhibitor-mediated apoptosis occurred through both p53-dependent and p53-independent signaling pathways. Selinexor treatment, alone and in combination with platinum, markedly decreased tumor growth and prolonged survival in platinum-resistant PDX and mice. In selinexor-treated patients, tumor growth was halted in 3 of 5 patients, including one with a partial response, and was safely tolerated by all.Conclusions: Taken together, these results provide evidence that XPO1 inhibition represents a new therapeutic strategy for overcoming platinum resistance in women with ovarian cancer. Clin Cancer Res; 23(6); 1552-63. ©2016 AACR.

Development of Branched Poly(5-Amino-1-pentanol-co-1,4-butanediol Diacrylate) with High Gene Transfection Potency Across Diverse Cell Types

One of the most significant challenges in the development of polymer materials for gene delivery is to understand how topological structure influences their transfection properties. Poly(5-amino-1-pentanol-co-1,4-butanediol diacrylate) (C32) has proven to be the top-performing gene delivery vector developed to date. Here, we report the development of branched poly(5-amino-1-pentanol-co-1,4-butanediol diacrylate) (HC32) as a novel gene vector and elucidate how the topological structure affects gene delivery properties. We found that the branched structure has a big impact on gene transfection efficiency resulting in a superior transfection efficiency of HC32 in comparison to C32 with a linear structure. Mechanistic investigations illustrated that the branched structure enhanced DNA binding, leading to the formation of toroidal polyplexes with smaller size and higher cationic charge. Importantly, the branched structure offers HC32 a larger chemical space for terminal functionalization (e.g., guanidinylation) to further enhance the transfection. Moreover, the optimized HC32 is capable of transfecting a diverse range of cell types including cells that are known to be difficult to transfect such as stem cells and astrocytes with high efficiency. Our study provides a new insight into the rational design of poly(β-amino ester) (PAE) based polymers for gene delivery.

Short article: Faldaprevir, deleobuvir and ribavirin in IL28B non-CC patients with HCV genotype-1a infection included in the SOUND-C3 phase 2b study

BACKGROUND

SOUND-C3 was a multicentre, open-label, phase 2b study exploring the safety and efficacy of the interferon-free combination of faldaprevir (an NS3/A4 protease inhibitor), deleobuvir (BI 207127, a non-nucleoside polymerase inhibitor) and ribavirin in treatment-naive patients with chronic hepatitis C virus (HCV) genotype-1 infection. Results in patients with HCV genotype-1b and in IL28B CC genotype patients with HCV genotype-1a have been described previously. This report describes the results in IL28B non-CC genotype patients with HCV genotype-1a.

METHODS

Patients were randomized to receive faldaprevir 120 mg once daily with deleobuvir at either 800 mg twice daily (b.i.d.; N=26) or 600 mg three times daily (t.i.d.; N=25), and weight-based ribavirin for 24 weeks. The primary endpoint was sustained virological response 12 weeks after treatment (SVR12).

RESULTS

In each group, five patients completed 24 weeks of treatment. SVR12 rates were 19% (5/26) and 8% (2/25) in the b.i.d. and t.i.d. groups, respectively. On-treatment breakthrough [50% (13/26) and 68% (17/25) in the b.i.d. and t.i.d. groups, respectively] was the most frequent reason for not achieving SVR12. Adverse events led to premature treatment discontinuation in six (23%) patients in the b.i.d. group and in two patients (8%) in the t.i.d. group. The majority of adverse events were mild or moderate; the most frequently reported were nausea (67%), fatigue (35%) and diarrhoea (35%).

CONCLUSION

In this small study, the interferon-free regimen of faldaprevir, deleobuvir and ribavirin resulted in high rates of virological breakthrough and low rates of SVR12 in IL28B non-CC genotype patients infected with genotype-1a HCV (http://www.clinicaltrials.gov NCT01132313).

Impaired neuronal and vascular responses to angiotensin II in a rabbit congestive heart failure model

Congestive heart failure (CHF) is characterised by activation of the renin-angiotensin-aldosterone system (RAAS) and the sympathetic nervous system (SNS). Both systems are known to interact and to potentiate each other's activities. We recently demonstrated that angiotensin II (Ang II) enhances sympathetic nerve traffic via prejunctionally-located AT1-receptors. At present, little is known about the effects of Ang II at the level of the sympathetic neurones in CHF.

Accordingly, we investigated the effect of Ang II in the presence and absence of the AT1-receptor antagonist, eprosartan, on stimulation-induced nerve traffic in isolated thoracic aorta preparations obtained from rabbits suffering from experimentally-induced CHF. Control-preparations were obtained from age-matched animals. Sympathetic activity was assessed by a [3H]noradrenaline spill-over model. Additionally, Ang II constrictor responses were compared between CHF and control vessels in the presence and absence of eprosartan. Additionally, to study postjunctional facilitation, the effects of Ang II on postsynaptic α-adrenoceptor-mediated responses were studied using noradrenaline.

Stimulation-evoked SNS-neurotransmission was similar in both groups (CHF versus control). Ang II (0.1 nM—0.1 µM) caused a concentration-dependent increase of the stimulation-evoked sympathetic outflow in both groups, with a maximum at 10 nM (control [n=7], FR2/FR12.03±0.11 and CHF-preparations [n=7], FR2/FR11.71±0.07). The enhancement by Ang II was decreased in CHF-preparations compared with controls (p<0.05). Eprosartan concentration-dependently attenuated the Ang II-enhanced (10 nM) sympathetic outflow in both CHF- and control preparations. The sympathoinhibitory potency of eprosartan was similar in both groups (control pIC508.81±0.31; CHF 8.65±0.42).

Ang II (1 nM—0.3 µM) concentration-dependently increased the contractile force in control preparations (Emax21.64±3.86 mN, pD27.63±0.02, n=7). Eprosartan (1 nM—0.1 µM) influenced the Ang IIcontractions via a mixed form of antagonism. In CHF-preparations, Ang II caused impaired vascular contraction. The KCl-induced contraction was decreased in the CHF- compared with control preparations (13.02±0.64 mN versus 30.40±0.89 mN). The relative Ang II contraction (% of KCl) was also decreased (2.3% vs. 58.0%). Concentration-response curves to noradrenaline (%KCl) were similar (control pD26.93±0.05, Emax131.0±2.7; CHF pD27.00±0.05, Emax136.7±2.6) (p>0.05) and were not affected by Ang II.

We conclude that Ang II-enhanced sympathetic neurotransmission is mediated by the prejunctional AT1-receptor in both control and CHF-preparations. The decreased facilitation of SNS effects by Ang II may be explained by down-regulation or desensitisation of the neuronal AT1-receptor. Additionally, the aortic contractile capacity in heart failure rabbits appears to be decreased, probably as a result of heart failure-associated neuroendocrine and functional changes.

A Novel Isoquinoline Derivative Anticancer Agent and Its Targeted Delivery to Tumor Cells Using Transferrin-Conjugated Liposomes

We have screened 11 isoquinoline derivatives and α-methylene-γ-butyrolactones using the 3-(4,5-dimethylthi-azol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) cytotoxicity assay in HeLa and HEK-293T cells. Compound 2 was identified as potential anticancer agent. To further improve its therapeutic potential, this agent was incorporated into transferrin (Tf)-conjugated liposomes (LPs) for targeted delivery to tumor cells. We have demonstrated Tf-LP-Compound 2 have superior antitumor activity compared to non-targeted controls and the free drug. These data show Tf-LP-Compound 2 to be a promising agent that warrants further evaluation.

Influence of formulation technique on acrylate methacrylate copolymer modified paracetamol matrix tablets

This work was designed to evaluate the influence of various methods such as dry granulation (DG), wet granulation (using the polymer in an ethanolic solution (WGO) or aqueous dispersion (WGA) and solid dispersion (SD) techniques, on properties of paracetamol matrix tablets prepared using varying concentrations of acrylate methacrylate copolymer. Tablet properties were investigated using official and unofficial standards. Drug dissolution profile assessed at pH 1.2 was studied spectrophotometrically at λ(max) of 245 nm. With the use of various kinetic models, the release mechanism of the drug was analyzed. The parameters, maximum amount of drug release (m(∞)) at time t(∞) were obtained, m(∞) was ≥ 91.36 %, while t(∞) was ≥ 4.5 h. The release rate constant (k) for DG tablets was 15.61 h(sup>-1(/sup>, while, WGO, WGA and SD tablets were 12.90, 11.03 and 10.75 h(-1) respectively. The matrix tablets, which exhibited marked retardation in drug release displayed a Higuchi square root of time model (R(2) > 0.98). The mechanism through which the drug was released was governed by Fickian diffusion release (n values < 0.5). The performance of the drug was affected by the formulation technique in the order of SD > WGO > WGA > DG.

Design, characterization and in-vitro evaluation of different cellulosic acrylic and methacrylic polymers loaded aceclofenac microspheres

The aspire of this attempt was to design and evaluate aceclofenac loaded sustained release microspheres by emulsion solvent evaporation method, using different polymers like Ethyl cellulose (EC), Kollidon SR (KSR), Eudragit RS 100, Eudragit RL 100 and Hydroxypropylmethyl Cellulose (HPMC K100M). Microspheres were prepared using different stirring rate (1200, 1500, 2000rpm) and larger microspheres were obtained with lower stirring rate. Performance of microspheres was evaluated in terms of in vitro dissolution study which was allowed according to USP paddle method using Phosphate Buffer (pH 6.8) for 8 hours. UV-spectrophotometric method was used to calculate the drug content and the maximum and minimum release of aceclofenac from microspheres was observed 96.08% and 46.41% for formulation F18 and F5 after 8 hours respectively. Dissolution data were fitted by different mathematical models such as the zero order plot, first order plot, Higuchi plot, Hixon-Crowel plot and korsemeyer plot. Korsemeyer model has found to best fitted with release data. Scanning electron microscopic technique was performed to obtain the particle size and morphological changes due to different polymers. Fourier Transform Infra-red (FT-IR) spectroscopy was performed to find out any interaction of drug with the polymers. The drug might be released by both diffusion and erosion as data were best fitted with Korsemeyer model. So it has been demonstrated that aceclofenac microspheres containing different cellulosic, acrylic and methacrylic loaded polymers may be excellent candidates for consideration in drug delivery systems.

Toxicology and carcinogenesis studies of trimethylolpropane triacrylate (technical grade) (CASRN 15625-89-5) in F344/N rats and B6C3F1/N mice (dermal studies)

BACKGROUND

Trimethylolpropane triacrylate (TMPTA) is used as an ingredient in a wide variety of coatings, resins, photosensitive materials, and superabsorbent baby diapers. We studied the effects of TMPTA on male and female rats and mice to identify potential toxic or cancer-related hazards.

METHODS

We applied solutions containing TMPTA in acetone on the backs of male and female rats and mice. Groups of 50 male and female rats and mice received 0.3, 1, or 3 milligrams of TMPTA per kilogram of body weight five days per week for two years. Groups of animals receiving acetone alone served as the control groups. At the end of the study, tissues from more than 40 sites were examined for every animal.

RESULTS

Survival and body weights of all groups of exposed animals were similar to the control groups. Epidermal hyperplasia was observed in the skin at the site where the chemical was applied in all groups of animals receiving 1 mg/kg or more. Hyperkeratosis at the site of application was also increased in rats receiving TMPTA, and chronic inflammation was also seen in the skin of male and female mice receiving TMPTA. Malignant mesotheliomas were seen in a few male rats exposed to TMPTA. Two different rare forms of liver cancer (hepatoblastoma and hepatocholangiocarcinoma) were observed in some of the female mice exposed to TMPTA, and tumors of the uterus (stromal polyp or stromal sarcoma) also occurred in some exposed female mice.

CONCLUSIONS

We conclude that exposure to TMPTA caused rare cancers of the liver and tumors of the uterus in female mice and may have been related to the occurrence of malignant mesothelioma in male rats. No occurrences of cancer were associated with exposure to TMPTA in female rats or male mice. Skin lesions at the site of application, including hyperplasia in rats and mice, hyperkeratosis in rats, and inflammation in mice occurred in all animal groups exposed to higher concentrations of TMPTA.

Screening paediatric rectal forms of azithromycin as an alternative to oral or injectable treatment

The aim of this study was to identify a candidate formulation for further development of a home or near-home administrable paediatric rectal form of a broad-spectrum antibiotic - specially intended for (emergency) use in tropical rural settings, in particular for children who cannot take medications orally and far from health facilities where injectable treatments can be given. Azithromycin, a broad-spectrum macrolide used orally or intravenously for the treatment of respiratory tract, skin and soft tissue infections, was selected because of its pharmacokinetic and therapeutic properties. Azithromycin in vitro solubility and stability in physiologically relevant conditions were studied. Various pharmaceutical forms, i.e. rectal suspension, two different rectal gels, polyethylene glycol (PEG) suppository and hard gelatin capsule (HGC) were assessed for in vitro dissolution and in vivo bioavailability in the rabbit. Azithromycin PEG suppository appears to be a promising candidate.

[Clinical cases about the therapeutic use of debriding dressing hidrodetersive polyacrylate fibers with TLC and foam dressings TLC-NOSF polyurethane in chronic wounds]

The treatment of chronic wounds requires the use of highly specific products for different phases of the healing process. This article raises a number of clinical cases with chronic wounds of vascular origin and pressure ulcers. Such cases required a initial debridement because of the large content of fibrin covering the wound bed at this stage was used dressing hidrodetersive polyacrylate fibers with TLC. Once the debridement is continued treatment with a polyurethane foam dressing with TLC-NOSF.

Solid lipid nanoparticles: a possible vehicle for zinc oxide and octocrylene

An efficient sunscreen formulation shows good absorption in the relevant UV range. Efficacy also means that the UV absorber must be easily incorporated in any kind of formulation. In this study, a chemical absorber, octocrylene, and one of the most important physical blockers, zinc oxide, could be successfully incorporated into Solid Lipid Nanoparticle (SLN) systems which themselves have UV blocking potential similar to physical sunscreens, and remained stable for a period of 360 days while providing UVA and UVB protection. Crystalline structure related to the chemical nature of the solid lipid is a key factor to decide whether a sunscreening agent will be expelled or incorporated in the long-term and for a controlled optimization of active ingredient incorporation and loading, intensive characterization of the physical state of the lipid particles was highly essential. Thus, FT-IR, NMR, XRD and DSC analyses were performed and the results did not indicate stability problems. pH values of the SLN systems were found to be between 5.4-5.9 in all formulations which may be buffered by the skin. Transpore test results proved the UV blocking potential of the SLNs with not any active ingredient and the synergistic effects by the incorporation of molecular sunscreens. Therefore, concentration of molecular sunscreens in the formulations was decreased to 0.6%. UVA and UVB screening potentials of octocrylene and zinc oxide formulations were compared in the 290-400 nm wavelength region. Zinc oxide loaded SLN suspensions were found to be more effective in the UVA region while octocrylene loaded ones performed better in the UVB region.

A liquid-film forming acrylate cream for the treatment of anal pruritus

Pruritus ani is a hidden but frequently occurring clinical condition, with a large impact on patients' quality of life. Currently, therapeutic options are scarce, offering mainly limited success. The authors performed a prospective, open-label, two-centre pilot study to analyse the efficacy and safety of a liquid-film forming acrylate cream for the treatment of pruritus ani and peri-anal skin irritation. A total of 28 patients were included and applied the cream to the cleansed anal and peri-anal skin once daily for a study period of 3-4 weeks. The primary outcome measure was the reduction of pruritis ani, comparing day 0 to day 28 results. For this purpose, a visual analog scale (VAS) was used. Secondary parameters included the physician global assessment score (PGA) of peri-anal skin condition, assessment of patients' quality of life using a specifically designed quality of life scoring tool, and patient satisfaction with the treatment regimen. The application of the acrylate skin protection cream resulted in a fast and substantial improvement of all study parameters, with a high score for patient satisfaction. The cream was well tolerated without any adverse events noted during the study period. The authors' pilot study has generated initial evidence that the acrylate skin protection cream may be effective for the treatment of pruritus ani. However, further randomized controlled studies are needed to confirm the authors' findings.

Efficacy of Carbopol 974P (Siccafluid) in the treatment of severe to moderate keratoconjunctivitis sicca (KCS) in patients with primary Sjögren’s syndrome (SS) not responding to standard treatment with artificial tears

OBJECTIVE

To determine efficacy and safety of Carbopol 974P in the treatment of severe to moderate keratoconjunctivitis sicca (KCS) in patients with primary Sjögren's syndrome (SS) not responding to standard treatment with artificial tears.

METHODS

60 patients (57 F, 3 M, mean age 52.5+/-12.0, mean disease duration 12.2+/-7.1 yrs) affected with primary SS diagnosed according to the European Community Study Group criteria were studied. Foregoing medications for SS and artificial tears for KCS have not been changed within 3 and 2 months respectively prior to the study onset. In all cases Carbopol 974P was added because symptoms of KCS were not adequately controlled with traditional lubricants. Schirmer I test, B.U.T. (break up time), rose Bengal-stain, clinical ophthalmological examination (i.e. fluorescein staining, keratis, corneal infiltrates and ulcers) and a questionnaire for dry eye symptoms (range 0-30) were performed at entry (T0) and after 2 (T1) and 12 (T2) weeks. Assessment of global efficacy was obtained by VAS 0-100 at T2 either by patients and by the ophthalmologist.

RESULTS

Lachrymal tests significantly improved after 2 and, even more, after 12 weeks. Clinical ophthalmologic picture also ameliorated: a remarkable reduction of fluorescein positive lesions was demonstrated from 71.6% of the cases at T0 to 38.3% at T2. Total score of symptoms (T0: 16.1+/-7.3) dropped to 11.9+/-6.6 (T1) (p=0.000) and then to 6.7+/-5.3 (T2) (p=0.000). Global efficacy expressed by patients and physician was 74.8+/-15.9 and 76.6+/-13.0, respectively. No adverse events (blurred vision, allergy) were reported throughout the study.

CONCLUSIONS

Our study seems to demonstrate that addition of Carbopol 974P to the traditional therapeutic armamentarium for moderate to severe KCS is useful and well accepted in patients with primary SS in which management of ocular symptoms is unsatisfactory.

Factors influencing polycation/siRNA colloidal stability toward aerosol lung delivery

Hexanediol diacrylate cross-linked oligoethylenimine (OEI-HD) is a non-viral polymeric vector designed to deliver siRNA. To achieve safe and effective in vivo siRNA delivery using this vector, the polyplex must have sufficient colloidal stability if administered intravenously or nebulized for delivery by the pulmonary route. In this study, polyplexes from OEI-HD and siRNA were formulated for aerosol-based lung delivery, regarding their colloidal stability, optimal particle size, and in vitro biological activity. Herein, we describe how these properties are dependent upon the polymer-to siRNA weight ratios, buffer composition they were complexed in, PEG-grafting, and the addition of commercial lung surfactants and/or non-ionic surfactants to the formulation. Lastly, the effects of nebulization of the formulation into aerosol droplets, on the polyplex particle size and transfection efficiency, were evaluated. Polyplex size was monitored for up to 2 h after polyplex formation to determine the extent of aggregation and final particle sizes when stability was achieved. Our results suggest that PEG-grafting and polyethylenimine-PEG mixing were effective in achieving colloidal stability in isotonic saline buffers. In addition, colloidal stability was achieved in isotonic glucose buffers using commercially available non-ionic surfactant Pluronic™ P68 or the lung-derived surfactant Alveofact™. The smallest particle size, 140 nm, was obtained with Pluronic™ F68. For transfection efficiency, both Alveofact™ and Pluronic™ F68 achieved equal or better transfection when added to the OEI-HD/siRNA polyplexes. For long term storage of OEI-HD/siRNA formulations, we propose a lyophilization method that created in situ polyplexes upon addition of water. Preparation of OEI-HD/siRNA polyplexes by this method allowed dry storage at room temperature for up to the 3 months. In conclusion, we have identified approaches to achieve formulation and colloidal stability of OEI-HD/siRNA complexes, a step toward successful application of polyplexes for in vivo siRNA delivery.

Preparation of fluconazole buccal tablet and influence of formulation expedients on its properties

The aim of present study was to prepare buccal tablets of fluconazole for oral candidiasis. The dosage forms were designed to release the drug above the minimum inhibitory concentration for prolonged period of time so as to reduce the frequency of administration and to overcome the side effects of systemic treatment. The buccal tablets were prepared by using Carbopol 71G and Noveon AA-1 by direct compression method. Microcrystalline cellulose was used as the filler and its effect was also studied. The prepared dosage forms were evaluated for physicochemical properties, in vitro release studies and mucoadhesive properties using sheep buccal mucosa as a model tissue. Tablets containing 50% of polymers (Carbopol & Noveon) were found to be the best with moderate swelling along with favorable bioadhesion force, residence time and in vitro drug release. The in vitro drug release studies revealed that drug released for 8 h, which in turn may reduce dosing frequency and improved patient compliance in oral candidiasis patients.

Oligoarginine-linked polymers as a new class of penetration enhancers

Oligoarginines, which are known as cell-penetrating peptides, enhance the cellular uptake of poorly membrane-permeable bioactive molecules that are chemically conjugated to them. We designed a novel polymer: oligoarginine-linked poly(N-vinylacetamide-co-acrylic acid), with the expectation that the polymers will enhance the cellular uptake of the bioactive molecules that are physically mixed with them. Oligoarginines were grafted onto the polymer backbone through the chemical reaction with acrylic acid functional groups. The changes in the blood glucose concentration after nasal administration of insulin with and without the polymer were monitored in mice. The blood glucose concentration was slightly reduced when insulin was given solely at a dose of 10IU/kg. A D-octaarginine-linked poly(N-vinylacetamide-co-acrylic acid) with a grafting degree of 2% significantly enhanced the insulin-induced hypoglycemic effect. A similar enhancement was not observed when the polymer was substituted with intact D-octaarginine. The penetration-enhancing function of D-octaarginine-linked poly(N-vinylacetamide-co-acrylic acid) increased dramatically with an increase in the grafting degree of D-octaarginine. Substitution of D-octaarginine with the corresponding optical isomer and an increase in the number of arginine residues rather reduced the penetration-enhancing function. In vitro cell studies also indicated that a D-octaarginine-linked poly(N-vinylacetamide-co-acrylic acid) with a grafting degree of 17% enabled fluorescein isothiocyanate-dextran to effectively penetrate the cell membrane. Results demonstrated that our oligoarginine-linked polymer has a potential to provide a new class of penetration enhancers.

Evaluation of a mucoadhesive lipid-based bioerodable tablet compared with Biotène mouthwash for dry mouth relief--a pilot study

OBJECTIVE

Salivary gland impairment is a major problem that can result in hyposalivation and a decrease in quality of life. Causes for mouth dryness can be grossly classified into three major groups: iatrogenic, immunogenic, and metabolic. At present, insufficient therapies exist to ease morbidity in this growing number of affected individuals. A need for new products to relieve oral dryness is mandatory. The aim of this study was to evaluate a mucoadhesive lipid-based bioerodable tablet as a novel device to decrease signs and symptoms associated with mouth dryness.

METHOD AND MATERIALS

Twenty xerostomic patients were divided into two groups. In group 1, the mucoadhesive tablet was applied to the hard palate, while in group 2, Biotène mouthwash was applied and served as a control. Sialometry measurements, as well as a questionnaire assessing mouth dryness, were obtained before and after treatment.

RESULTS

Application of the mucoadhesive tablets resulted in a significant reduction in the sensation of the mouth dryness (P = .016) compared to Biotène. Moreover, a 1.5-fold increase in unstimulated whole saliva flow was obtained after 30 minutes in the treatment group.

CONCLUSION

A lipid-based mucoadhesive tablet has a beneficial role in reducing the sensation of dryness in patients with xerostomia.

[Bone targeting of antitumor conjugate phenamine acid aryolysine-hexanedioic acid bridge grafting-bisphosphonates]

OBJECTIVE

To develop a new bone targeting antitumor therapy system which uses diphosphonate and bone-seeking nuclide to enhance the coordinated effects of chemotherapy and radiotherapy on bones, and to validate the targeting of the new therapy system in vitro and in vivo.

METHODS

Phenamine acid caryolysine was connected to bisphosphonates, and then combined with radioactive nuclide 153Sm to establish a new bone targeting chemotherapeutic and radioactive drug for bone cancers. The targeting of this new therapy system was validated by hydroxyapatite crystal absorbing test and body distribution in vivo methods.

RESULTS

The optical spectrum of the phenamine acid caryolysine-bisphosphonates conjugate detected by the nuclear magnetic resonance was consistent with the standard structure of synthesized drugs. The conjugate had good absorbability to hydroxyapatite crystals. The body distribution of the conjugate showed higher radiocounting in bones than in other tissues.

CONCLUSION

The conjugate has a structure that is consistent with the active compound targeting bone tumors.

[The use of melaxen in combined therapy of arterial hypertension in subjects occupied in assembly line production]

The work was designed to study effect of melaxen on circadian chronostructure of arterial pressure and pulse rate in subjects with arterial hypertension occupied in assembly line production. A total of 57 patients were examined of whom 23 received teveten together with melaxen and 34 were treated with teveten alone for 3 weeks. Inclusion of melaxen in combined therapy of hypertension reduced arterial pressure and normalized disturbed circadian hemodynamics. It is concluded that combined therapy effectively eliminates sleep disorders frequent in this group of patients.

[Sensitization to acrylates caused by artificial acrylic nails: review of 15 cases]

BACKGROUND

Allergic contact dermatitis due to acrylates present in the workplace is a disease frequently reported among dentists, printers, and fiberglass workers. Recently, the number of cases of contact allergic dermatitis among beauticians specialized in sculpting artificial nails has increased.

OBJECTIVE

Our objective was to study the clinical characteristics and allergens implicated in allergic contact dermatitis due to acrylates in beauticians and users of sculpted nails.

MATERIAL AND METHODS

This was an observational, retrospective study of patients diagnosed with allergic contact dermatitis due to acrylates used in sculpting artificial nails over the last 26 years in the Hospital General Universitario, Valencia, Spain.

RESULTS

In total, 15 patients were diagnosed: 14 beauticians and 1 client. Most cases were diagnosed in the past 2 years. All were women, their mean age was 32.2 years, and 26.7 % had a personal or family history of atopy. The sensitization time varied between 1 month and 15 years. The most frequently affected areas were the fleshy parts of the fingers and hands. Three patients - 2 beauticians and 1 client - presented allergic asthma due to acrylates. All patients underwent patch testing with a standard battery of allergens and a battery of acrylates. The most frequent allergens were ethylene glycol dimethacrylate (13/15, 86.7 %), hydroxyethyl methacrylate (13/15, 86.7 %), triethylene glycol dimethacrylate (7/15, 46.7 %), 2-hydroxypropyl methacrylate (5/15, 33.3 %), and methyl methacrylate (5/15, 33.3 %).

CONCLUSIONS

Acrylate monomers used for sculpting artificial nails are important sensitizers for contact and occupational dermatitis. The most important consideration is primary and secondary prevention.

Effect of Added Pharmatose DCL11 on the Sustained-Release of Metronidazole From Methocel K4M and Carbopol 971P NF Floating Matrices

In vitro dissolution of metronidazole from sustained release floating tablets was studied with varied proportions of sodium bicarbonate (SB) and Pharmatose DCL 11. Two polymers with different hydration characteristics, Methocel K4M and Carbopol 971P NF, were used to formulate the matrices. The variables studied include the matrices' release profile, hydration volume, and floating behavior. All Methocel matrices floated more than 8 h with SB proportions up to 24%, while Carbopol matrices floated more than 8 h with SB proportions only up to 12%. Matrices' hydration increased with time until reaching a peak and declining thereafter. Methocel matrices showed greater hydration volumes and greater drug dissolution compared to Carbopol matrices. After adding increasing quantities of Pharmatose to matrices containing 12% SB, hydration volume decreased while dissolution increased. These results were attributed to water-filled pores that formed following the Pharmatose dissolution and to reduced polymer proportions. Carbopol matrices showed greater susceptibility to the added Pharmatose, becoming more erodible and releasing higher quantities of metronidazole. The greater Carbopol susceptibility to added Pharmatose was attributed to its faster hydration. Methocel matrices hydrate rapidly only at the surface, delaying hydration and Pharmatose dissolution.

Preparation and Characterization of Solid Dispersions of Piroxicam with Hydrophilic Carriers

The objective of this study was to improve the dissolution rate of a poor water soluble drug, piroxicam, by solid dispersion technique. Solid dispersions were prepared by three different methods depending on the type of carrier. The dissolution rate of piroxicam was markedly increased in solid dispersion of myrj 52, Eudragit E100 and mannitol. Solubility studies revealed a marked increase in the solubility of piroxicam with an increase in myrj 52 and Eudragit E100 concentrations. Data from the X-ray diffraction and FT-IR spectroscopy showed that piroxicam was amorphous in the solid dispersions prepared with dextrin and Eudragit E100.

Endovascular embolization of the swine rete mirabile with Eudragit-E 100 polymer

BACKGROUND AND PURPOSE

Both adhesive and nonabrasive embolic agents are available for arteriovenous malformation (AVM) embolization. The purpose of this study was to evaluate a novel ethanol-based nonadhesive liquid embolic material in a swine AVM model.

MATERIALS AND METHODS

Eudragit (copolymer of methyl and butyl methacrylate and dimethylaminoethyl methacrylate) was dissolved in 50% ethanol and 50% iopamidol. Eudragit was injected into 9 retia mirabilia (RMs). Ethanol and iopamidol mixture were injected into 4 RMs for comparison. Three RMs embolized with Eudragit mixture were evaluated both angiographically and histopathologically acutely (3-24 hours) and at 30 days and 90 days after embolization.

RESULTS

No procedural complications from Eudragrit embolization were noted, including retention or adhesion of the microcatheter. Various degrees of inflammation were observed in the acute and 30-day specimens. Two RMs showed partial recanalization on both histopathology and follow-up angiography in the 30-day group. Arterial fibrosis and calcification were observed in the 30- and 90-day specimens. The internal elastic lamina was disrupted in the 30- and 90-day specimens, but there was no evidence of Eudragit extravasation or hemorrhage. Endothelial damage was seen in all specimens and was particularly severe in the 30- and 90-day specimens.

CONCLUSION

Eudragit polymer induced inflammation in thrombosis similar to n-butyl 2-cyanoacrylate, but without the disadvantages of perivascular hemorrhage and extravasation of embolization material. Although recanalization of some embolized RMs was noted, further investigation into Eudragit as a potentially useful embolic material for brain AVMs is warranted.

Effect of hydrophilic polymers on buccoadhesive Eudragit patches of propranolol hydrochloride using factorial design

The purpose of this study was to develop formulations and systematically evaluate in vitro performances of buccoadhesive patches of propranolol hydrochloride using the hydrophobic polymer Eudragit L-100 as the base matrix. The hydrophilic polymers Carbopol 934 and polyvinyl pyrrolidone (PVP) K30 were incorporated into the Eudragit patches, to provide the patches with bioadhesive properties and to modify the rate of drug release. The patches, which were prepared by the solvent casting method, were smooth and elegant in appearance; were uniform in thickness, weight, and drug content; showed no visible cracks; and showed good folding endurance. A 3(2) full factorial design was employed to study the effect of independent variables like hydrophilic polymers Carbopol 934 and PVP K30, which significantly influenced characteristics like swelling index, ex vivo mucoadhesive strength, in vitro drug release, and ex vivo residence time. A stability study of optimized Eudragit patches was done in natural human saliva; it was found that both drug and buccal patches were stable in human saliva. It can be concluded that the present buccal formulation can be an ideal system to improve the bioavailability of the drug by avoiding hepatic first-pass metabolism.

Poly(2-hydroxy-3-phenoxypropylacrylate, 4-hydroxybutyl acrylate, dibutyl maleate) membrane controlled clonidine zero-order release

Poly(2-hydroxy-3-phenoxypropylacrylate, 4-hydroxybutyl acrylate, dibutyl maleate) membrane was synthesized by UV curing method in our laboratory for the first time. When above-mentioned monomers were in the weight ratio of 4:4:2, the membrane not only had perfect permeation property but also had excellent plasticity, so the membrane made from monomers in the ratio of 4:4:2 was chosen as an optimized membrane. The optimized membrane provided perfect linear permeation properties in clonidine transdermal drug delivery system. The permeation rate decreased in proportion to the thickness of membrane. When the concentrations of clonidine were in the range of 0.5-7.0mg/ml, the permeation rate was proportional to the square root of clonidine concentrations. The optimized membrane was characterized by FTIR, DSC and SEM.

Surgery for Foreign Body Reactions due to Injectable Fillers

BACKGROUND

An increasing number of soft tissue fillers have been introduced to the beauty market and these filler substances are widely used as non-toxic, non-immunogenic and relatively harmless injectable alternatives to surgical rejuvenation. Generally, facial fillers are injectable - or surgically insertable - products that are used to fill up the volume loss in the aging face. Depending on bioavailability, chemical composition and degradation, fillers can be classified as temporary or permanent, organic or inorganic and autologous or heterologous.

OBJECTIVE

A plethora of new products has swamped the beauty market since face rejuvenation has become socially acceptable as well as affordable to a wider population, but adverse reactions cannot be excluded. We present 4 patients with complications after injection of facial fillers [including Artecoll(polymethylmethacrylate microspheres), Restylane (hyaluronic acid), DermaLive (hyaluronic acid plus acrylic hydrogel particles) and Newfill (polylactic acid)] and surgical correction.

RESULTS

Surgical intervention led to good aesthetic and functional results after multiple unsuccessful conservative therapies.

CONCLUSION

We recommend that only physicians familiar with the injection techniques and the biological and chemical characteristics of the various injectable products should perform such interventions. Especially permanent fillers should be used with utmost reticence in cosmetic surgery and we would recommend their application only in reconstructive procedures. Additionally, documentation and reporting of all adverse effects must be mandatory.

Facial granulomas secondary to Dermalive microimplants: Report of a case with histopathologic differential diagnosis among the granulomas secondary to different injectable permanent filler materials

Wrinkle reduction and the correction of skin defects using injectable aesthetic microimplants are now widely performed by dermatologists and plastic surgeons. In recent years, dermal filler substances containing polymer particle suspensions such as Bioplastique, Artecoll, and Dermalive are the most commonly used materials. These microimplants are permanent, non-biodegradable, and generally well tolerated, although various adverse reactions are still possible. We describe here a patient with facial granulomas secondary to Dermalive injections for correction of naso-labial folds and wrinkles. The particular shape of the injected particles allows for correct identification of the implanted material. Therefore, histopathologic examination is the best means to obtain the correct diagnosis of foreign body granuloma and to identify the type of filler particles. We discuss the histopathologic differential diagnosis among the granulomas secondary to the most commonly used aesthetic permanent filler materials.

Extruded and spheronized beads containing Carbopol® 974P to deliver nonelectrolytes and salts of weakly basic drugs

The purpose of the study was to explore the utilization of Carbopol 974P, NF, resin in a bead dosage form manufactured by extrusion and spheronization. It was possible to prepare beads in this study by using calcium chloride to overcome the tack problem associated with wetted Carbopol 974P. The actives included both salts of weakly basic drugs (chlorpheniramine maleate and diphenhydramine hydrochloride) and nonelectrolytes (caffeine and dyphylline) which have a broad range of solubilities. Nonelectrolytes were released faster than the salts of weakly basic drugs. This is contrary to the behavior typically seen with a matrix system where the more soluble drug is released faster than a poorly soluble one. In the results of the present study, the solubility does not determine the drug release rate. Ionic interactions between the protonated amines of the salts and the carboxylates of the Carbopol resin are suggested to be the reason for the slower release of the salts of weakly basic drugs. Data from tack measurements confirm that this ionic interaction affects the behavior of the wetted Carbopol. In addition to the drug release profiles, bead average diameter, roundness, friability, and density were also determined.

Once-daily eprosartan mesylate in the treatment of elderly patients with isolated systolic hypertension: data from a 13-week double-blind, placebo-controlled, parallel, multicenter study

This was a double-blind, randomized, placebo-controlled multicenter, titration-to-effect study of eprosartan in patients > or =60 years of age with isolated systolic hypertension. The study consisted of a 3 to 5-week placebo run-in period, a 13-week double-blind treatment period (6-week titration with eprosartan 600-1200 mg/day, 3-week maintenance, 4-week combination therapy with hydrochlorothiazide/HCTZ 12.5 mg), and a follow-up period within 5-7 days of last treatment dose. Overall, 283 patients (placebo/P: 135; eprosartan /E: 148) were randomized [female patients-P: 55.6%, E:54.7%; white-P:66.7%, E:67.6%). Mean sitting systolic blood pressure (SitSBP) at baseline was comparable (P: 170+/-0.8 mmHg; E: 171+/-0.8 mm Hg). At monotherapy end point, eprosartan produced a significant reduction in SitSBP (E: 16.1 mmHg vs P: 8.4 mmHg; P<0.0001). In all, 57.4% of patients responded to eprosartan monotherapy. Among nonresponders, the addition of HCTZ resulted in a decrease in SitSBP from baseline (E: 21.7 mmHg; P: 14.4 mmHg; P<0.002). Reductions were also noted in Standing SBP (monotherapy: P<0.001; combination therapy: P=0.03). No reductions in SitDBP >4 mmHg were found during the study. Age, gender, and race did not have any impact on the results. Post hoc analysis showed a reduction in pulse pressure from 87.3 to 78.2 mmHg with placebo and from 87.6 to 70.7 mmHg with eprosartan monotherapy. Treatment with eprosartan in once-daily doses up to 1200 mg alone or in combination with HCTZ was well tolerated, with dizziness and asthenia being the most common side effects.

[Study on preparation of the pH sensitive hydroxyethyl chitin/poly (acrylic acid) hydrogel and its drug release property]

Hydroxyethyl chitin (HECH) is a water soluble chitin derivative made by etherification of chitin, ethylene chlorohydrin was used as etherification reagent in this reaction. A novel interpenetrating polymer network (IPN) composed of HECH/PAA was prepared. The IR spectra confirmed that HECH/PAA was formed through chemical bond interaction. The sensitivity of this hydrogel to temperature and pH was studied. The swelling ratio of this hydrogel in artificial intestinal juice is much greater than that in artificial gastric juice. The IPN hydrogel exhibited a typical pH-sensitivity, and its degree of swelling ratio increased with the increase of temperature. The sustained-release drug system of Dichlofenac potassium was prepared by using HECH/PAA as the drug carrier. The release experiment showed a perfect release behavior in artificial intestinal juice. This IPN is expected to be used as a good drug delivery system of enteric medicine.

Spray-dried mucoadhesive microspheres: preparation and transport through nasal cell monolayer

The purpose of this research was to prepare spray-dried mucoadhesive microspheres for nasal delivery. Microspheres composed of hydroxypropyl methylcellulose (H), chitosan (CS), carbopol 934P (CP) and various combinations of these mucoadhesive polymers, and maltodextrin (M), colloidal silicon dioxide (A), and propylene glycol (P) as filler and shaper, were prepared by spray-drying technique. Using propranolol HCl as a model drug, microspheres were prepared at loadings exceeding 80% and yields between 24% and 74%. Bulky, free flowing microspheres that had median particle size between 15 and 23 mum were obtained. Their zeta potential was according to the charge of polymer. Adhesion time of mucoadhesive microspheres on isolated pig intestine was ranked, CS > CP:H > CP > H, while the rank order of swelling was CP > CS > H. Increasing the amount of CP in CP:H formulations increased the percentage of swelling. Infrared (IR) spectra showed no interaction between excipients used except CS with acetic acid. The release of drug from CP and CP:H microspheres was slower than the release from H and CS microspheres, correlated to their viscosity and swelling. Long lag time from the CP microspheres could be shortened when combined with H. The permeation of drug through nasal cell monolayer corresponded to their release profiles. These microspheres affected the integrity of tight junctions, relative to their swelling and charge of polymer. Cell viability was not affected except from CS microspheres, but recovery could be obtained. In conclusion, spray-dried microspheres of H, CS, CP, and CP:H could be prepared to deliver drug through nasal cell monolayer via the opening of tight junction without cell damaging.

Topical application of representative multifunctional acrylates produced proliferative and inflammatory lesions in F344/N rats and B6C3F1 mice, and squamous cell neoplasms in Tg.AC mice

Widespread human exposure to multifunctional acrylates is of concern, due to their inherent reactivity and irritating properties. Trimethylolpropane triacrylate (TMPTA) and pentaerythritol triacrylate (PETA) are industrially important representatives of multifunctional acrylates. The current studies characterized the toxicity of 3-month topical administration of technical grade TMPTA and PETA in F344/N rats and B6C3F1 mice, and evaluated the carcinogenic potential of TMPTA and PETA in hemizygous Tg.AC (v-Ha-ras) transgenic mice. Administration of 0.75, 1.5, 3, 6, and 12 mg/kg TMPTA and PETA for 3 months resulted in hyperplastic, degenerative, and necrotic lesions, accompanied by chronic inflammation of the skin, with severities generally increasing with dose. Lesions were slightly more severe in rats, when compared with mice, and illustrate the irritant potential of TMPTA and PETA. A similar dosage regimen was used for the 6-month study with Tg.AC mice. Topical application of TMPTA and PETA to Tg.AC mice showed dose-dependent increases in squamous cell papillomas at the site of application, with decreases in the latency of their appearance in mice receiving 3 mg/kg or greater. Papillomas, the reporter phenotype in Tg.AC mice, were accompanied by a few squamous cell carcinomas, along with hyperplastic and inflammatory lesions. Although chronic inflammation might have contributed to the development of the skin lesions, the dose-related nature of the induction of the skin papillomas in Tg.AC mice by TMPTA and PETA may reflect a potential for carcinogenicity.

[An AT-II blocker in patients with type II diabetes and arterial hypertension]

The subjects of the study were 30 patients with type II diabetes mellitus and mild or moderate arterial hypertension. Clinical-and-hemodinamic organoprotective effects of eprosartan, a new angiotensin II blocker, was evaluated in these patients within 16 weeks. The study found a good hypotensive effect of monotherapy with eprosartan in a mean therapeutic dose of 600 mg/day--the target blood pressure levels were achieved in 63.3% of the patients. Fasting insulin level and insulin resistance decreased, which improved hydrocarbonate and lipid exchange parameters. Eprosartan was significantly effective as an organoprotective agent: the patients displayed improvement of eye ground vessel condition, decrease of microalbuminuria, improvement of cardiodynamic parameters i.e. decrease of the thickness of left ventricular (LV) back wall and intravenricular septum, as well as reduction of myocardial mass index. 70% of the patients demonstrated improvement of LV diastolic function.

Effect of angiotensin II receptor blockade on autonomic nervous system function in patients with essential hypertension

It has long been proposed that the renin-angiotensin system exerts a stimulatory influence on the sympathetic nervous system, including augmentation of central sympathetic outflow and presynaptic facilitation of norepinephrine release from sympathetic nerves. We tested this proposition in 19 patients with essential hypertension, evaluating whether the angiotensin receptor blockers (ARBs) eprosartan and losartan had identifiable antiadrenergic properties. This was done in a prospective, randomized, three-way placebo-controlled study of crossover design. Patients were randomized to 600 mg of eprosartan daily, 50 mg of losartan daily, or placebo. The treatment period was 4 wk, with 2-wk washout periods. Multiunit firing rates in efferent sympathetic nerves distributed to skeletal muscle vasculature (muscle sympathetic nerve activity, MSNA) were measured with microneurography, testing whether ARBs inhibit central sympathetic outflow. In parallel, isotope dilution methodology was used to measure whole body norepinephrine spillover to plasma. Mean blood pressure on placebo was 151/98 mmHg, with both ARBs causing reductions of approximately 11 mmHg systolic and 6 mmHg diastolic pressure, placebo corrected. Both MSNA [35 +/- 12 bursts/min (mean +/- SD) on placebo] and whole body norepinephrine spillover [366 +/- 247 ng/min] were unchanged by ARB administration, indicating that the ARBs did not materially inhibit central sympathetic outflow or act presynaptically to reduce norepinephrine release at existing rates of nerve firing. These findings contrast with the easily demonstrable reduction in sympathetic nervous activity produced by antihypertensive drugs of the imidazoline-binding class, which are known to act within the brain to inhibit sympathetic nervous outflow. We conclude that sympathetic nervous inhibition is not a major component of the blood pressure-lowering action of ARBs in essential hypertension.

The effect of pressurized carbon dioxide as a temporary plasticizer and foaming agent on the hot stage extrusion process and extrudate properties of solid dispersions of itraconazole with PVP-VA 64

The aim of the current research project was to explore the possibilities of combining pressurized carbon dioxide with hot stage extrusion during manufacturing of solid dispersions of itraconazole and polyvinylpyrrolidone-co-vinyl acetate 64 (PVP-VA 64) and to evaluate the ability of the pressurized gas to act as a temporary plasticizer as well as to produce a foamed extrudate. Pressurized carbon dioxide was injected into a Leistritz Micro 18 intermeshing co-rotating twin-screw melt extruder using an ISCO 260D syringe pump. The physicochemical characteristics of the extrudates with and without injection of carbon dioxide were evaluated with reference to the morphology of the solid dispersion and dissolution behaviour and particle properties. Carbon dioxide acted as plasticizer for itraconazole/PVP-VA 64, reducing the processing temperature during the hot stage extrusion process. Amorphous dispersions were obtained and the solid dispersion was not influenced by the carbon dioxide. Release of itraconazole from the solid dispersion could be controlled as a function of processing temperature and pressure. The macroscopic morphology changed to a foam-like structure due to expansion of the carbon dioxide at the extrusion die. This resulted in increased specific surface area, porosity, hygroscopicity and improved milling efficiency.

Toxicology studies of trimethylolpropane triacrylate (technical grade) (CAS No. 15625-89-5) in F344/N rats, B6C3F1 mice, and genetically modified (FVB Tg.AC hemizygous) mice (dermal studies)

Trimethylolpropane triacrylate is a multifunctional monomer with a wide range of industrial applications. It is used in the production of ultraviolet-curable inks, electron beam irradiation-curable coatings, and polymers and resins; as a component of photopolymer and flexographic printing plates and photoresists; and as an ingredient in acrylic glues and anaerobic sealants. The chemical is also used in paper and wood impregnates, wire and cable extrusion, polymer-impregnated concrete, and polymer concrete structural composites. Trimethylolpropane triacrylate was nominated by the National Cancer Institute for testing due to its high production volume and use, its potential for consumer exposure, and a lack of adequate testing of the chemical. Male and female F344/N rats and B6C3F(1) mice were administered technical grade trimethylolpropane triacrylate (it is reactive and therefore not available as pure trimethylolpropane triacrylate) in acetone dermally for 2 weeks or 3 months. Male and female Tg.AC hemizygous mice were administered technical grade trimethylolpropane triacrylate in acetone for 6 months. Genetic toxicology studies were conducted in B6C3F(1) and Tg.AC hemizygous mouse peripheral blood erythrocytes. 2-WEEK STUDY IN RATS: Groups of five male and five female F344/N rats were administered 0, 12.5, 25, 50, 100, or 200 mg trimethylolpropane triacrylate/kg body weight in acetone 5 days per week for 16 days. All rats survived to the end of the study, and mean body weights of dosed groups were similar to those of the vehicle controls. Dosed rats had irritation at the site of application; this clinical finding was most commonly seen in rats administered 50 mg/kg or greater. Male and female rats had epidermal hyperplasia, hyperkeratosis, sebaceous gland hyperplasia, inflammation of the epidermis and dermis, ulceration, epidermal degeneration, and parakeratosis at the site of application. 2-WEEK STUDY IN B6C3F(1) MICE: Groups of five male and five female B6C3F(1) mice were administered 0, 12.5, 25, 50, 100, or 200 mg trimethylolpropane triacrylate/kg body weight in acetone 5 days per week for 16 days. All mice survived to the end of the study. The final mean body weight gain of 200 mg/kg males was less than that of the vehicle controls; 100 and 200 mg/kg females had significantly increased final mean body weights. Irritation at the site of application occurred in all dosed males, all 100 and 200 mg/kg females, and one 50 mg/kg female. Thymus weights of males administered 50 mg/kg or greater were significantly decreased. Dosed male and female mice had epidermal hyperplasia, hyperkeratosis, chronic active inflammation of the dermis, sebaceous gland hyperplasia, ulcer, epidermal degeneration, parakeratosis, and/or suppurative inflammation of the epidermis at the site of application. Atrophy of the thymus occurred in 100 and 200 mg/kg male mice. 3-MONTH STUDY IN RATS: Groups of 10 male and 10 female F344/N rats were administered 0, 0.75, 1.5, 3, 6, or 12 mg trimethylolpropane triacrylate/kg body weight in acetone 5 days per week for 14 weeks. All rats survived to the end of the study, and mean body weights of dosed groups were similar to those of the vehicle controls. Irritation at the site of application was noted in five males and all females administered 12 mg/kg. Hematology results indicated that trimethylolpropane triacrylate at the doses selected induced a neutrophil count increase at 12 mg/kg that would be consistent with an inflammatory response related to the dermatitis observed histopathologically. Thymus weights of 12 mg/kg males and 0.75 and 12 mg/kg females were decreased. Incidences of epidermal hyperplasia, degeneration, and necrosis (females only); chronic active inflammation of the dermis, hyperkeratosis, and sebaceous gland hyperplasia were generally increased at the site of application in 1.5 mg/kg or greater males and in 3 mg/kg or greater females. 3-MONTH STUDY IN B6C3F(1) MICE: Groups of 10 male and 10 female B6C3F(1) mice were administered 0, 0.75, 1.5, 3, 6, or 12 mg trimethylolpropane triacrylate/kg body weight in acetone 5 days per week for 14 weeks. All animals survived to the end of the study; mean body weights of dosed groups were similar to those of the vehicle controls. Irritation at the site of application occurred in male and female mice administered 12 mg/kg. Hematology results indicated that trimethylolpropane triacrylate induced a neutrophil count increase at 12 mg/kg that would be consistent with an inflammatory response related to the dermatitis observed histopathologically. Increased incidences of several nonneoplastic lesions occurred at the site of application in 3 mg/kg and greater males and females, including hyperplasia of the epidermis, hyperkeratosis, epidermal degeneration (except 3 mg/kg females) and necrosis, chronic active inflammation of the dermis, and sebaceous gland hyperplasia. Epidermal suppurative inflammation and necrosis and dermal fibrosis occurred in 12 mg/kg males and females. 6-MONTH STUDY IN Tg.AC HEMIZYGOUS MICE: Groups of 15 male and 15 female Tg.AC hemizygous mice were administered 0, 0.75, 1.5, 3, 6, or 12 mg trimethylolpropane triacrylate/kg body weight in acetone 5 days per week for 28 weeks. Additional groups of 15 male and 15 female mice maintained as positive controls received dermal applications of 1.25 microg 12-O-tetradecanoylphorbol-13-acetate per 100 mL acetone 3 days per week for 28 weeks; the dosing volume was held constant at 100 microL. Survival and mean body weights of dosed groups were similar to those of the vehicle controls throughout the study. Treatment-related clinical findings included papillomas at the site of application in 3 mg/kg and greater males and 6 and 12 mg/kg females. The heart weights of males and females administered 12 mg/kg and the kidney and lung weights of 12 mg/kg females were significantly increased. The lung weights of 6 and 12 mg/kg males and females were decreased. Squamous cell neoplasms at the site of application were associated with dermal application of trimethylolpropane triacrylate. At 6 months, the incidences of squamous cell papilloma were significantly increased in 6 and 12 mg/kg males and females. One female in each of the 1.5, 6, and 12 mg/kg groups also had squamous cell carcinoma. The incidence of squamous cell papilloma of the forestomach in 12 mg/kg females was significantly greater than that in the vehicle control group. Nonneoplastic skin lesions at the site of application in dosed mice included epidermal hyperplasia, hyperkeratosis, and chronic active inflammation. A hematopoietic disorder (myelodysplasia) also occurred in some 12 mg/kg males and females.

GENETIC TOXICOLOGY

No increase in the frequency of micronucleated erythrocytes was observed in peripheral blood samples from male or female B6C3F(1) mice treated with trimethlylolpropane triacrylate by skin painting for 3 months. Similarly, no increase in micronucleus frequency was seen in male or female Tg.AC hemizygous mice administered trimethylolpropane triacrylate by skin painting for 6 months.

CONTACT HYPERSENSITIVITY STUDIES

Studies were conducted with female BALB/c mice to evaluate the potential for trimethylolpropane triacrylate to induce contact hypersensitization. In an irritancy study in which the chemical, in acetone, was applied to the ear, the maximal nonirritating and minimal irritating doses were 0.1% and 0.25% trimethylolpropane triacrylate. No significant differences in the percentage of ear swelling occurred between trimethylolpropane triacrylate-sensitized and -challenged mice and background controls at 24 or 48 hours after dosing. The local lymph node assay indicated no significant increase in lymph node cell proliferation in mice administered trimethylolpropane triacrylate compared to that in the vehicle controls. Testing for sensitizing potential using the mouse ear swelling test and local lymph node assay failed to indicate trimethylolpropane triacrylate as a potential contact sensitizer.

CONCLUSIONS

Male and female Tg.AC hemizygous mice dosed with trimethylolpropane triacrylate for 6 months had significantly increased incidences and multiplicity of papillomas of the skin at the site of dermal application. Treatment-related squamous cell carcinomas occurred at the site of application in dosed female mice. Increased incidences of forestomach squamous cell papilloma in female mice may have been related to chemical administration. Increased incidences of minimal to moderate (mostly mild) hyperplasia of the epidermis, hyperkeratosis, and chronic active inflammation also occurred at the site of application. A hematopoietic disorder (myelodysplasia) also occurred in exposed male and female mice.

Haemodynamic effects of eprosartan and valsartan in hypertensive patients during isometric and mental stress

OBJECTIVE

To assess the effects of eprosartan and valsartan on the haemodynamics of forearm circulation in hypertensives undergoing isometric and mental stress.

DESIGN AND METHODS

Thirty-six patients with essential stable hypertension underwent haemodynamic evaluations on the left arm: humeral flux and calibre by means of colour Doppler ultrasound, microcirculatory flux on the third finger of left hand by means of laser Doppler flowmetry, blood pressure and heart rate monitor. District resistance was calculated as the ratio between mean arterial pressure and blood flow, and microcirculatory conductance was calculated as the ratio between flux and the mean pressure. The evaluations were performed at rest, during handgrip and during mental stress. Patients were randomized to receive eprosartan (600 mg) or valsartan (160 mg); tests were repeated after 15 days of therapy.

RESULTS

Both treatments reduced blood pressure (P<0.05) and peripheral resistance during tests. Eprosartan obtained a greater reduction in resistance during handgrip than valsartan. Laser Doppler flowmetry showed a significant decrease of flux only with mental stress. Laser Doppler flowmetry showed a reduction in conductance during both tests--this reduction was smaller with eprosartan during handgrip. None of the molecules affected the conductance during mental stress. While both were able to reduce microcirculatory decrease in conductance; in particular, eprosartan controlled this drop during handgrip better than valsartan.

CONCLUSIONS

Angiotensin II receptor type 1 inhibition exerts protective effects during adrenergic and noradrenergic stress in hypertensives. Eprosartan is more efficacious than valsartan in controlling noradrenergic effects.

Filler injection enhances the projection of the reconstructed nipple: an original easy technique

BACKGROUND

Reduced nipple projection is the main reason for unsatisfactory nipple-areola complex reconstruction, and many techniques have been proposed to maintain projection of the reconstructed nipple.

METHODS

For 70 patients, 90 nipples were reconstructed using either a small wedge from the labia minora (LMW) (n=70) or nipple sharing (NS) (n=20). Two months after reconstruction, each reconstructed nipple was injected with DermaLive. Second and third injections were performed 2 and 5 months later. The injected volume was tailored to the desired projection. Nipple projection was measured at the moment of implant, before and after each injection, and 6 and 12 months after the last injection.

RESULTS

Nipple projection was satisfactory in all cases and comparable with that of the contralateral nipple. The average nipple projection at 6 months was 5.8 mm in the LMW group and 3.8 mm in the NS group (p<0.01) and, respectively, 5.6 mm and 3.5 mm at 12 months (p<0.01). No complications occurred, except for one positron emission tomography (PET) false-positive result.

CONCLUSIONS

The described method is simple and safe. It provides precise projection with no need for intraoperative forecasting of tissue reabsorption. The result was better for the LMW patients, perhaps because of their higher distensibility.

A new cannula to ease cement injection during vertebroplasty

One of the main limitations of vertebroplasty is the excessive pressure required to inject a sufficient amount of cement into a vertebral body. Based on previous work that shows that approximately 95% of the injection pressure is required to deliver the cement through the cannula, we proposed a new cannula design with a larger internal diameter in the proximal section. The objective of this study is to determine whether the new cannula geometry significantly reduces the delivery pressure and eases cement injection during vertebroplasty. Two different methods were employed to examine the delivery pressure in a conventional and two redesigned cannulae: (1) analytical model: Hagen-Poisseuille's flow through a tube was used to predict the pressure drop in the cannulae; (2) experiment: first a Newtonian silicone oil and then an acrylic bone cement was injected through the cannulae at a constant rate of 4 cc/min, and the delivery pressure was recorded. Both the experimental and analytical findings confirmed that the redesigned cannula reduces the delivery pressure significantly. Specifically, when the internal diameter of the proximal section was increased by a factor of two, which is clinically feasible, the delivery pressure dropped by about 63%. The redesigned cannula appears to have the potential to improve vertebroplasty. The key benefits are that (1) it eases cement injection, (2) it can be easily integrated into the existing procedure, and (3) it is cost-effective.

Enhancement of oral bioavailability of poorly water-soluble drugs by poly(ethylene glycol)-block-poly(alkyl acrylate-co-methacrylic acid) self-assemblies

The purpose of the present study was to determine whether pH-sensitive polymeric micelles could improve the oral bioavailability of a poorly water-soluble drug. Poly(ethylene glycol)-block-poly(alkyl acrylate-co-methacrylic acid)s were synthesized by atom transfer radical polymerization and the composition of the ionizable polymer block was varied to maximize drug loading and pH-dependent release. Poorly water-soluble model drugs viz. fenofibrate (FNB) and progesterone (PRG) were incorporated in the self-assemblies by the oil-in-water emulsion or film casting methods. The pH-dependent release of several formulations was studied in vitro and the oral bioavailabilities of FNB-loaded micelles, Lipidil Micro and FNB coarse suspension were assessed in Sprague-Dawley rats at a dose of 7.5 mg/kg. Entrapment efficiency (defined as the ratio of experimental drug loading in self-assemblies to the initial amount of drug added) ranged between 55-75% and was dependent on polymer composition and drug-loading method. Hydrophobic chain composition of the polymer had tremendous impact on in vitro release kinetics, with only poly(ethylene glycol)-block-poly(n-butyl acrylate(17)-co-methacrylic acid(17)) micelles showing the desired pH-dependent drug-release profile. The oral bioavailability of FNB from these self-assemblies revealed 156% and 15% increases vs. FNB coarse suspension and Lipidil Micro, respectively. The results suggest that these pH-sensitive self-assemblies have potential for improving the oral bioavailability of poorly water-soluble drugs.

Injectable Skin Fillers

The list of injectable skin fillers available for soft tissue augmentation is constantly growing, giving aesthetic surgeons more options in the treatment of scars, lines, and wrinkles. Each type of filler is distinct with regard to intended use, placement technique, duration in tissue, ease of use, and cost. Physicians who are well acquainted with the strengths and weaknesses of each class of filler will be best equipped to use this rapidly expanding class of agents in serving their patients. The authors review the most commonly used injectable skin fillers and discuss their differences in terms of composition, source (eg, human, animal), intended use, placement technique, tissue duration (nonpermanent, semipermanent, or permanent), side effects, and specific advantages and disadvantages.

Biopharmaceutical characterization of sustained release matrix tablets based on novel carbomer polymers: formulation and in vivo investigation

With the increased interest in modified release dosage forms and drug delivery systems, there is an increasing concern for biopharmaceutical characterization of the formulation in the early stages of drug product development. The main objectives of biopharmaceutical characterization are the in vitro and in vivo evaluation of the selected formulations in order to identify the factors influencing drug release; define the in vitro test methodology that would be predictive of drug products in vivo behavior and develop quantitative in vitro - in vivo correlation. The purpose of this study was to assess the potential of novel carbomer polymers, Carbopol 971P and Carbopol 71G, as a sustained release agents in matrix tablets containing high dosage drug substance. Although chemically identical, the two polymers exhibited substantially different drug release properties in vitro. Hypothetical in vivo drug release profiles were calculated by numerical deconvolution from cumulative urinary excretion data observed in vivo. The obtained results indicated that sound and reliable in vivo drug release profiles could be obtained from urinary excretion data and also, emphasized the need for in vitro testing under a range of experimental conditions in order to develop the biorelevant drug release methodology.