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1.
Front Cardiovasc Med ; 9: 942430, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36386326

RESUMO

Diabetes and its major key determinants insulin resistance and hyperglycemia are known risk factors for calcific aortic valve disease (CAVD). The processes leading to molecular and structural alterations of the aortic valve are yet not fully understood. In previous studies, we could show that valvular interstitial cells (VIC) display canonical elements of classical insulin signaling and develop insulin resistance upon hyperinsulinemia and hyperglycemia accompanied by impaired glucose metabolism. Analyses of cultured VIC and aortic valve tissue revealed extracellular matrix remodeling and degenerative processes. Since PI3K signaling through mammalian target of rapamycin (mTOR) is involved in fibrotic processes of the heart, we aim at further functional investigation of this particular Akt-downstream signaling pathway in the context of diabetes-induced CAVD. Primary cultures of VIC were treated with hyperinsulinemia and hyperglycemia. Phosphorylation of mTOR(Ser2448) was determined by Western blot analysis after acute insulin stimulus. Inhibition of mTOR phosphorylation was performed by rapamycin. Phosphorylation of mTOR complex 1 (MTORC1) downstream substrates 4E-BP1(Thr37/46) and P70S6K(Thr389), and MTORC2 downstream substrate Akt(Ser473) as well as the PDK1-dependent phosphorylation of Akt(Thr308) was investigated. Markers for extracellular matrix remodeling, cell differentiation and degenerative changes were analyzed by Western blot analysis, semi-quantitative real-time PCR and colorimetric assays. Hyperinsulinemia and hyperglycemia lead to alterations of VIC activation, differentiation and matrix remodeling as well as to an abrogation of mTOR phosphorylation. Inhibition of mTOR signaling by rapamycin leads to a general downregulation of matrix molecules, but to an upregulation of α-smooth muscle actin expression and alkaline phosphatase activity. Comparison of expression patterns upon diabetic conditions and rapamycin treatment reveal a possible regulation of particular matrix components and key degeneration markers by MTORC1 downstream signaling. The present findings broaden the understanding of mitogenic signaling pathways in VIC triggered by hyperinsulinemia and hyperglycemia, supporting the quest for developing strategies of prevention and tailored treatment of CAVD in diabetic patients.

3.
Trends Microbiol ; 29(2): 89-92, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-32800611

RESUMO

The microbiome research field is rapidly evolving, but the required biobanking infrastructure is currently fragmented and not prepared for the biobanking of microbiomes. The rapid advancement of technologies requires an urgent assessment of how biobanks can underpin research by preserving microbiome samples and their functional potential.


Assuntos
Bancos de Espécimes Biológicos/normas , Microbiota , Animais , Bactérias/classificação , Bactérias/genética , Bactérias/isolamento & purificação , Bancos de Espécimes Biológicos/tendências , Pesquisa Biomédica , Humanos , Mamíferos/microbiologia , Plantas/microbiologia , Preservação Biológica
4.
Environ Sci Pollut Res Int ; 24(12): 11120-11125, 2017 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-26903124

RESUMO

The use of nanotechnology and advanced materials promises to revolutionise many areas of technology and improve our daily life. In that respect, many positive effects on the environment are expected, either directly, by developing new technologies for remediation, filtering techniques or energy generation, or indirectly, by e.g. saving resources due to lower consumption of raw materials, or lower energy and fuel consumption due to reduced weight of vehicles. However, such beneficial effects of new technologies are often confronted by concerns regarding the safety of novel substances or materials. During the past 10 years, great effort has been put into research on potential hazards of nanomaterials towards environmental organisms. As the methodology for reliable assessment of nanomaterials was immature, many studies reporting contradictory results have been published, hindering both risk assessment for nanomaterials, as well as the knowledge communication to all involved stakeholders. Thus, DaNa2.0 serves as a platform to implement trusted knowledge on nanomaterials for an objective discussion.


Assuntos
Meio Ambiente , Nanoestruturas , Nanotecnologia , Pesquisa , Medição de Risco
5.
NeuroRehabilitation ; 28(2): 81-3, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-21447907

RESUMO

We report on a patient with tetraspasticity due to perinatal cerebral palsy requiring total hip joint endoprosthesis because of hip dysplasia. In order to minimize the risk of postoperative luxation Botulinum Toxin A was injected preoperatively into hip flexor and adductor muscles guided by CT-fluoroscopy. Outcome measures included muscle tone, limb position and self-reported pain relief. Seven days post injections the tone of the right hip flexor and adductor muscles improved from three to one points on the five-point Modified Ashworth Scale (MAS), the spastic joint position improved from 45° to 20° in flexion and from 20° to 10° in adduction, and the patient was free of pain. Ten days after injection of Botulinum Toxin operation of total hip joint arthroplasty was performed without complication. Improvement of spasticity sustained for another eight weeks. Subsequent Botulinum Toxin A injection three months post surgery resulted in identical results. This case demonstrates a new preoperative indication for Botulinum Toxin A in patients with an increased muscle tone at the hip who have to undergo total hip joint endoprosthesis to reduce the risk of postoperative luxation.


Assuntos
Toxinas Botulínicas Tipo A/administração & dosagem , Espasticidade Muscular/tratamento farmacológico , Fármacos Neuromusculares/administração & dosagem , Cuidados Pré-Operatórios/métodos , Artroplastia de Quadril/métodos , Paralisia Cerebral/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Espasticidade Muscular/etiologia , Espasticidade Muscular/cirurgia
6.
Fortschr Neurol Psychiatr ; 78(11): 644-51, 2010 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-21069629

RESUMO

Technological interventions into the brain raise a number of ethical questions, particularly, questions of personality change and control or manipulation of the human mind. Taking patients undergoing deep brain stimulation as an example, the authors analyse the possible impact of neurotechnologies on human self-perception in individual cases as well as in general. Following the concept of narrative-based medicine and ethics patients' narrations are presented in order to discuss the value of this approach for developing normative considerations as well as for deriving practical consequences regarding the physician-patient-relationship.


Assuntos
Encéfalo/fisiologia , Encéfalo/efeitos da radiação , Estimulação Encefálica Profunda , Narração , Autoimagem , Estimulação Encefálica Profunda/ética , Humanos , Relações Médico-Paciente
7.
Nervenarzt ; 80(8): 941-7, 2009 Aug.
Artigo em Alemão | MEDLINE | ID: mdl-19271206

RESUMO

In recent years the ability of neuroscience to identify and intervene in mental functions has progressed immensely, which raises several anthropologic and ethical questions. Meanwhile neuroethics arose as a new interdisciplinary field for critical analysis of neuroscientific actions and ethical reflection on the increasing knowledge of the human brain, with regard to society and politics. This article provides a survey of neuroethical implications for clinical practice.


Assuntos
Antropologia/ética , Genética/ética , Neurologia/ética , Neurociências/ética , Padrões de Prática Médica/ética , Alemanha
8.
Environ Pollut ; 157(4): 1134-9, 2009 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-18824284

RESUMO

Since the discovery of fullerenes in 1985, these carbon nanospheres have attracted attention regarding their physico/chemical properties. Despite little knowledge about their impact on the environment and human health, the production of fullerenes has already reached an industrial scale. However, the toxicity of C(60) is still controversially discussed. The aim of this study was to clarify the biological effects of tetrahydrofuran (THF) suspended C(60) fullerene in comparison to water stirred C(60) fullerene suspensions. Beyond that, we analyzed the effects on the Crustacea Daphnia magna an indicator for ecotoxicological effects and the human lung epithelial cell line A549 as a simplified model for the respiratory tract. We could demonstrate that water-soluble side products which were formed in THF nC(60) suspension were responsible for the observed acute toxic effects, whereas fullerenes themselves had no negative effect regardless of the preparative route on either A549 cell in vitro or D. magna in vivo.


Assuntos
Antioxidantes/química , Citotoxinas/química , Fulerenos/química , Animais , Antioxidantes/toxicidade , Citotoxinas/toxicidade , Daphnia , Ecotoxicologia/métodos , Fulerenos/toxicidade , Furanos , Humanos , Teste de Materiais , Microscopia Eletrônica de Varredura , Soluções , Testes de Toxicidade Aguda
9.
Ann Rheum Dis ; 67(12): 1689-96, 2008 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-18272671

RESUMO

OBJECTIVE: To describe the epidemiology and clinical spectrum of reactive arthritis (ReA) following culture-confirmed infection with bacterial enteric pathogens in a population-based study in the USA. METHODS: We conducted telephone interviews of persons age>1 year with culture confirmed Campylobacter, Escherichia coli O157, Salmonella, Shigella and Yersinia infections reported to FoodNet (http://www.cdc.gov/FoodNet/) in Minnesota, USA and Oregon, USA between 2002 and 2004. SUBJECTS: with new onset joint pain, joint swelling, back pain, heel pain and morning stiffness lasting >or=3 days within 8 weeks of culture (possible ReA) were invited to complete a detailed questionnaire and physical examination. RESULTS: A total of 6379 culture-confirmed infections were reported; 70% completed screening interviews. Of these, 575 (13%) developed possible ReA; incidence was highest following Campylobacter (2.1/100,000) and Salmonella (1.4/100,000) infections. Risk was greater for females (relative risk (RR) 1.5, 95% CI, 1.3 to 1.7), adults (RR 2.5, 95% CI, 2.0 to 3.1) and subjects with severe acute illness (eg, fever, chills, headache, persistent diarrhoea). Risk was not associated with antibiotic use or human leukocyte antigen (HLA)-B27. A total of 54 (66%) of 82 subjects examined had confirmed ReA. Enthesitis was the most frequent finding; arthritis was less common. The estimated incidence of ReA following culture-confirmed Campylobacter, E coli O157, Salmonella, Shigella and Yersinia infections in Oregon was 0.6-3.1 cases/100,000. CONCLUSIONS: This is the first population-based study of ReA following infections due to bacterial enteric pathogens in the USA. These data will help determine the burden of illness due to these pathogens and inform clinicians about potential sequelae of these infections.


Assuntos
Artrite Reativa/epidemiologia , Infecções por Enterobacteriaceae/epidemiologia , Doença Aguda , Adolescente , Adulto , Distribuição por Idade , Artrite Reativa/microbiologia , Infecções por Campylobacter/epidemiologia , Criança , Pré-Escolar , Métodos Epidemiológicos , Feminino , Humanos , Lactente , Masculino , Minnesota/epidemiologia , Oregon/epidemiologia , Exame Físico/métodos , Proibitinas , Infecções por Salmonella/epidemiologia , Distribuição por Sexo , Adulto Jovem
10.
Nano Lett ; 6(6): 1261-8, 2006 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-16771591

RESUMO

New materials of emerging technological importance are single-walled carbon nanotubes (SWCNTs). Because SWCNTs will be used in commercial products in huge amounts, their effects on human health and the environment have been addressed in several studies. Inhalation studies in vivo and submerse applications in vitro have been described with diverging results. Why some indicate a strong cytotoxicity and some do not is what we report on here. Data from A549 cells incubated with carbon nanotubes fake a strong cytotoxic effect within the MTT assay after 24 h that reaches roughly 50%, whereas the same treatment with SWCNTs, but detection with WST-1, reveals no cytotoxicity. LDH, FACS-assisted mitochondrial membrane potential determination, and Annexin-V/PI staining also reveal no cytotocicity. SWCNTs appear to interact with some tetrazolium salts such as MTT but not with others (such as WST-1, INT, XTT). This interference does not seem to affect the enzymatic reaction but lies rather in the insoluble nature of MTT-formazan. Our findings strongly suggest verifying cytotoxicity data with at least two or more independent test systems for this new class of materials (nanomaterials). Moreover, we intensely recommend standardizing nanotoxicological assays with regard to the material used: there is a clear need for reference materials. MTT-formazan crystals formed in the MTT reaction are lumped with nanotubes and offer a potential mechanism to guide bioremediation and clearance for SWCNTs from "contaminated" tissue. SWCNTs are good supporting materials for tissue growth, as attachment of focal adhesions and connections to the cytoskeleton suggest.


Assuntos
Artefatos , Sobrevivência Celular/efeitos dos fármacos , Medicina Baseada em Evidências/métodos , Nanotubos de Carbono/toxicidade , Medição de Risco/métodos , Testes de Toxicidade/métodos , Fraude , Dose Letal Mediana , Reprodutibilidade dos Testes , Fatores de Risco , Sensibilidade e Especificidade
11.
J Biosci ; 28(1): 51-5, 2003 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-12682424

RESUMO

Fly ash was used as a model for ambient particulate matter which is under suspicion to cause adverse pulmonary health effects. The fly ash was pre-sized and contained only particles < 20 microm including an ultrafine fraction (< 100 nm) that contributed 31% to the particle number. In our study, we investigated the influence of fly ash on the promotion of early inflammatory reactions like the formation of reactive oxygen species (ROS) in rat lung epithelial cells (RLE-6TN). Furthermore, we determined the formation of nitric oxide (NO). The cells show a clear dose-response relationship concerning the formation of ROS with regard to the mass of particles applied. Lipopolysaccharide (LPS) added as a co-stimulus did not increase the formation of ROS induced by fly ash. Furthermore, in LPS (0.1 microg/ml) and tumour necrosis factor-alpha (TNF-alpha; 1 ng/ml) pre-treated cells no increase in reactive oxygen species comparable to fly ash alone is observable. In presence of the metal chelator, desferrioxamine (DFO), ROS formation can be significantly reduced. Neither fly ash nor LPS induced a significant NO release in RLE-6TN cells.


Assuntos
Poluentes Atmosféricos/farmacologia , Carbono/farmacologia , Células Epiteliais/metabolismo , Espécies Reativas de Oxigênio/metabolismo , Animais , Linhagem Celular , Transformação Celular Viral , Quelantes/farmacologia , Cinza de Carvão , Meios de Cultura/química , Desferroxamina/farmacologia , Relação Dose-Resposta a Droga , Células Epiteliais/efeitos dos fármacos , Lipopolissacarídeos/farmacologia , Pulmão/citologia , Óxido Nítrico/biossíntese , Nitritos/análise , Tamanho da Partícula , Material Particulado , Ratos , Acetato de Tetradecanoilforbol/farmacologia , Fator de Necrose Tumoral alfa/farmacologia
12.
Ann N Y Acad Sci ; 1010: 335-8, 2003 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-15033746

RESUMO

Lipids are involved in a multitude of important cellular functions. They act as signaling molecules and can even provoke apoptosis. In this context we investigated the efficacy of synthetic alkylphosphocholines (APCs) as potential anti-cancer membrane-affecting drugs. Leading to novel therapeutic strategies for cancer treatment, the new agents interact with the cell membrane and do not affect the DNA. The data presented here show a cell death-inducing capacity for 1-O-phosphocholine-2[S]-O-acetyl-octadecane and 1-O-phosphocholin-2[S]-N-acetyl-octadecane in Jurkat T cells as well as in BJAB cells. The activation of caspases is generally required for the induction of apoptosis as shown by experiments with specific caspase inhibitors. The results point on the one hand to the formation of a functional DISC after APC-treatment as indicated by the clustering of receptor molecules and on the other hand to the dependency on the instrinsic apoptotic machinery and the downstream of mitochondria-activated apoptosome.


Assuntos
Divisão Celular/efeitos dos fármacos , Fosfatidilcolinas/farmacologia , Alquilação , Inibidores de Caspase , Linhagem Celular Tumoral , Inibidores Enzimáticos/farmacologia , Citometria de Fluxo , Humanos , Células Jurkat , Leucemia
13.
J Biomol Screen ; 6(4): 245-54, 2001 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-11689124

RESUMO

Lipofection, the transfer of genetic material into cells by means of cationic lipids, is of growing interest for in vitro and in vivo approaches. In order to identify ideal lipofection reagents in a HTS, we have developed an automated lipofection method for the transfer of reporter genes into cells and for determination of the lipofection results. The method has specifically been designed and optimized for 96-well microtiter plates and can successfully be carried out by a pipetting robot with accessory equipment. It consists of two separate parts: (1) pretransfection (preparation of liposomes, formation of lipoplexes, and lipoplex transfer to the cells) and (2) posttransfection (determination of the reporter enzyme activity and the protein content of the transfected cells). Individual steps of the lipofection method were specifically optimized - for example, lipoplex formation and incubation time as well as cell lysis, cell cultivating, and the reporter gene assay. The HTS method facilitates characterization of the transfection properties (efficiency and cytotoxicity) of large numbers of (cationic) lipids in various adherent cell types.


Assuntos
Cátions/metabolismo , Avaliação Pré-Clínica de Medicamentos/instrumentação , Avaliação Pré-Clínica de Medicamentos/métodos , Metabolismo dos Lipídeos , Lipossomos/metabolismo , Transfecção , Animais , Automação , Células COS , Adesão Celular , Linhagem Celular , DNA/metabolismo , Humanos , Fatores de Tempo
15.
Cancer Genet Cytogenet ; 128(2): 108-13, 2001 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-11463448

RESUMO

Near-haploid (<30 chromosomes) acute lymphoblastic leukemia (ALL) is a rare and unique subgroup of childhood common ALL associated with a very poor outcome. It may be underdiagnosed when masked by a co-existing hyperdiploid line, which has to be distinguished from the common good-prognostic hyperdiploid (>50 chromosomes) ALL. We present three children in whom, by conventional cytogenetics, near-haploid ALL was detected on relapse. Using interphase FISH probes of chromosomes X, Y, 4, 12, and 21, we were able, in two cases, to trace the hidden near-haploid lines of approximately 5% and 20% of the cells, masked by hyperdiploid cells of approximately 80% and 70%, respectively; at relapse, the proportion was reversed, with predominant near-haploid lines of over 80% and residual hyperdiploidy of less than 10%. The near-haploid lines consisted of 24 and 27 chromosomes, and always retained the second copy of chromosome 21 or its derivative, as detected in one of our patients by SKY. The hyperdiploid clones were the exact duplicates of the near-haploid ones and contained four and two copies of the chromosomes represented in two and one copies in the near-haploid stem line, respectively. Unlike the common hyperdiploid ALL, no trisomies were observed. The patients were all aged >10 years, with WBC 0.7-30 x 10(9)/L, and a common ALL phenotype. They were treated with the ALL-BFM-95 protocol, medium risk group, and responded well to 8 days of steroid therapy, but relapsed early, within 11 months, and died a few months later. Interphase FISH technique is recommended for the detection of cryptic near-haploid clones in the diagnostic survey of ALL. To assess the prognostic value of near-haploidy in the context of the ALL-BFM protocols, a larger cohort of patients is required.


Assuntos
Diploide , Haploidia , Leucemia-Linfoma Linfoblástico de Células Precursoras/genética , Adolescente , Criança , Feminino , Humanos , Hibridização in Situ Fluorescente , Cariotipagem , Masculino , Leucemia-Linfoma Linfoblástico de Células Precursoras/tratamento farmacológico , Resultado do Tratamento
16.
Eur J Cell Biol ; 80(1): 1-10, 2001 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-11211929

RESUMO

Many lipids act as cellular messengers and lead to a variety of different cellular responses. Out of the group of these compounds the ceramides are able to induce apoptosis, and some synthetic lipids can mimic this effect. Apoptosis is an important mechanism whereby chemotherapeutics exhibit their anti-oncogenic activity. Although, some lipid analogues were used in clinical trials, they exert severe side effects and their mechanism of action is widely unknown. We present here a new class of synthetic alkylphosphocholines (APC) that induce programmed cell death in leukaemia cells. The signs of apoptosis arise after 1 h of incubation with these compounds as shown by phosphatidylserine externalisation followed by caspase activation and DNA fragmentation. We demonstrate that the molecular target of these lipids is upstream of caspases and Bcl-2. Experiments with FADD dominant negative cells reveal that induction of apoptosis occurs on the level of CD95 and that these compounds can now be optimised for their capacity to activate the apoptosis-inducing receptor CD95.


Assuntos
Antineoplásicos/farmacologia , Apoptose/efeitos dos fármacos , Fosforilcolina/farmacologia , Proteínas Virais , Receptor fas/metabolismo , Alcanos/química , Alcanos/metabolismo , Alcanos/farmacologia , Clorometilcetonas de Aminoácidos/farmacologia , Antineoplásicos/química , Antineoplásicos/metabolismo , Caspase 3 , Caspases/metabolismo , Membrana Celular/efeitos dos fármacos , Cromatina/efeitos dos fármacos , Inibidores de Cisteína Proteinase/farmacologia , Fragmentação do DNA , Ativação Enzimática , Células HL-60 , Humanos , Células Jurkat , Mitocôndrias/fisiologia , Estrutura Molecular , Fosforilcolina/química , Fosforilcolina/metabolismo , Poli(ADP-Ribose) Polimerases/metabolismo , Proteínas Proto-Oncogênicas c-bcl-2/metabolismo , Serpinas/biossíntese , Células Tumorais Cultivadas
18.
J Rheumatol ; 27(5): 1257-9, 2000 May.
Artigo em Inglês | MEDLINE | ID: mdl-10813297

RESUMO

OBJECTIVE: To investigate whether HLA-B27 influences the expression of murine progressive ankylosis (MPA), a single-gene autosomal recessive mouse model of ankylosing spondylitis that arises in mice homozygous for the ank gene. METHODS: Mice transgenic for HLA-B27 were bred with ank/ank mice, and the phenotypes of the F1 and F2 progeny were observed. RESULTS: ank/+ mice showed no abnormalities, and ank/ank mice showed the typical phenotype of MPA, irrespective of B27 status. CONCLUSION: HLA-B27 and the ank/ank genotype both predispose to diseases involving progressive bony ankylosis. These findings suggest that these disease processes are distinct and noninteractive, and they provide no support for the hypothesis that the human homolog of the ank locus participates in the pathogenesis of ankylosing spondylitis.


Assuntos
Anquilose/genética , Antígeno HLA-B27/genética , Animais , Anquilose/imunologia , Anquilose/fisiopatologia , Progressão da Doença , Feminino , Humanos , Masculino , Camundongos , Camundongos Endogâmicos C3H , Camundongos Endogâmicos C57BL , Camundongos Transgênicos , Fenótipo
19.
J Cell Biol ; 149(2): 255-62, 2000 Apr 17.
Artigo em Inglês | MEDLINE | ID: mdl-10769019

RESUMO

Polyglutamine tract expansion in androgen receptor is a recognized cause of spinal and bulbar muscular atrophy (SBMA), an X-linked motor neuronopathy. Similar mutations have been identified in proteins associated with other neurodegenerative diseases. Recent studies have shown that amplified polyglutamine repeat stretches form cellular aggregates that may be markers for these neurodegenerative diseases. Here we describe conditions that lead to aggregate formation by androgen receptor with polyglutamine stretch amplification. In transfection experiments, the mutant, compared with the wild-type receptor, was delayed in its cytoplasmic-nuclear translocation and formed large cytoplasmic aggregates in the presence of androgen. The cytoplasmic environment appears crucial for this aggregation, since retention of both the wild-type and mutant receptors in this cellular compartment by the deletion of their nuclear localization signals resulted in massive aggregation. Conversely, rapid nuclear transport of both receptors brought about by deletion of their ligand binding domains did not result in aggregate formation. However, androgen antagonists that altered the conformation of the ligand binding domain and promoted varying rates of cytoplasmic-nuclear translocation all inhibited aggregate formation. This demonstrates that in addition to the cytoplasmic localization, a distinct contribution of the ligand binding domain of the receptor is necessary for the aggregation. The finding that antiandrogens inhibit aggregate formation may provide the basis for in vivo determination of the role of these structures in SBMA.


Assuntos
Núcleo Celular/metabolismo , Amplificação de Genes , Peptídeos , Receptores Androgênicos/genética , Animais , Células COS , Núcleo Celular/ultraestrutura , Citoplasma/metabolismo , Humanos , Receptores Androgênicos/química , Receptores Androgênicos/fisiologia , Proteínas Recombinantes/química , Proteínas Recombinantes/metabolismo , Transdução de Sinais , Transfecção
20.
Clin Ther ; 22(1): 40-52, 2000 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-10688389

RESUMO

OBJECTIVE: The purpose of this study was to compare the tolerability and efficacy of nabumetone and naproxen in the treatment of patients with rheumatoid arthritis (RA). The occurrence of gastrointestinal (GI) adverse events was compared. BACKGROUND: Nonsteroidal anti-inflammatory drugs (NSAIDs) have similar efficacy at equipotent doses, but the therapeutic response to various NSAIDs often differs in individual patients. METHODS: This was a 3-month, randomized, double-blind, multicenter, parallel-group study conducted in adult patients with RA. The study had 2 phases: a 3- to 14-day washout period and a 12-week treatment period. During the treatment phase, the tolerability and efficacy of nabumetone 2000 mg/d were compared with those of naproxen 1000 mg/d. The change from baseline in efficacy variables, including global assessments, number of tender or swollen joints, and pain, was evaluated. The study was sized to provide an 80% power to detect a 15% difference in the percentage improvement on the physician's global assessment (alpha = 0.05). GI safety was assessed by monitoring the occurrence of clinically important adverse GI events. RESULTS: A total of 346 RA patients at 31 US rheumatology centers were randomly assigned to treatment (173 patients per group). The study population was predominantly white (87.0%) and female (70.5%), with a mean age of 54 years. Both treatments improved the signs and symptoms of RA, with no statistically significant differences between groups for any efficacy variables. No serious GI adverse events occurred with either NSAID. The most frequent treatment-related adverse events in both groups were predominantly GI in origin, as were those that resulted in withdrawal from the study. Diarrhea with lower abdominal pain was the most common adverse event in the nabumetone group; upper abdominal pain was the most common adverse event in the naproxen group. The only significant difference between the 2 groups was a higher incidence of diarrhea (P < 0.01) in patients receiving nabumetone. CONCLUSIONS: Nabumetone 2000 mg/d was as effective as naproxen 1000 mg/d in relieving the signs and symptoms of RA. In this study, no serious GI adverse events were observed with either NSAID, but nabumetone was associated with a higher incidence of diarrhea.


Assuntos
Anti-Inflamatórios não Esteroides/efeitos adversos , Anti-Inflamatórios não Esteroides/uso terapêutico , Artrite Reumatoide/tratamento farmacológico , Butanonas/efeitos adversos , Butanonas/uso terapêutico , Naproxeno/efeitos adversos , Naproxeno/uso terapêutico , Adulto , Idoso , Idoso de 80 Anos ou mais , Anti-Inflamatórios não Esteroides/administração & dosagem , Butanonas/administração & dosagem , Método Duplo-Cego , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nabumetona , Naproxeno/administração & dosagem
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