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1.
Neuropsychiatr Dis Treat ; 14: 2807-2816, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-30498351

RESUMEN

OBJECTIVE: The aim of this study was to evaluate the safety of 3-monthly paliperidone palmitate (PP3M) vs once-monthly paliperidone palmitate (PP1M) treatment with regard to extrapyramidal symptom (EPS)-related treatment-emergent adverse events (TEAEs) in patients with schizophrenia, previously stabilized on PP1M treatment. PATIENTS AND METHODS: Data on overall incidence, time to onset (TTO), and time to resolution (TTR) of EPS-related TEAEs (overall, subclasses such as dyskinesia, dystonia, hyperkinesia, parkinsonism, and tremor) from a randomized double-blind (DB) non-inferiority study were compared between PP3M and PP1M. Subgroup analysis was performed by age (18-25, 26-50, and 50+ years) and final open-label (OL) dose (50/75, 100, and 150 mg eq.). RESULTS: Overall incidence of spontaneously reported EPS-related TEAEs decreased from 12.6% (PP1M) in OL phase to 8.3% (PP3M) and 7.4% (PP1M) in the DB phase; overall median TTO and TTR values were comparable between both groups. Among patients with reported EPS-related TEAEs, the median TTO for all EPS-related TEAEs was 17 days (PP1M) in OL phase and 115 days (PP3M) and 98.5 days (PP1M) in DB phase; median TTR was 36.5 days (PP1M) in OL phase and 91 days (PP3M) and 85.5 days (PP1M) in DB phase. No clear dose- or age-related differences in TTO and TTR of EPS-related TEAEs were noted. CONCLUSION: Despite differences in apparent half-life and pharmacokinetic profiles (peak plasma exposure of PP3M formulation is 70% higher than that of PP1M formulation), both PP3M and PP1M formulations exhibited comparable incidence of EPS-related TEAEs, TTO, and TTR in patients with schizophrenia.

2.
JAMA Psychiatry ; 72(8): 830-9, 2015 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-25820612

RESUMEN

IMPORTANCE: Treatment nonadherence and relapse are common problems in patients with schizophrenia. The long-acting 3-month formulation of paliperidone palmitate, owing to its extended elimination half-life, may offer a valuable therapeutic option for these patients. OBJECTIVE: To evaluate the efficacy and safety of the 3-month formulation of paliperidone palmitate vs placebo in delaying time to relapse of schizophrenia symptoms. DESIGN, SETTING, AND PARTICIPANTS: This randomized, multicenter trial conducted from April 26, 2012, through April 9, 2014, in 8 countries consisted of 4 phases: 3-week screening phase, flexible-dose 17-week open-label transition phase, 12-week open-label maintenance phase, and open-ended double-blind (DB) phase. Of the 506 patients enrolled (aged 18-70 years; DSM-IV-TR diagnosis of schizophrenia), 305 were randomized to 3-month paliperidone palmitate (n = 160) or placebo (n = 145) in the DB phase. INTERVENTIONS: Patients received once-monthly doses of the 1-month formulation of paliperidone palmitate (50, 75, 100, or 150 mg eq) during the transition phase, followed by a single dose of the 3-month formulation (3.5 times the stabilized dose of once-monthly paliperidone palmitate) during the maintenance phase. Stabilized patients were randomized to receive either a fixed dose of 3-month paliperidone palmitate (175, 263, 350, or 525 mg eq) or placebo once every 3 months during the DB phase. MAIN OUTCOMES AND MEASURES: Time from randomization to the first relapse event (time to relapse) in the DB phase. RESULTS: In the interim analysis, time to first relapse was significantly different in favor of the paliperidone palmitate group vs the placebo group (hazard ratio = 3.45; 95% CI, 1.73-6.88; P < .001); median time to relapse was 274 days for placebo but not estimable for 3-month paliperidone palmitate. An independent data monitoring committee recommended early study termination due to efficacy. In the DB phase, 183 of 305 patients (62% with 3-month paliperidone palmitate; 58% with placebo) had at least 1 treatment-emergent adverse event; those noted more frequently in the group receiving paliperidone palmitate than in the placebo group were headache (9% vs 4%), weight increased (9% vs 3%), nasopharyngitis (6% vs 1%), and akathisia (4% vs 1%). CONCLUSIONS AND RELEVANCE: Compared with placebo, the 3-month formulation of paliperidone palmitate administered 4 times yearly significantly delayed time to relapse in patients with schizophrenia. The 3-month formulation was generally tolerable and has a safety profile consistent with other marketed paliperidone formulations. TRIAL REGISTRATION: clinicaltrials.gov Identifier:NCT01529515.


Asunto(s)
Isoxazoles/uso terapéutico , Palmitatos/uso terapéutico , Esquizofrenia/tratamiento farmacológico , Prevención Secundaria/métodos , Adolescente , Adulto , Anciano , Antipsicóticos/administración & dosificación , Antipsicóticos/efectos adversos , Antipsicóticos/uso terapéutico , Preparaciones de Acción Retardada/efectos adversos , Preparaciones de Acción Retardada/uso terapéutico , Relación Dosis-Respuesta a Droga , Método Doble Ciego , Femenino , Humanos , Isoxazoles/administración & dosificación , Isoxazoles/efectos adversos , Masculino , Persona de Mediana Edad , Palmitato de Paliperidona , Palmitatos/administración & dosificación , Palmitatos/efectos adversos , Esquizofrenia/prevención & control , Resultado del Tratamiento , Adulto Joven
3.
Biochem J ; 463(3): 405-12, 2014 Nov 01.
Artículo en Inglés | MEDLINE | ID: mdl-25088564

RESUMEN

The four-component polypeptides of the 2-oxoacid dehydrogenase complex from the thermophilic archaeon Thermoplasma acidophilum assemble to give an active multienzyme complex possessing activity with the branched-chain 2-oxoacids derived from leucine, isoleucine and valine, and with pyruvate. The dihydrolipoyl acyl-transferase (E2) core of the complex is composed of identical trimer-forming units that assemble into a novel 42-mer structure comprising octahedral and icosahedral geometric aspects. From our previously determined structure of this catalytic core, the inter-trimer interactions involve a tyrosine residue near the C-terminus secured in a hydrophobic pocket of an adjacent trimer like a ball-and-socket joint. In the present study, we have deleted the five C-terminal amino acids of the E2 polypeptide (IIYEI) and shown by equilibrium centrifugation that it now only assembles into a trimeric enzyme. This was confirmed by SAXS analysis, although this technique showed the presence of approximately 20% hexamers. The crystal structure of the trimeric truncated E2 core has been determined and shown to be virtually identical with the ones observed in the 42-mer, demonstrating that removal of the C-terminal anchor does not significantly affect the individual monomer or trimer structures. The truncated E2 is still able to bind both 2-oxoacid decarboxylase (E1) and dihydrolipoamide dehydrogenase (E3) components to give an active complex with catalytic activity similar to the native multienzyme complex. This is the first report of an active mini-complex for this enzyme, and raises the question of why all 2-oxoacid dehydrogenase complexes assemble into such large structures.


Asunto(s)
Proteínas Arqueales/química , Complejos Multienzimáticos/química , Oxidorreductasas/química , Thermoplasma/enzimología , Proteínas Arqueales/genética , Cristalografía por Rayos X , Dihidrolipoamida Deshidrogenasa/química , Estabilidad de Enzimas , Calor , Cinética , Complejos Multienzimáticos/genética , Oxidorreductasas/genética , Conformación Proteica , Dispersión del Ángulo Pequeño
4.
Acta Crystallogr D Biol Crystallogr ; 69(Pt 10): 2104-15, 2013 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-24100328

RESUMEN

Bifunctional alcohol/aldehyde dehydrogenase (ADHE) enzymes are found within many fermentative microorganisms. They catalyse the conversion of an acyl-coenzyme A to an alcohol via an aldehyde intermediate; this is coupled to the oxidation of two NADH molecules to maintain the NAD(+) pool during fermentative metabolism. The structure of the alcohol dehydrogenase (ADH) domain of an ADHE protein from the ethanol-producing thermophile Geobacillus thermoglucosidasius has been determined to 2.5 Šresolution. This is the first structure to be reported for such a domain. In silico modelling has been carried out to generate a homology model of the aldehyde dehydrogenase domain, and this was subsequently docked with the ADH-domain structure to model the structure of the complete ADHE protein. This model suggests, for the first time, a structural mechanism for the formation of the large multimeric assemblies or `spirosomes' that are observed for this ADHE protein and which have previously been reported for ADHEs from other organisms.


Asunto(s)
Alcohol Deshidrogenasa/química , Biocombustibles/microbiología , Etanol , Geobacillus/enzimología , Modelos Moleculares , Alcohol Deshidrogenasa/genética , Alcohol Deshidrogenasa/aislamiento & purificación , Secuencia de Aminoácidos , Cristalografía por Rayos X , Fermentación , Geobacillus/genética , Geobacillus/crecimiento & desarrollo , Datos de Secuencia Molecular , Complejos Multienzimáticos/química , Complejos Multienzimáticos/genética
6.
BMC Psychiatry ; 12: 26, 2012 Mar 28.
Artículo en Inglés | MEDLINE | ID: mdl-22455454

RESUMEN

BACKGROUND: There are no previous reports of paliperidone palmitate's (PP) long term tolerability or pharmacokinetics of the highest dose in patients with schizophrenia. This study evaluates safety and tolerability, as well as pharmacokinetics, of the highest marketed dose of PP (150 mg eq. [234 mg]) in stable patients with schizophrenia over a 1-year period. METHODS: In this 1-year prospective study, eligible patients (aged 18-65 years; Positive and Negative Syndrome Scale's total score ≤ 70) received an initial deltoid injection of PP 150 mg eq. The second injection one week later and subsequent once-monthly injections were deltoid or gluteal. All injections were to be PP 150 mg eq. Patients willing to participate in intensive pharmacokinetic sampling were classified as Treatment A. Patients unwilling to undergo intensive pharmacokinetic sampling or unable to tolerate the 150 mg eq. dose (consequently receiving flexible doses of 50, 100 or 150 mg eq.) were classified as Treatment B. RESULTS: Of the 212 patients (safety analysis set), 73% were men; 45% white; 20% black; 34% Asians; mean (SD) age 41 (10.2) years, and mean (SD) baseline Positive and Negative Syndrome Scale total score 54.9 (9.03). A total of 53% (n = 113) patients completed the study and 104 received PP 150 mg eq. throughout. Mean (SD) mode dose of PP was 144.8 (19.58) mg eq. The dosing initiation regimen resulted in rapidly achieved and maintained therapeutic paliperidone levels over the study (average concentrations during the dosing interval were 34.7, 40.0, and 47.8 ng/mL after the 2nd, 8th, and 14th injection respectively). Most frequent (≥ 10%) treatment-emergent adverse events were nasopharyngitis (n = 37), insomnia (n = 32), injection-site pain (n = 32), headache (n = 28), and tachycardia (n = 27). Akathisia (n = 19) and tremor (n = 11) were the most common extrapyramidal adverse events. 33 patients had an SAE and 27 discontinued due to treatment-emergent adverse events. No deaths were reported. Mean (SD) weight change from baseline was 2.5 (5.41) kg at endpoint. Patients' psychoses remained stable. CONCLUSIONS: Safety results after one-year therapy with the highest available dose of once-monthly paliperidone palmitate were consistent with results from previous studies, with no new concerns noted. Plasma concentrations were within the expected range. TRIAL REGISTRATION NO: ClinicalTrials.gov: NCT01150448.


Asunto(s)
Antipsicóticos/uso terapéutico , Isoxazoles/uso terapéutico , Palmitatos/uso terapéutico , Esquizofrenia/tratamiento farmacológico , Psicología del Esquizofrénico , Adolescente , Adulto , Anciano , Antipsicóticos/administración & dosificación , Antipsicóticos/efectos adversos , Antipsicóticos/farmacocinética , Relación Dosis-Respuesta a Droga , Esquema de Medicación , Femenino , Humanos , Inyecciones Intramusculares/efectos adversos , Inyecciones Intramusculares/estadística & datos numéricos , Isoxazoles/administración & dosificación , Isoxazoles/efectos adversos , Isoxazoles/farmacocinética , Masculino , Persona de Mediana Edad , Palmitato de Paliperidona , Palmitatos/administración & dosificación , Palmitatos/efectos adversos , Palmitatos/farmacocinética , Estudios Prospectivos , Escalas de Valoración Psiquiátrica/estadística & datos numéricos , Esquizofrenia/sangre , Insuficiencia del Tratamiento
7.
FEBS J ; 279(5): 713-23, 2012 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-22188654

RESUMEN

The dihydrolipoyl acyl-transferase (E2) enzyme forms the structural and catalytic core of the tripartite 2-oxoacid dehydrogenase multienzyme complexes of the central metabolic pathways. Although this family of multienzyme complexes shares a common architecture, their E2 cores form homo-trimers that, depending on the source, further associate into either octahedral (24-mer) or icosahedral (60-mer) assemblies, as predicted by the principles of quasi-equivalence. In the crystal structure of the E2 core from Thermoplasma acidophilum, a thermophilic archaeon, the homo-trimers assemble into a unique 42-mer oblate spheroid. Analytical equilibrium centrifugation and small-angle X-ray scattering analyses confirm that this catalytically active 1.08 MDa assembly exists as a single species in solution, forming a hollow spheroid with a maximum diameter of 220 Å. In this paper we show that a monodisperse macromolecular assembly, built from identical subunits in non-identical environments, forms an irregular protein shell via non-equivalent interactions. This unusually irregular protein shell, combining cubic and dodecahedral geometrical elements, expands on the concept of quasi-equivalence as a basis for understanding macromolecular assemblies by showing that cubic point group symmetry is not a physical requirement in multienzyme assembly. These results extend our basic knowledge of protein assembly and greatly expand the number of possibilities to manipulate self-assembling biological complexes to be utilized in innovative nanotechnology applications.


Asunto(s)
Proteínas Arqueales/metabolismo , Complejos Multienzimáticos/metabolismo , Thermoplasma/enzimología , Proteínas Arqueales/química , Proteínas Arqueales/genética , Sitios de Unión , Dominio Catalítico , Cristalografía por Rayos X , Modelos Moleculares , Complejos Multienzimáticos/química , Complejos Multienzimáticos/genética , Conformación Proteica
8.
Extremophiles ; 15(3): 327-36, 2011 May.
Artículo en Inglés | MEDLINE | ID: mdl-21424517

RESUMEN

Using citrate synthase from the hyperthermophile Pyrococcus furiosus (PfCS) as our test molecule, we show through guanidine hydrochloride-induced unfolding that the dimer separates into folded, but inactive, monomers before individual subunit unfolding takes place. Given that forces across the dimer interface are vital for thermostability, a robust computational method was derived that uses the University of Houston Brownian Dynamics (UHBD) program to calculate both the hydrophobic and electrostatic contribution to the dimerisation energy at 100°C. The results from computational and experimental determination of the lowered stability of interface mutants were correlated, being both of the same order of magnitude and placing the mutant proteins in the same order of stability. This computational method, optimised for hyperthermophilic molecules and tested in the laboratory, after further testing on other examples, could be of widespread use in the prediction of thermostabilising mutations in other oligomeric proteins for which dissociation is the first step in unfolding.


Asunto(s)
Proteínas Arqueales/química , Citrato (si)-Sintasa/química , Pyrococcus furiosus/enzimología , Proteínas Arqueales/genética , Proteínas Arqueales/metabolismo , Citrato (si)-Sintasa/genética , Citrato (si)-Sintasa/metabolismo , Simulación por Computador , Estabilidad de Enzimas , Guanidina/química , Calor , Enlace de Hidrógeno , Interacciones Hidrofóbicas e Hidrofílicas , Modelos Moleculares , Mutación , Pliegue de Proteína , Multimerización de Proteína , Estructura Cuaternaria de Proteína , Subunidades de Proteína , Pyrococcus furiosus/genética , Espectrometría de Fluorescencia , Electricidad Estática , Relación Estructura-Actividad , Propiedades de Superficie , Ultracentrifugación
9.
Int Clin Psychopharmacol ; 26(1): 25-34, 2011 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-20881844

RESUMEN

The effect of two atypical antipsychotics on QTc intervals (heart rate-corrected QT interval) was evaluated. Patients (N=109) with schizophrenia (79%) or schizoaffective disorder (21%) were randomly assigned in 2 : 2 : 1 ratio to paliperidone extended release (ER), quetiapine, or placebo. Doses of 12 and 18 mg/day of paliperidone ER were compared with quetiapine 800 mg/day. Least-squares mean change from baseline in population-specific linear-derived correction method from baseline to days 6-7 at individual tmax was 5.1 ms less [90% confidence interval: -9.2 to -0.9] with paliperidone ER 12 mg/day than with quetiapine 800 mg/day. On the basis of a prespecified 10-ms noninferiority margin, paliperidone ER was thus declared noninferior to quetiapine (primary analysis). Mean change in population-specific linear-derived correction method from baseline to days 11-12 at individual tmax was 2.3 ms less (90% confidence interval: -6.8 to 2.3) with paliperidone ER 18 mg/day than with quetiapine 800 mg/day. Treatment-emergent adverse events occurred in 36 (82%) patients treated with paliperidone ER, 41 (95%) patients treated with quetiapine, and 14 (64%) patients treated with placebo. No adverse events of a proarrhythmic nature were noted. The effect on the QTc interval in patients with schizophrenia or schizoaffective disorder was comparable between paliperidone ER 12 mg/day (maximum recommended dose), paliperidone ER 18 mg/day (supratherapeutic dose), and quetiapine 800 mg/day.


Asunto(s)
Antipsicóticos/efectos adversos , Dibenzotiazepinas/farmacología , Isoxazoles/farmacología , Síndrome de QT Prolongado/prevención & control , Pirimidinas/farmacología , Adulto , Preparaciones de Acción Retardada , Dibenzotiazepinas/uso terapéutico , Método Doble Ciego , Electrocardiografía , Femenino , Humanos , Isoxazoles/uso terapéutico , Síndrome de QT Prolongado/inducido químicamente , Síndrome de QT Prolongado/fisiopatología , Masculino , Persona de Mediana Edad , Palmitato de Paliperidona , Pirimidinas/uso terapéutico , Fumarato de Quetiapina , Esquizofrenia/tratamiento farmacológico , Resultado del Tratamiento
10.
J Affect Disord ; 129(1-3): 252-60, 2011 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-20947174

RESUMEN

BACKGROUND: Combination treatment with atypical antipsychotics and a mood stabilizer is often recommended for treatment of manic or mixed episodes associated with bipolar I disorder. METHODS: Eligible patients (n=300) with a Young Mania Rating Scale (YMRS) total score ≥20 were randomly allocated (1:1) to continue mood stabilizer monotherapy or receive flexibly-dosed paliperidone ER (3-12 mg/day) in addition (combination treatment) for 6 weeks. The primary efficacy variable was the change from baseline to endpoint in the YMRS total score. RESULTS: The mean (SD) YMRS total score at baseline was 26.7 (5.26); 33% of patients presented with a mixed (as distinct from a manic) episode and 62% were on valproate and 38% on lithium. The mean (SD) change from baseline to endpoint in the YMRS total score was not significantly different for combination treatment (-14.3 [10.0]) compared with mood stabilizer monotherapy (-13.2 [10.9]; p=0.16). Combination treatment also failed to separate from mood stabilizer monotherapy for the secondary efficacy measures. The incidence of treatment-emergent adverse events was higher with combination treatment (70%) than with mood stabilizer monotherapy (54%); insomnia was the most common adverse event in both treatment groups (11%). LIMITATIONS: The relatively low doses of paliperidone ER used in this study and the conduct across different countries may have contributed to its failure to differentiate combination treatment from mood stabilizer monotherapy for the primary and secondary efficacy measures. CONCLUSIONS: In this study, flexibly-dosed paliperidone ER used as adjunctive therapy to mood stabilizers did not demonstrate efficacy over mood stabilizer monotherapy. No new safety signals were observed with combination treatment in this population.


Asunto(s)
Antimaníacos/uso terapéutico , Antipsicóticos/uso terapéutico , Trastorno Bipolar/tratamiento farmacológico , Isoxazoles/uso terapéutico , Compuestos de Litio/uso terapéutico , Pirimidinas/uso terapéutico , Ácido Valproico/uso terapéutico , Adulto , Antimaníacos/administración & dosificación , Antipsicóticos/administración & dosificación , Antipsicóticos/efectos adversos , Antipsicóticos/farmacocinética , Preparaciones de Acción Retardada , Método Doble Ciego , Quimioterapia Combinada , Femenino , Humanos , Isoxazoles/administración & dosificación , Isoxazoles/efectos adversos , Isoxazoles/farmacocinética , Compuestos de Litio/administración & dosificación , Masculino , Palmitato de Paliperidona , Escalas de Valoración Psiquiátrica , Pirimidinas/administración & dosificación , Pirimidinas/efectos adversos , Pirimidinas/farmacocinética , Resultado del Tratamiento , Ácido Valproico/administración & dosificación
11.
J Biol Chem ; 285(44): 33701-9, 2010 Oct 29.
Artículo en Inglés | MEDLINE | ID: mdl-20736170

RESUMEN

We have previously shown that the hyperthermophilic archaeon, Sulfolobus solfataricus, catabolizes d-glucose and d-galactose to pyruvate and glyceraldehyde via a non-phosphorylative version of the Entner-Doudoroff pathway. At each step, one enzyme is active with both C6 epimers, leading to a metabolically promiscuous pathway. On further investigation, the catalytic promiscuity of the first enzyme in this pathway, glucose dehydrogenase, has been shown to extend to the C5 sugars, D-xylose and L-arabinose. In the current paper we establish that this promiscuity for C6 and C5 metabolites is also exhibited by the third enzyme in the pathway, 2-keto-3-deoxygluconate aldolase, but that the second step requires a specific C5-dehydratase, the gluconate dehydratase being active only with C6 metabolites. The products of this pathway for the catabolism of D-xylose and L-arabinose are pyruvate and glycolaldehyde, pyruvate entering the citric acid cycle after oxidative decarboxylation to acetyl-coenzyme A. We have identified and characterized the enzymes, both native and recombinant, that catalyze the conversion of glycolaldehyde to glycolate and then to glyoxylate, which can enter the citric acid cycle via the action of malate synthase. Evidence is also presented that similar enzymes for this pentose sugar pathway are present in Sulfolobus acidocaldarius, and metabolic tracer studies in this archaeon demonstrate its in vivo operation in parallel with a route involving no aldol cleavage of the 2-keto-3-deoxy-pentanoates but direct conversion to the citric acid cycle C5-metabolite, 2-oxoglutarate.


Asunto(s)
Carbohidratos/química , Sulfolobus acidocaldarius/metabolismo , Sulfolobus solfataricus/metabolismo , Acetilcoenzima A/química , Oxidorreductasas de Alcohol/química , Archaea/metabolismo , Ciclo del Ácido Cítrico , Regulación de la Expresión Génica Arqueal , Hidroliasas/química , Isocitratoliasa/química , Malato Sintasa/química , Modelos Biológicos , Oxígeno/química , Fosforilación , Proteínas Recombinantes/química
12.
J Am Chem Soc ; 132(33): 11753-8, 2010 Aug 25.
Artículo en Inglés | MEDLINE | ID: mdl-20684556

RESUMEN

2-Keto-3-deoxygluconate aldolase from the hyperthermophile Sulfolobus solfataricus is a highly thermostable type I aldolase that can catalyze carbon-carbon bond formation using nonphosphorylated substrates. However, it exhibits poor diastereocontrol in many of its aldol reactions, including the reaction of its natural substrates, pyruvate and D-glyceraldehyde, which afford a 55:45 mixture of D-2-keto-3-deoxygluconate (D-KDGlu) and D-2-keto-3-deoxy-galactonate (D-KDGal). We have employed detailed X-ray crystallographic structural information of this aldolase bound to these diastereoisomeric aldol products to selectively target specific amino acids for mutation for the rapid creation of stereochemically complementary mutants that catalyze either (Re)- or (Si)-facial selective aldol reactions to afford either D-KDGlu or D-KDGal with good levels of diastereocontrol.


Asunto(s)
Aldehído-Liasas/química , Aldehído-Liasas/genética , Aldehído-Liasas/metabolismo , Biocatálisis , Cristalografía por Rayos X , Modelos Moleculares , Mutagénesis Sitio-Dirigida , Conformación Proteica , Estereoisomerismo , Sulfolobus solfataricus/enzimología
13.
Bipolar Disord ; 12(3): 230-43, 2010 May.
Artículo en Inglés | MEDLINE | ID: mdl-20565430

RESUMEN

OBJECTIVES: To evaluate the antimanic efficacy and safety of paliperidone extended-release (ER) tablets in patients with bipolar I disorder. METHODS: This study included a 3-week, double-blind, acute treatment phase (paliperidone ER versus placebo, with quetiapine as control), and a 9-week, double-blind, maintenance phase (paliperidone ER versus quetiapine). Patients [n = 493; Young Mania Rating Scale (YMRS) score >or= 20] were randomized (2:2:1) to flexibly dosed paliperidone ER (3-12 mg/day), quetiapine (400-800 mg/day), or placebo for the acute treatment phase. During the maintenance phase, patients assigned to placebo were switched to paliperidone ER but not included in analysis of efficacy. RESULTS: Paliperidone ER was superior to placebo at the 3-week endpoint {primary outcome; least-squares mean difference in change from baseline in YMRS scores [95% confidence interval (CI)]: -5.5 (-7.57; -3.35); p < 0.001} and noninferior to quetiapine at the 12-week endpoint [least-squares mean difference (95% CI): 1.7 (-0.47; 3.96)]. The median mode dose during the 12-week treatment period was 9 mg for paliperidone ER and 600 mg for quetiapine. The most common (>or= 10%) treatment-emergent adverse events during the 12-week period were: headache (16%), somnolence (10%), and akathisia (10%) for paliperidone ER; somnolence (21%), sedation and dry mouth (17% each), headache (14%), and dizziness (13%) for quetiapine. Body weight increase >or= 7% from baseline to 12-week endpoint was 8% with paliperidone ER and 17% with quetiapine. A higher percentage of paliperidone ER (13.9%) versus quetiapine patients (7.5%) 'switched to depression' at the12-week endpoint. CONCLUSIONS: Paliperidone ER (3-12 mg/day) was efficacious and tolerable in the treatment of acute mania.


Asunto(s)
Antipsicóticos/uso terapéutico , Trastorno Bipolar/tratamiento farmacológico , Isoxazoles/uso terapéutico , Pirimidinas/uso terapéutico , Adulto , Trastorno Bipolar/clasificación , Dibenzotiazepinas/uso terapéutico , Método Doble Ciego , Sistemas de Liberación de Medicamentos , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Palmitato de Paliperidona , Escalas de Valoración Psiquiátrica , Fumarato de Quetiapina , Resultado del Tratamiento
14.
Int Clin Psychopharmacol ; 25(5): 247-56, 2010 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-20389255

RESUMEN

This 13-week, double-blind study evaluated the efficacy and safety of the atypical antipsychotic paliperidone palmitate (recently approved in the United States) versus placebo administered as monthly gluteal injections (after two initial doses given 1 week apart) in acutely symptomatic patients with schizophrenia. Patients (N=388) were randomly assigned (1 : 1 : 1 : 1) to paliperidone palmitate 50, 100, or 150 mg eq. or placebo. As the 150 mg eq. dose was administered to fewer patients (n=30) than planned, meaningful and definitive conclusions cannot be drawn from the results of this group. The change from baseline in Positive and Negative Syndrome Scale total score at endpoint showed improvement in both paliperidone palmitate 50 and 100 mg eq. groups but was significant only in the 100 mg eq. group (P=0.019). The paliperidone palmitate 50 (P=0.004) and 100 mg eq. (P<0.001) groups showed significant improvement in the Personal and Social Performance score from baseline to endpoint versus placebo. Common adverse events (in >or=2% of patients in any group) more frequent with paliperidone palmitate 50 or 100 mg eq. than placebo (>or=5% difference) were headache, vomiting, extremity pain, and injection site pain. Treatment with paliperidone palmitate (100 mg eq.) was efficacious and all doses tested were tolerable.


Asunto(s)
Antipsicóticos/efectos adversos , Antipsicóticos/uso terapéutico , Isoxazoles/efectos adversos , Isoxazoles/uso terapéutico , Palmitatos/efectos adversos , Palmitatos/uso terapéutico , Esquizofrenia/tratamiento farmacológico , Adulto , Antipsicóticos/sangre , Antipsicóticos/farmacología , Relación Dosis-Respuesta a Droga , Método Doble Ciego , Femenino , Humanos , Isoxazoles/sangre , Isoxazoles/farmacología , Masculino , Persona de Mediana Edad , Palmitato de Paliperidona , Palmitatos/sangre , Palmitatos/farmacología , Escalas de Valoración Psiquiátrica , Factores de Tiempo
15.
FEBS Lett ; 584(6): 1231-4, 2010 Mar 19.
Artículo en Inglés | MEDLINE | ID: mdl-20171216

RESUMEN

Like many other aerobic archaea, the hyperthermophile Sulfolobus solfataricus possesses a gene cluster encoding components of a putative 2-oxoacid dehydrogenase complex. In the current paper, we have cloned and expressed the first two genes of this cluster and demonstrate that the protein products form an alpha(2)beta(2) hetero-tetramer possessing the catalytic activity characteristic of the first component enzyme of an acetoin dehydrogenase multienzyme complex. This represents the first report of an acetoin multienzyme complex in archaea, and contrasts with the branched-chain 2-oxoacid dehydrogenase complex activities characterised in two other archaea, Thermoplasma acidophilum and Haloferax volcanii.


Asunto(s)
Acetoina Deshidrogenasa/aislamiento & purificación , Complejos Multienzimáticos/aislamiento & purificación , Sulfolobus solfataricus/enzimología , Acetoína/metabolismo , Acetoina Deshidrogenasa/genética , Acetoina Deshidrogenasa/metabolismo , Archaea/química , Archaea/enzimología , Archaea/genética , Secuencia de Bases , Clonación Molecular , Calor , Complejos Multienzimáticos/genética , Complejos Multienzimáticos/metabolismo , Familia de Multigenes , Proteínas Recombinantes/genética , Proteínas Recombinantes/aislamiento & purificación , Proteínas Recombinantes/metabolismo , Especificidad por Sustrato , Sulfolobus solfataricus/química , Sulfolobus solfataricus/genética , Termodinámica
16.
FEBS J ; 276(15): 4012-22, 2009 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-19594830

RESUMEN

Members of the 2-oxoacid dehydrogenase multienzyme complex family play a key role in the pathways of central metabolism. Post-translational lipoylation of the dihydrolipoyl acyltransferase component of these complexes is essential for their activity, the lipoyllysine moiety performing the transfer of substrates and intermediates between the different active sites within these multienzyme systems. We have previously shown that the thermophilic archaeon, Thermoplasma acidophilum, has a four-gene cluster encoding the components of such a complex, which, when recombinantly expressed in Escherichia coli, can be assembled into an active multienzyme in vitro. Crucially, the E. coli host carries out the required lipoylation of the archaeal dihydrolipoyl acyltransferase component. Because active 2-oxoacid dehydrogenase multienzyme complexes have never been detected in any archaeon, the question arises as to whether Archaea possess a functional lipoylation system. In this study, we report the cloning and heterologous expression of two genes from Tp. acidophilum whose protein products together show significant sequence identity with the single lipoate protein ligase enzyme of bacteria. We demonstrate that both recombinantly expressed Tp. acidophilum proteins are required for lipoylation of the acyltransferase, and that the two proteins associate together to carry out this post-translational modification. From the published DNA sequences, we suggest the presence of functional transcriptional and translational regulatory elements, and furthermore we present preliminary evidence that lipoylation occurs in vivo in Tp. acidophilum. This is the first report of the lipoylation machinery in the Archaea, which is unique in that the catalytic activity is dependent on two separate gene products.


Asunto(s)
Proteínas Arqueales/metabolismo , Acetiltransferasa de Residuos Dihidrolipoil-Lisina/genética , Lipoilación/fisiología , Thermoplasma/genética , Proteínas Arqueales/genética , Secuencia de Bases , Dominio Catalítico , Clonación Molecular , Acetiltransferasa de Residuos Dihidrolipoil-Lisina/metabolismo , Escherichia coli/genética , Datos de Secuencia Molecular , Procesamiento Proteico-Postraduccional , TATA Box/genética , Thermoplasma/enzimología , Thermoplasma/metabolismo
17.
Biochem Pharmacol ; 77(1): 21-9, 2009 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-18840409

RESUMEN

5-aziridinyl-2,4-dinitrobenzamide (CB1954) has potential applications in enzyme/prodrug targeted anti-cancer therapies since it can be activated by nitroreductases to form a cytotoxic, bifunctional hydroxylamine derivative. A nitroreductase that can activate CB1954 has been previously isolated from Escherichia coli, but its usefulness is limited by its poor stability and low catalytic efficiency for CB1954. We now report the identification and characterization of a nitroreductase enzyme from the thermophilic bacterium Bacillus licheniformis. Although there is only 28% amino acid sequence identity between this enzyme and the previously isolated E. coli nitroreductase, the two enzymes have a number of characteristics in common. Both enzymes have been shown to reduce both CB1954 and menadione in the presence of NADH and NADPH. However, whereas E. coli nitroreductase produces equimolar amounts of the 2- and 4- hydroxylamine derivative of CB1954, the B. licheniformis enzyme produces only the desired 4-hydroxylamine derivative. It has a preference for NADPH as cosubstrate, and is also active with a range of CB1954 derivatives as substrate and reduced pyridinium cofactor analogues. Moreover, the enzyme is much more thermostable than the E. coli nitroreductase and shows maximum activity at 30 degrees C. These characteristics suggest that the B. licheniformis nitroreductase may be a possible candidate enzyme for enzyme/prodrug therapies due to its bacterial origin, the high activity observed with CB1954 and its enhanced stability.


Asunto(s)
Bacillus/enzimología , Proteínas Bacterianas/química , Nitrorreductasas/química , Profármacos/metabolismo , Secuencia de Aminoácidos , Bacillus/metabolismo , Proteínas Bacterianas/metabolismo , Clonación Molecular , Activación Enzimática/fisiología , Estabilidad de Enzimas/fisiología , Datos de Secuencia Molecular , Nitrorreductasas/metabolismo
18.
Acta Crystallogr D Biol Crystallogr ; 64(Pt 12): 1283-7, 2008 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-19018105

RESUMEN

The hyperthermophilic archaeon Sulfolobus solfataricus grows optimally above 353 K and utilizes an unusual promiscuous nonphosphorylative Entner-Doudoroff pathway to metabolize both glucose and galactose. It has been proposed that a part-phosphorylative Entner-Doudoroff pathway occurs in parallel in S. solfataricus, in which the 2-keto-3-deoxygluconate kinase (KDGK) is promiscuous for both glucose and galactose metabolism. Recombinant S. solfataricus KDGK protein was expressed in Escherichia coli, purified and crystallized in 0.1 M sodium acetate pH 4.1 and 1.4 M NaCl. The crystal structure of apo S. solfataricus KDGK was solved by molecular replacement to a resolution of 2.0 A and a ternary complex with 2-keto-3-deoxygluconate (KDGlu) and an ATP analogue was resolved at 2.1 A. The complex suggests that the structural basis for the enzyme's ability to phosphorylate KDGlu and 2-keto-3-deoxygalactonate (KDGal) is derived from a subtle repositioning of residues that are conserved in homologous nonpromiscuous kinases.


Asunto(s)
Adenosina Trifosfato/metabolismo , Gluconatos/metabolismo , Fosfotransferasas (Aceptor de Grupo Alcohol)/química , Sulfolobus solfataricus/enzimología , Factores Complejos Ternarios/metabolismo , Adenosina Trifosfato/análogos & derivados , Adenosina Trifosfato/química , Cristalización , Activación Enzimática , Galactosa/metabolismo , Glucosa/metabolismo , Fosforilación , Fosfotransferasas (Aceptor de Grupo Alcohol)/metabolismo , Unión Proteica , Conformación Proteica , Relación Estructura-Actividad , Especificidad por Sustrato , Factores Complejos Ternarios/química
19.
Extremophiles ; 12(1): 89-96, 2008 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-17571210

RESUMEN

Those aerobic archaea whose genomes have been sequenced possess four adjacent genes that, by sequence comparisons with bacteria and eukarya, appear to encode the component enzymes of a 2-oxoacid dehydrogenase multienzyme complex. However, no catalytic activity of any such complex has ever been detected in the archaea. In Thermoplasma acidophilum, evidence has been presented that the heterologously expressed recombinant enzyme possesses activity with the branched chain 2-oxoacids and, to a lesser extent, with pyruvate. In the current paper, we demonstrate that in Haloferax volcanii the four genes are transcribed as an operon in vivo. However, no functional complex or individual enzyme, except for the dihydrolipoamide dehydrogenase component, could be detected in this halophile grown on a variety of carbon sources. Dihydrolipoamide dehydrogenase is present at low catalytic activities, the level of which is increased three to fourfold when Haloferax volcanii is grown on the branched-chain amino acids valine, leucine and isoleucine.


Asunto(s)
Aldehído Oxidorreductasas/metabolismo , Aminoácidos de Cadena Ramificada/metabolismo , Proteínas Arqueales/metabolismo , Dihidrolipoamida Deshidrogenasa/metabolismo , Haloferax volcanii/enzimología , Aldehído Oxidorreductasas/genética , Proteínas Arqueales/genética , Dihidrolipoamida Deshidrogenasa/genética , Genes Arqueales/fisiología , Haloferax volcanii/genética , Haloferax volcanii/crecimiento & desarrollo , Operón/fisiología , Thermoplasma/enzimología , Thermoplasma/genética , Thermoplasma/crecimiento & desarrollo , Transcripción Genética/fisiología
20.
FEBS J ; 274(20): 5406-15, 2007 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-17894823

RESUMEN

The aerobic archaea possess four closely spaced, adjacent genes that encode proteins showing significant sequence identities with the bacterial and eukaryal components comprising the 2-oxoacid dehydrogenase multi-enzyme complexes. However, catalytic activities of such complexes have never been detected in the archaea, although 2-oxoacid ferredoxin oxidoreductases that catalyze the equivalent metabolic reactions are present. In the current paper, we clone and express the four genes from the thermophilic archaeon, Thermoplasma acidophilum, and demonstrate that the recombinant enzymes are active and assemble into a large (M(r) = 5 x 10(6)) multi-enzyme complex. The post-translational incorporation of lipoic acid into the transacylase component of the complex is demonstrated, as is the assembly of this enzyme into a 24-mer core to which the other components bind to give the functional multi-enzyme system. This assembled complex is shown to catalyze the oxidative decarboxylation of branched-chain 2-oxoacids and pyruvate to their corresponding acyl-CoA derivatives. Our data constitute the first proof that the archaea possess a functional 2-oxoacid dehydrogenase complex.


Asunto(s)
Proteínas Arqueales/metabolismo , Cetona Oxidorreductasas/metabolismo , Complejos Multienzimáticos/metabolismo , Proteínas Recombinantes/metabolismo , Thermoplasma/enzimología , Secuencia de Aminoácidos , Proteínas Arqueales/química , Proteínas Arqueales/genética , Cromatografía en Gel , Clonación Molecular , Biología Computacional , Cetona Oxidorreductasas/química , Cetona Oxidorreductasas/genética , Cinética , Espectrometría de Masas , Datos de Secuencia Molecular , Complejos Multienzimáticos/química , Complejos Multienzimáticos/genética , Proteínas Recombinantes/genética , Proteínas Recombinantes/aislamiento & purificación , Homología de Secuencia de Aminoácido
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