Efficacy and Safety of Hydroxychloroquine in Patients with IgA Nephropathy: A Meta-Analysis

Aim: The purpose of this study was to determine efficacy and safety of hydroxychloroquine (HCQ) for patients with IgA nephropathy (IgAN). Methods: PubMed, Embase, Web of Science, Cochrane Central Register of Controlled Trials, Wanfang database, Chinese National Knowledge Infrastructure and VIP database up to February 2023 were searched for associated studies comparing HCQ with any other nonHCQ for treating IgAN. The effects of proteinuria, a 50% decrease in proteinuria, estimated glomerular filtration rate (eGFR) and adverse events in patients with IgAN were examined in a meta-analysis. Data were extracted and pooled using RevMan 5.3. Results: Three randomized controlled trials (RCTs), two retrospective and two prospective studies (675 patients) that matched our inclusion criteria were identified. Compared with a control group, HCQ significantly reduced proteinuria (mean difference (MD): −0.26, 95% confidence interval (CI): −0.44 to −0.08, p < 0.01). Patients receiving HCQ plus renin-angiotensin system inhibitors (RASSi) had a better efficacy in proteinuria alleviation and a 50% decrease in proteinuria compared with control groups (MD: −0.38, 95% CI: −0.50 to −0.25, p < 0.001 and relative risk (RR) = 3.31, 95% CI: 1.73 to 6.36, p < 0.001). No appreciable variations were observed in eGFR between HCQ groups and control groups in treating patients with IgAN (MD: −2.00, 95% CI: −4.36 to 0.36, p = 0.10). Moreover, no serious adverse events were observed during HCQ treatment. Conclusions: Our results indicate HCQ is an efficient, secure treatment for IgAN (AU)

The role of protein tyrosine phosphatase 1B (PTP1B) in the pathogenesis of type 2 diabetes mellitus and its complications

Insulin resistance, the most important characteristic of the type 2 diabetes mellitus (T2DM), is mostly caused by impairment in the insulin receptor (IR) signal transduction pathway. Protein tyrosine phosphatase 1B (PTP1B), one of the main negative regulators of the IR signaling pathway, is broadly expressed in various cells and tissues. PTP1B decreases the phosphorylation of the IR resulting in insulin resistance in various tissues. The evidence for the physiological role of PTP1B in regulation of metabolic pathways came from whole-body PTP1B-knockout mice. Whole-body and tissue-specific PTP1B-knockout mice showed improvement in adiposity, insulin resistance, and glucose tolerance. In addition, the key role of PTP1B in the pathogenesis of T2DM and its complications was further investigated in mice models of PTP1B deficient/overexpression. In recent years, targeting PTP1B using PTP1B inhibitors is being considered an attractive target to treat T2DM. PTP1B inhibitors improve the sensitivity of the insulin receptor and have the ability to cure insulin resistance-related diseases. We herein summarized the biological functions of PTP1B in different tissues in vivo and in vitro. We also describe the effectiveness of potent PTP1B inhibitors as pharmaceutical agents to treat T2DM. (AU)

Tirbanibulina: revisión de su mecanismo de acción novedoso y de cómo encaja en el tratamiento de la queratosis actínica / Tirbanibulin: review of its novel mechanism of action and how it fits into the treatment of actinic keratosis

La queratosis actínica (QA) es una afección cutánea caracterizada por la proliferación de queratinocitos mutados que pueden convertirse en carcinoma escamoso cutáneo. Las terapias disponibles, aunque efectivas, están asociadas con una alta frecuencia de reacciones cutáneas locales graves. Tirbanibulina, uno de los tratamientos para la QA actualmente en desarrollo, es un nuevo fármaco sintético de origen químico con potentes efectos antiproliferativos y antitumorales in vitro e in vivo con eficacia probada en el tratamiento de la QA, demostrada recientemente en dos ensayos clínicos de faseIII. En la presente revisión se muestra el mecanismo de acción de tirbanibulina en base a la literatura relevante y los resultados de varios estudios preclínicos no publicados. Además, se plantea el escenario actual en cuanto a los tratamientos disponibles y cómo el mecanismo de acción novedoso de tirbanibulina encaja en el tratamiento de la QA (AU)

Actinic keratosis (AK) is a skin condition characterized by the proliferation of mutated keratinocytes that can develop into squamous cell carcinoma. Available therapies, although effective, are associated with a high frequency of severe local skin reactions. Tirbanibulin, one of the treatments for AK currently in development, is a new synthetic chemical entity with anti-proliferative and anti-tumor effects, both in vitro and in vivo, with proved efficacy in the treatment of AK, which has been recently demonstrated in two phase III clinical trials. In the present review, the tirbanibulin mechanism of action, based on the relevant literature and the results of several unpublished preclinical studies, is shown. In addition, the current scenario regarding the available treatments and how the novel tirbanibulin mechanism of action fits into the treatment of AK is raised (AU)

[Translated article] Tirbanibulin: review of its novel mechanism of action and how it fits into the treatment of actinic keratosis / Tirbanibulina: revisión de su mecanismo de acción novedoso y de cómo encaja en el tratamiento de la queratosis actínica

Actinic keratosis (AK) is a skin condition characterized by the proliferation of mutated keratinocytes that can develop into squamous cell carcinoma. Available therapies, although effective, are associated with a high frequency of severe local skin reactions. Tirbanibulin, one of the treatments for AK currently in development, is a new synthetic chemical entity with anti-proliferative and anti-tumor effects, both in vitro and in vivo, with proved efficacy in the treatment of AK, which has been recently demonstrated in two phase III clinical trials. In the present review, the tirbanibulin mechanism of action, based on the relevant literature and the results of several unpublished preclinical studies, is shown. In addition, the current scenario regarding the available treatments and how the novel tirbanibulin mechanism of action fits into the treatment of AK is raised (AU)

La queratosis actínica (QA) es una afección cutánea caracterizada por la proliferación de queratinocitos mutados que pueden convertirse en carcinoma escamoso cutáneo. Las terapias disponibles, aunque efectivas, están asociadas con una alta frecuencia de reacciones cutáneas locales graves. Tirbanibulina, uno de los tratamientos para la QA actualmente en desarrollo, es un nuevo fármaco sintético de origen químico con potentes efectos antiproliferativos y antitumorales in vitro e in vivo con eficacia probada en el tratamiento de la QA, demostrada recientemente en dos ensayos clínicos de faseIII. En la presente revisión se muestra el mecanismo de acción de tirbanibulina en base a la literatura relevante y los resultados de varios estudios preclínicos no publicados. Además, se plantea el escenario actual en cuanto a los tratamientos disponibles y cómo el mecanismo de acción novedoso de tirbanibulina encaja en el tratamiento de la QA (AU)

Allelic and phenotypic characterization of CYP2D6 and its encoded P450 cytochrome enzyme in a serie of Spanish type 1 Gaucher disease patients / Caracterización alélica y fenotípica del gen y la enzima Cyp2d6 en una cohorte de pacientes españoles con enfermedad de Gaucher tipo 1

BACKGROUND: Cytochrome p450 is the main drug metabolic pathway. CYP2D6 is a highly polymorphic gene that encodes a cytochrome p450 enzyme with three activity levels: null, reduced and normal. Apart from another type of mutations CYP2D6 can suffer duplications and deletions of the entire gene. This is the pathway to metabolize one of the Gaucher disease treatments, whose dose administration is regulated according to the metabolizer phenotype, this being one of the administration limitations. OBJECTIVES: The aim of this paper is to evaluate the allelic frequencies and the metabolizer status of Gaucher type 1 patients in the Spanish population and compare it with the general Spanish population and other Gaucher disease groups. METHODS: In this study, 109 type 1 Gaucher disease patients were analyzed with the xTAG(R)CYP2D6 kit to identify the CYP2D6 gene alleles. RESULTS: We observed that eighty-seven patients could be classified as extensive, 14 as intermediate, 6 as poor and 2 as ultra-rapid metabolizers. The allelic duplication frequency is 5.5% and deletion is 4.5%. The most common allele is wild-type and the second is the null *4 allele. Intermediate phenotype frequency is higher than expected (p < 0.05). CONCLUSIONS: Our Spanish GD series shows an unexpected distribution of some alleles and phenotypic metabolizer status, in contrast to that previously reported in the Spanish population

INTRODUCCIÓN: La superfamilia citocromo P450 es la principal vía de metabolización de fármacos. Uno de los genes que la componen, CYP2D6, es altamente polimórfico y puede producir enzimas con 3 niveles de actividad: nula, reducida o normal. Además de presentar variantes puntuales, este gen puede sufrir duplicidad o deleción. CYP2D6 es la principal vía de metabolización del último tratamiento aprobado para la enfermedad de Gaucher, cuya administración y dosificación depende del estado metabolizador de CYP2D6. OBJETIVOS: El objetivo de este trabajo es evaluar la frecuencia alélica y la distribución de fenotipos metabolizadores en una serie de pacientes españoles con enfermedad de Gaucher, y compararla con los datos publicados para población española general y con otros grupos de pacientes de Gaucher. MÉTODOS: Se han genotipificado 109 pacientes con enfermedad de Gaucher tipo 1 mediante el sistema xTAG(R) CYP2D6. RESULTADOS: Nuestra población se distribuye en 87 pacientes con un fenotipo metabolizador normal, 14 intermedios, 6 lentos y 2 ultrarrápidos. La frecuencia de la duplicación y deleción del gen es del 5,5 y 4,5%, respectivamente. El alelo más común es la forma nativa de la proteína y el segundo el alelo *4 que codifica para una proteína inactiva. La frecuencia de fenotipos intermedios es superior a la esperada en población general (p < 0,05), principalmente a causa de un incremento en la frecuencia de los alelos que codifican enzimas con actividad reducida (p < 0,05). CONCLUSIONES: El grupo español de pacientes con enfermedad de Gaucher muestra una distribución alélica y fenotípica diferente a la esperada para la población española

Hydroxychloroquine as Prophylaxis for Coronavirus SARS-CoV-2 Infection: Review of the Ongoing Clinical Trials / Hidroxicloroquina como profilaxis para la infección por coronavirus SARS-CoV-2: revisión de los ensayos clínicos en curso

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Mycophenolate mofetil for induction and maintenance of remission in naïve patients with granulomatosis with polyangiitis without renal involvement / Micofenolato mofetilo para la inducción y el mantenimiento de la remisión en pacientes no tratados con granulomatosis con poliangitis

Antineutrophil cytoplasmic antibodies (ANCA) associated vasculitides include granulomatosis with polyangiitis (GPA, previously called Wegener's), microscopic polyangiitis (MPA) and eosinophilic granulomatosis with polyangiitis (EGPA), previously called Churg-Strauss). In this report we used mycophenolate mofetil (MMF) and steroids to induce and maintain remission in two newly diagnosed cases with c-ANCA associated GPA. The two patients' maintained remission with no disease relapses during one year follow-up

Las vasculitis asociadas a anticuerpos anticitoplasma de neutrófilos (ANCA) incluyen granulomatosis con poliangeitis (GPA) anteriormente llamada de Wegener, poliangeítis microscópica (MPA) y granulomatosis eosinofílica con poliangeítis (EGPA) anteriormente llamada síndrome de Churg-Strauss. En este informe utilizamos micofenolato mofetilo (MMF) y esteroides para inducir y mantener la remisión en 2 casos recientemente diagnosticados con GPA asociado a c-ANCA. La remisión mantenida de los 2 pacientes sin enfermedad recae durante un año de duración del seguimiento

Estabilidad del ARN viral en muestras clínicas para el diagnóstico viral / Stability of viral RNA in clinical specimens for viral diagnosis

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In silico identification of potential inhibitors against shikimate dehydrogenase through virtual screening and toxicity studies for the treatment of tuberculosis

The present study attempts to identify the novel inhibitors of shikimate dehydrogenase (SD), the enzyme that catalyzes the fourth reaction in the shikimate pathway, through virtual screening and toxicity studies. Crystal structure of SD was obtained from Protein Data Bank (PDB ID 4P4G, 1.7 Å) and subjected to energy minimization and structure optimization. A total of 13,803 compounds retrieved from two public databases and used for the virtual screening based on physicochemical properties (Lipinski rule of five) and molecular docking analyses. A total of 26 compounds with good AutoDock binding energies values ranging between −12.03 and −8.33 kcal/mol was selected and further filtered for absorption distribution metabolism excretion and toxicity analyses (ADMET). In this, eight compounds were selected, which satisfied all the ADME and toxicity analysis properties. Three compounds with better AutoDock binding energies values (ZINC12135132, −12.03 kcal/mol; ZINC08951370, −10.04 kcal/mol; and ZINC14733847, 9.82 kcal/mol) were considered for molecular dynamic (MD) simulation and molecular generalized born surface area (MM-GBSA) analyses. The results of the analyses revealed that the two ligands (ZINC12135132 and ZINC08951370) had better inhibitory activities within their complexes, after the 50-ns MD simulation, which suggested that the complexes formed stable conformation. It is noteworthy that compounds identified by docking, MD simulation, and MM-GBSA methods could be a drug for tuberculosis which required further experimental validation

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Integration of virtual screening and susceptibility test to discover active-site subpocket-specific biogenic inhibitors of Helicobacter pylori shikimate dehydrogenase

Shikimate dehydrogenase (HpSDH) (EC 1.1.1.25) is a key enzyme in the shikimate pathway of Helicobacter pylori (H. pylori), which catalyzes the NADPH-dependent reversible reduction of 3-dehydroshikimate to shikimate. Targeting HpSDH has been recognized as an attractive therapeutic strategy against H. pylori infection. Here, the catalytic active site in the crystal structure of HpSDH in complex with its substrate NADPH and product shikimate was examined in detail; the site can be divided into three spatially separated subpockets that separately correspond to the binding regions of shikimate, NADPH dihydronicotinamide moiety, and NADPH adenine moiety. Subsequently, a cascading protocol that integrated virtual screening and antibacterial test was performed against a biogenic compound library to identify biologically active, subpocket-specific inhibitors. Consequently, five, eight, and six promising compounds for, respectively, subpockets 1, 2, and 3 were selected from the top-100 docking-ranked hits, from which 11 compounds were determined to have high or moderate antibacterial potencies against two reference H. pylori strains, with MIC range between 8 and 93 μg/mL. It is found that the HpSDH active site prefers to accommodate amphipathic and polar inhibitors that consist of an aromatic core as well as a number of oxygen-rich polar/charged substituents such as hydroxyl, carbonyl, and carboxyl groups. Subpockets 1- and 2-specific inhibitors exhibit a generally higher activity than subpocket 3-specific inhibitors. Molecular dynamics simulations revealed an intense nonbonded network of hydrogen bonds, π-π stacking, and van der Waals contacts at the tightly packed complex interfaces of active-site subpockets with their cognate inhibitors, conferring strong stability and specificity to these complex systems. Binding energetic analysis demonstrated that the identified potent inhibitors can target their cognate subpockets with an effective selectivity over noncognate ones

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Mortalidad inmediata y a los 30 días en las intoxicaciones digitálicas atendidas en servicios de urgencias de Cataluña / Immediate and 30 days mortality in digoxin poisoning cases attended in the Hospital Emergency Services of Catalonia, Spain

Introducción: La intoxicación digitálica es un motivo frecuente de consulta en los servicios de urgencias hospitalarios (SUH). El objetivo de este estudio es conocer la mortalidad asociada a dicha intoxicación. Método: Estudio descriptivo y observacional de las intoxicaciones digitálicas atendidas en los SUH de 4 hospitales de Cataluña durante los años 2013-15. Se recogieron datos relativos a la intoxicación, la mortalidad inmediata y a los 30 días. Se analizó la existencia de posibles factores asociados a la mortalidad. Resultados: Se registraron 171 intoxicaciones digitálicas. Siete eran agudas (4,1%) y 164 (95,9%) crónicas. La mortalidad inmediata fue del 6,4% y a los 30 días fue del 13,4%. El análisis binario no identificó ningún factor relacionado con la mortalidad inmediata. En cuanto a la mortalidad a 30 días, los pacientes que fallecieron tenían con mayor frecuencia una intoxicación aguda (13% vs 2,7%; p= 0,05), había más intoxicaciones con intencionalidad suicida (8,7% vs 0,7%; p= 0,048), más afectación renal (21,7% vs 9,5%; p= 0,037), menos sintomatología neurológica (4,3% vs 17,8%; p= 0,005), mayor digoxinemia (4,7 mg/dl vs 3,7 mg/dl; p= 0,027) y menor puntuación en el índice de Barthel (IB) (49,1 (33,4) vs 70,3 (28,5); p= 0,006). El análisis de regresión logística identificó la digoxinemia como un factor independiente de mortalidad inmediata y la puntuación en el IB en la mortalidad a 30 días. Conclusiones: La digoxinemia se relaciona con la mortalidad inmediata y el IB se relaciona con la mortalidad a 30 días

Background and objective: Digoxin poisoning is a frequent reason for seeking emergency care. This study aimed to assess mortality related to digoxin poisoning. Methods: Descriptive observational study of digoxin poisonings attended in the emergency departments of 4 hospitals in Catalonia from 2013 through 2015. We gathered data relevant to the poisonings and recorded immediate and 30-day mortality. Factors possibly related to mortality were explored. Results: A total of 171 digoxin poisonings were attended. Seven (4.1%) were acute and 164 (95.9%) were chronic. The immediate and 30-day mortality rates were 6.4% and 13.4%, respectively. Bivariate analysis did not identify factors related to immediate mortality. However, the variables more often associated with 30-day mortality in this analysis were acute poisoning (after which 13% died vs 2.7% of those with chronic poisoning, P=.05), suicide attempts (8.7% of whom died vs 0.7%, P=.048), more compromised renal function (21.7% vs 9.5%, P=.037), fewer neurologic symptoms (4.3% vs 17.8% with more symptoms, P=.005), higher mean digoxin concentrations (4.7 mg/dL in those who died vs 3.7 mg/dL, P=.027), and a lower Barthel index (mean [SD] 49.1 [33.4] in those who died vs 70.3 [28.5]; P=.006). Logistic regression analysis identified serum digoxin concentration to be independently associated with immediate mortality. A lower Barthel index was associated with 30-day mortality. Conclusions: Immediate mortality is related to a high digoxin concentration in serum, and 30-day mortality to a low Barthel index

Baloxavir marboxil: un potente inhibidor de la endonucleasa cap-dependiente de los virus gripales / Baloxavir marboxil: a potent cap-dependent endonuclease inhibitor of influenza viruses

Baloxavir marboxil (ácido 5-hidroxi-4-piridona-3-carboxilo) es un nuevo fármaco antiviral con especial eficacia sobre los virus gripales que actúa inhibiendo la endonuclease cap-dependiente que precisan para su replicación. Es el primer representante de los denominados inhibidores de la proteína básica 2 (PB2) gripal. Ha mostrado eficacia frente a los virus gripales A y B y la mayoría de cepas de origen animal (gripe aviar). Los ensayos clínicos realizados en pacientes sanos de entre 12 y 64 años sin patologías y no hospitalizados (gripe leve) han mostrado una reducción de la duración de la sintomatología parecida a la obtenida por oseltamivir. Sin embargo baloxavir es un inhibidor de la replicación viral mucho más potente que este fármaco. Se ha mostrado como un fármaco seguro y bien tolerado. Se administra una sola dosis de 40-80 mg las primeras 48 horas del inicio de los síntomas. En estos ensayos se han detectado cepas con sensibilidad moderada (mutantes PA/I38T) en el 2,2% de la gripe A (H1N1)pdm09 y en el 9,7% de la gripe A (H3N2). A pesar de estos datos podría ser un buen fármaco para tratar la gripe leve o moderada, precisando de ensayos en gripe grave y pacientes con patologías crónicas para establecer su verdadera utilidad clínica

Baloxavir marboxil (5-hydroxy-4-pyridone-3-carboxyl acid) is a new antiviral drug with special efficacy on influenza viruses that acts by inhibiting the cap-dependent endonuclease required for its replication. It is the first representative of the so-called inhibitors of influenza-like PB2. It has shown efficacy against influenza viruses A and B and most strains of animal origin (avian flu). Clinical trials conducted in healthy patients between 12 and 64 years without pathologies and not hospitalized (mild flu) have shown a reduction in the duration of symptoms similar to that obtained by oseltamivir. However, baloxavir is a much more potent inhibitor of viral replication than this drug. It has been shown as a safe and well tolerated drug. A single dose of 40-80 mg is administered the first 48 hours after onset of symptoms. In these trials, strains with moderate sensitivity (PA / I38T mutants) were detected in 2.2% of influenza A (H1N1) pdm09 and in 9.7% of influenza A (H3N2). Although these data could be a good drug to treat mild or moderate influenza, requiring trials in severe influenza and patients with chronic diseases to establish their true clinical utility

Mechanisms of the antilipolytic response of human adipocytes to tyramine, a trace amine present in food

Tyramine is found in foodstuffs, the richest being cheeses, sausages, and wines. Tyramine has been recognized to release catecholamines from nerve endings and to trigger hypertensive reaction. Thereby, tyramine-free diet is recommended for depressed patients treated with irreversible inhibitors of monoamine oxidases (MAO) to limit the risk of hypertension. Tyramine is a substrate of amine oxidases and also an agonist at trace amine-associated receptors. Our aim was to characterize the dose-dependent effects of tyramine on human adipocyte metabolic functions. Lipolytic activity was determined in adipocytes from human subcutaneous abdominal adipose tissue. Glycerol release was increased by a fourfold factor with classical lipolytic agents (1 μM isoprenaline, 1 mM isobutylmethylxanthine) while the amine was ineffective from 0.01 to 100 μM and hardly stimulatory at 1 mM. Tyramine exhibited a partial antilipolytic effect at 100 μM and 1 mM, which was similar to that of insulin but weaker than that obtained with agonists at purinergic A1 receptors, α2-adrenoceptors, or nicotinic acid receptors. Gi-protein blockade by Pertussis toxin abolished all these antilipolytic responses save that of tyramine. Indeed, tyramine antilipolytic effect was impaired by MAO-A inhibition. Tyramine inhibited protein tyrosine phosphatase activities in a manner sensitive to ascorbic acid and amine oxidase inhibitors. Thus, millimolar tyramine restrained lipolysis via the hydrogen peroxide it generates when oxidized by MAO. Since tyramine plasma levels have been reported to reach 0.2 μM after ingestion of 200 mg tyramine in healthy individuals, the direct effects we observed in vitro on adipocytes could be nutritionally relevant only when the MAO-dependent hepato-intestinal detoxifying system is overpassed

Efecto inhibitorio de fracciones peptídicas derivadas de la hidrólisis de semillas de chía (salvia hispanica) sobre las enzimas alfa-amilasa y alfa-glucosidasa / Inhibitory effect of peptide fractions derivatives from chia (Salvia hispanica) hydrolysis against alfa-amylase and alfa-glucosidase enzymes

Introducción: los biopéptidos son secuencias aminoacídicas que pueden ejercer funciones biológicas sobre el metabolismo y la absorción de carbohidratos. Objetivo: la finalidad de este estudio fue evaluar el efecto inhibitorio de fracciones peptídicas derivadas de la hidrólisis de Salvia hispanica sobre las enzimas alfa-amilasa y alfa-glucosidasa, para comprobar su actividad en el metabolismo glucídico. Material y métodos: se obtuvo una fracción rica en proteína, la cual fue hidrolizada mediante dos sistemas enzimáticos: Alcalasa(R)-Flavourzima(R) y pepsina-pancreatina. A las muestras obtenidas se les determinó el grado de hidrólisis. El hidrolizado fue centrifugado y la porción soluble fue ultrafiltrada, utilizando diferentes membranas de corte. A cada fracción se le determinó el contenido de proteína. Se realizó un análisis in vitro midiendo el porcentaje de inhibición de las fracciones de Salvia hispanica sobre α-amilasa y α-glucosidasa. Resultados: el sistema enzimático que presentó el mayor grado de hidrólisis (63,53%) fue la pepsina-pancreatina. De la ultrafiltración se obtuvieron cinco fracciones peptídicas: > 10 kDa, 5-10 kDa, 3-5 kDa, 1-3 kDa y < 1 kDa. El mayor contenido de proteína lo presentaron las fracciones de > 10 kDa y 5-10 kDa (0,90 y 0,93 mg/ml, respectivamente) para pepsina-pancreatina. Los porcentajes de inhibición obtenidos fueron de 85,61% y 79,19% para las fracciones de > 10 kDa y 5-10 kDa, respectivamente para la enzima α-amilasa. Para la enzima alfa-glucosidasa, el mayor porcentaje de inhibición fue para la fracción de > 10 kDa, con 96,91%. Conclusión: los péptidos obtenidos de la chía podrían incrementar las fuentes naturales para la elaboración de alimentos funcionales importantes para la dieta de pacientes diabéticos

Introduction: biopeptides are amino acid sequences with biological functions about metabolism and carbohydrates absorption. Objective: the aim of this study was the evaluation of the inhibitory effect of peptide fractions derivatives of the hydrolysis of Salvia hispanica against alfa-amylase and α-glucosidase enzymes to know their activity on the carbohydrates metabolism. Material and methods: the fraction rich in protein was hydrolyzed by two enzymatic systems: Alcalase (R)-Flavourzyme(R) and pepsin-pancreatine. The grade of hydrolysis was determined for the samples. The hydrolyzed samples were centrifuged and the soluble portion was ultra-fi ltered using different cut membranes. The content of protein was determined for each fraction. An in vitro analysis was made, measuring the percentage of inhibition of the Salvia hispanica fractions against α-amylase and alfa-glucosidase. Results: the enzymatic system showing the highest grade of hydrolysis (63.53%) was pepsin-pancreatine. From the ultrafi ltration, fi ve peptide fractions were obtained: 10 kDa, 5-10 kDa, 3-5 kDa, 1-3 kDa and 1 kDa. The highest protein content was for these fractions: 10 kDa and 5-10 kDa, (0.90 and 0.93 mg/ml, respectively) for pepsin-pancreatine. The inhibition percentages obtained were 85.61% and 79.19% for the 10 kDa and 5-10 kDa fractions, respectively, for the alfa-amylase enzyme. With respect to the alfa-glucosidase enzyme, the highest inhibition was for the 10 kDa fraction, with 96.91%. Conclusion: the peptide fractions obtained from the chia may increase the natural sources for the preparation of functional foods important for the diabetic patient's diet

Infección nosocomial por microorganismos multirresistentes y otros de relevancia epidemiológica y consumo hospitalario de antimicrobianos / No disponible

ntroducción: El objetivo es conocer la evolución de la prevalencia de infección nosocomial por microorga-nismos multirresistentes y el consumo hospitalario de antimicrobianos. Métodos: Análisis descriptivo de los datos del EPINE del Hospital Universitario de Salamanca periodo 2004-2015. Variables: tipo infección, consumo de antimicrobianos, cirugía, profilaxis quirúrgica y factores de riesgo. Resultados: La prevalencia de infección nosocomial por gérmenes multirresistentes se incrementó desde el año 2004, destaca el aumento de infecciones por Clostridium difficile. El consumo de antimicrobianos se mantiene estable pero se ha producido un cambio en las prevalencias individuales con disminución de amoxicilina e inhibidor enzimático (IE) y aumento de otros destacando a piperacilina e inhibidor enzimático. Conclusiones: El aumento de gérmenes multirresistentes y el cambio en el consumo de antimicrobianos hace que nos planteemos el desarrollo de nuevas estrategias y la necesidad de actualizar y evaluar de manera continua los protocolos de adecuación del uso de antimicrobianos

Introduction: The objective is to know the evolution of the prevalence of nosocomial infection by multiresistant microorganisms and the hospital consumption of antimicrobials. Methods: Descriptive analysis of EPINE data from Hospital Universitario de Salamanca period 2004-2015. Variables: infection type, antimicrobial consumption, surgery, surgical prophylaxis and risk factors. Results: The prevalence of nosocomial infection by multiresistant germs has increased since 2004, with the increase in Clostridium difficile infections. The consumption of antimicrobials remains stable but there has been a change in the individual prevalences with decrease of amoxicillin and enzyme inhibitor (IE) and increase of others emphasizing piperacillin and IE. Conclusions: The increase of multiresistant germs and the change in antimicrobial consumption makes us consider the development of new strategies and the need to continuously update and evaluate protocols for adequacy of antimicrobial use

The weakening effect of soluble epoxide hydrolase inhibitor AUDA on febrile response to lipopolysaccharide and turpentine in rat

A still growing body of evidence suggests the importance of epoxyeicosatrienoic acids (EETs) in the regulation of inflammatory response; therefore, drugs that stabilize their levels by targeting the soluble epoxide hydrolase (sEH), an enzyme responsible for their metabolism, are currently under investigation. The effect of sEH inhibitors on molecular components of fever mechanism, i.e., on synthesis of pro-inflammatory cytokines or prostaglandins, has been repeatedly proven; however, the hypothesis that sEH inhibitors affect febrile response has never been tested. The aim of this study was to examine if sEH inhibition affects core body temperature (Tb) as well as Tb changes during febrile response to infectious (lipopolysaccharide; LPS) or non-infectious (turpentine; TRP) stimuli. Male Wistar rats were implanted intra-abdominally with miniature biotelemeters to monitor Tb. A potent sEH inhibitor 12-(3-adamantan-1-yl-ureido)-dodecanoic acid (AUDA) was suspended in olive oil and administrated into animals in the intraperitoneal (i.p.) dose of 15 mg/kg, which, as we showed, has no significant influence on normal Tb. We have found that AUDA injected 3 h after LPS (50 μg/kg i.p.) significantly weakened febrile rise of Tb. Moreover, injection of sEH inhibitor 7 h after turpentine (administrated subcutaneously in a dose of 100 μL/rat) markedly reduced the peak period of aseptic fever. Obtained results provide first experimental evidence that sEH inhibitors possess anti-pyretic properties. Therefore, medicines targeting sEH enzymatic activity should be considered as a complement to the arsenal of topical medications used to treat fever especially in clinical situations when non-steroidal anti-inflammatory drugs are ineffective

Understanding pacing postconditioning-mediated cardiac protection: a role of oxidative stress and a synergistic effect of adenosine

We and others have demonstrated a protective role for pacing postconditioning (PPC) against ischemia/reperfusion (I/R) injury in the heart; however, the underlying mechanisms behind these protective effects are not completely understood. In this study, we wanted to further characterize PPC-mediated cardiac protection, specifically identify optimal pacing sites; examine the role of oxidative stress; and test the existence of a potential synergistic effect between PPC and adenosine. Isolated rat hearts were subjected to coronary occlusion followed by reperfusion. PPC involved three, 30 s, episodes of alternating left ventricular (LV) and right atrial (RA) pacing. Multiple pacing protocols with different pacing electrode locations were used. To test the involvement of oxidative stress, target-specific agonists or antagonists were infused at the beginning of reperfusion. Hemodynamic data were digitally recorded, and cardiac enzymes, oxidant, and antioxidant status were chemically measured. Pacing at the LV or RV but not at the heart apex or base significantly (P < 0.001) protected against ischemia-reperfusion injury. PPC-mediated protection was completely abrogated in the presence of reactive oxygen species (ROS) scavenger, ebselen; peroxynitrite (ONOO-) scavenger, uric acid; and nitric oxide synthase inhibitor, L-NAME. Nitric oxide (NO) donor, snap, however significantly (P < 0.05) protected the heart against I/R injury in the absence of PPC. The protective effects of PPC were significantly improved by adenosine. PPC-stimulated protection can be achieved by alternating LV and RA pacing applied at the beginning of reperfusion. NO, ROS, and the product of their interaction ONOO− play a significant role in PPC-induced cardiac protection. Finally, the protective effects of PPC can be synergized with adenosine (AU)

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The role of sirtuns in cellular homeostasis

Sirtuins are evolutionarily conserved nicotinamide adenine dinucleotide (NAD+)-dependent lysine deacylases or ADP-ribosyltransferases. These cellular enzymes are metabolic sensors sensitive to NAD+ levels that maintain physiological homeostasis in the animal and plant cells (AU)

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Doublet BRAF/MEK inhibition versus single-agent BRAF inhibition in the management of BRAF-mutant advanced melanoma, biological rationale and meta-analysis of published data

BACKGROUND: We executed a comparative systematic review and meta-analysis of the efficacy and toxicity of doublet BRAF/MEK inhibition versus single-agent BRAF inhibitor in the management of BRAF-mutant advanced melanoma. METHODS: Eligible studies included prospective studies evaluating doublet regimens versus BRAF-inhibitor monotherapy for the management of BRAF-mutant advanced melanoma. RESULTS: Our search strategy yielded 200 potentially relevant citations from searched databases. After preclusion of ineligible studies, four studies were included in the final analysis. Efficacy analyses demonstrate that BRAF/MEK inhibition strategy is associated with a significant improvement in ORR [OR 1.35; 95 % CI (1.16, 1.58); P = 0.0002], PFS [HR 0.56; 95 % CI (0.49, 0.64); P < 0.00001] and OS [HR 0.70; 95 % CI (0.58, 0.84); P = 0.0001]. Moreover, this combination is associated with a higher RR for diarrhea [1.30; 95 % CI (1.30, 1.49); P = 0.0002], decreased ejection fraction [4.63; 95 % CI (2.56, 8.37); P = <0.00001], acneiform dermatitis [1.61; 95 % CI (1.03, 2.53); P = 0.04] and pyrexia [1.98; 95 % CI (1.72, 2.27); P < 0.00001]. CONCLUSIONS: Our meta-analysis has demonstrated that combination of MEK/BRAF inhibitors is associated with higher ORR, PFS and OS. However, this comes at the expense of a higher risk of selected toxicities

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