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1.
Bioorg Med Chem Lett ; 94: 129450, 2023 10 01.
Artículo en Inglés | MEDLINE | ID: mdl-37591318

RESUMEN

Methionine adenosyltransferase 2A (MAT2A) has been indicated as a drug target for oncology indications. Clinical trials with MAT2A inhibitors are currently on-going. Here, a structure-based virtual screening campaign was performed on the commercially available chemical space which yielded two novel MAT2A-inhibitor chemical series. The binding modes of the compounds were confirmed with X-ray crystallography. Both series have acceptable physicochemical properties and show nanomolar activity in the biochemical MAT2A inhibition assay and single-digit micromolar activity in the proliferation assay (MTAP -/- cell line). The identified compounds and the relating structural data could be helpful in related drug discovery projects.


Asunto(s)
Bioensayo , Metionina Adenosiltransferasa , Línea Celular , Cristalografía por Rayos X , Metionina Adenosiltransferasa/antagonistas & inhibidores , Terapia Molecular Dirigida
2.
Knee Surg Sports Traumatol Arthrosc ; 27(11): 3432-3440, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-30715593

RESUMEN

PURPOSE: In medial patellofemoral ligament (MPFL) reconstruction, it remains controversial whether more accurate femoral tunnel positioning is correlated with improved clinical outcomes. The purpose was to verify the accuracy of methods for evaluating tunnel positioning, one of which is the use of postoperative radiographs, in determining the femoral tunnel position following MPFL reconstruction and to compare the variability of tunnel positions to the intraoperatively documented positions on a true-lateral view. METHODS: Seventy-three consecutive MPFL reconstructions were prospectively enrolled. Femoral tunnel positions were intraoperatively determined using fluoroscopy to obtain true-lateral radiographs. Postoperatively, lateral radiographic images were taken. Seven independent radiologists and seven independent orthopaedic knee surgeons evaluated the femoral tunnel position and amount of malrotation for each radiograph. Deviations from the Schoettle's point were measured and repeated after 4 weeks. Intraobserver and interobserver analyses of variance were calculated to determine the reliability of measurements on both intraoperative and postoperative radiographs. RESULTS: Fifty-six patients were included in the final analysis. Tunnel positions were unable to be identified on postoperative radiographs in 14% of cases on average, independent of the degree of radiograph rotation. Intraoperative images showed mean deviations from the tunnel position to the centre of Schoettle's point of 1.9 ± 1.4 mm and 1.6 ± 1.0 mm in anterior-posterior and proximal-distal direction, respectively. Postoperative radiographs showed mean anterior-posterior and deviations of 7.4 ± 4.4 mm and 8.9 ± 5.8 mm assessed by orthopaedic surgeons and 10.6 ± 6.3 mm and 11.6 ± 7.1 mm assessed by radiologists at first and repeated measurement, respectively. The mean proximal-distal deviations were 4.8 ± 4.4 mm and 6.5 ± 6.0 mm and 7.2 ± 6.3 mm and 8.1 ± 7.1 mm, respectively. Measurement of tunnel position on intraoperative fluoroscopic images was significantly different compared to postoperative radiographs for each of the 14 observers (p < 0.05). Significant intraobserver and interobserver differences between the first and repeat measurements for both orthopaedic surgeons and radiologists were observed (p < 0.05). CONCLUSION: Measurement of the femoral tunnel position on postoperative lateral radiographs is not an accurate or reliable method for evaluating tunnel position after MPFL reconstruction due to exposure, contrast, and malrotation of the radiograph from a true-lateral image. In contrast, intraoperative fluoroscopic control allows for a precise lateral view and correct tunnel positioning. Thus, postoperative radiographic images may be unnecessary for the evaluation of femoral tunnel positions, particularly when intraoperative fluoroscopy has been used. STUDY DESIGN: Level II, prospective cohort study.


Asunto(s)
Fémur/diagnóstico por imagen , Fémur/cirugía , Ligamentos Articulares/cirugía , Adolescente , Adulto , Femenino , Fluoroscopía , Humanos , Periodo Intraoperatorio , Masculino , Persona de Mediana Edad , Variaciones Dependientes del Observador , Periodo Posoperatorio , Estudios Prospectivos , Radiografía , Adulto Joven
3.
Br J Haematol ; 178(6): 949-953, 2017 09.
Artículo en Inglés | MEDLINE | ID: mdl-28573668

RESUMEN

To elucidate their mechanism of action, inhibitors of Bruton tyrosine kinase (BTK) and resistant BTK mutants were employed to dissect target-dependent cellular functions. BTK-C481S and -T474I, expressed in Ramos and NALM-6 cells, maintained BTK auto-phosphorylation under treatment with ibrutinib or dasatinib, respectively, which showed only modest cytotoxicity. Retained activity of BTK-T474 partially rescued cell migration from inhibition by dasatinib. Importantly, resistant BTK mutants reconstituted B cell receptor-triggered chemokine secretion in the presence of corresponding inhibitors, demonstrating that BTK activity is connected with cell-intrinsic functions of malignant B cells with importance for their dialogue with the micro-environment.


Asunto(s)
Linfocitos B/enzimología , Leucemia de Células B/genética , Linfoma de Células B/genética , Proteínas Tirosina Quinasas/genética , Adenina/análogos & derivados , Agammaglobulinemia Tirosina Quinasa , Antineoplásicos , Quimiocinas/metabolismo , Quimiotaxis/efectos de los fármacos , Dasatinib/administración & dosificación , Dasatinib/farmacología , Relación Dosis-Respuesta a Droga , Resistencia a Antineoplásicos/genética , Humanos , Leucemia de Células B/enzimología , Leucemia de Células B/patología , Linfoma de Células B/enzimología , Linfoma de Células B/patología , Mutación , Fosforilación/efectos de los fármacos , Piperidinas , Inhibidores de Proteínas Quinasas/farmacología , Proteínas Tirosina Quinasas/antagonistas & inhibidores , Proteínas Tirosina Quinasas/metabolismo , Pirazoles/administración & dosificación , Pirazoles/farmacología , Pirimidinas/administración & dosificación , Pirimidinas/farmacología , Células Tumorales Cultivadas
4.
Proc Natl Acad Sci U S A ; 110(20): 8081-6, 2013 May 14.
Artículo en Inglés | MEDLINE | ID: mdl-23630251

RESUMEN

In contrast with the very well explored concept of structure-activity relationship, similar studies are missing for the dependency between binding kinetics and compound structure of a protein ligand complex, the structure-kinetic relationship. Here, we present a structure-kinetic relationship study of the cyclin-dependent kinase 8 (CDK8)/cyclin C (CycC) complex. The scaffold moiety of the compounds is anchored in the kinase deep pocket and extended with diverse functional groups toward the hinge region and the front pocket. These variations can cause the compounds to change from fast to slow binding kinetics, resulting in an improved residence time. The flip of the DFG motif ("DMG" in CDK8) to the inactive DFG-out conformation appears to have relatively little influence on the velocity of binding. Hydrogen bonding with the kinase hinge region contributes to the residence time but has less impact than hydrophobic complementarities within the kinase front pocket.


Asunto(s)
Ciclina C/química , Quinasa 8 Dependiente de Ciclina/química , Secuencias de Aminoácidos , Dominio Catalítico , Cristalografía por Rayos X , Diseño de Fármacos , Humanos , Enlace de Hidrógeno , Cinética , Ligandos , Modelos Moleculares , Unión Proteica , Conformación Proteica , Sales (Química)/química , Temperatura , Factores de Tiempo
5.
Int J Cancer ; 137(9): 2234-42, 2015 Nov 01.
Artículo en Inglés | MEDLINE | ID: mdl-25912635

RESUMEN

Pharmacological inhibition of phosphatiylinositide-3-kinase (PI3K)-mediated signaling holds great promise for treating chronic lymphocytic leukemia (CLL). Therefore we assessed three structurally related PI3K inhibitors targeting the PI3K-δ isoform for their ability to inhibit the survival of freshly isolated CLL cells. The purely PI3K-δ-selective inhibitor idelalisib was compared to copanlisib (BAY 80-6946) and duvelisib (IPI-145), with isoform target profiles that additionally include PI3K-α or PI3K-γ, respectively. The concentrations leading to half-maximal reduction of the survival of CLL cells were more than ten-fold lower for copanlisib than for idelalisib and duvelisib. At concentrations reflecting the biological availability of the different inhibitors, high levels of apoptotic response among CLL samples were attained more consistently with copanlisib than with idelalisib. Copanlisib selectively reduced the survival of CLL cells compared to T cells and to B cells from healthy donors. In addition copanlisib and duvelisib impaired the migration of CLL cells towards CXCL12 to a greater extent than equimolar idelalisib. Similarly copanlisib and duvelisib reduced the survival of CLL cells in co-cultures with the bone marrow stroma cell line HS-5 more strongly than idelalisib. Survival inhibition by copanlisib and idelalisib was enhanced by the monoclonal CD20 antibodies rituximab and obinutuzumab (GA101), while antibody-dependent cellular cytotoxicity mediated by alemtuzumab and peripheral blood mononuclear cells was not substantially impaired by both PI3K inhibitors for the CLL-derived JVM-3 cell line as target cells. Taken together, targeting the α- and δ- p110 isoforms with copanlisib may be a useful strategy for the treatment of CLL and warrants further clinical investigation.


Asunto(s)
Anticuerpos Monoclonales de Origen Murino/farmacología , Isoquinolinas/farmacología , Leucemia Linfocítica Crónica de Células B/tratamiento farmacológico , Purinas/farmacología , Pirimidinas/farmacología , Quinazolinas/farmacología , Quinazolinonas/farmacología , Antineoplásicos , Línea Celular Tumoral , Movimiento Celular/efectos de los fármacos , Supervivencia Celular/efectos de los fármacos , Quimiocina CXCL12/fisiología , Ensayos de Selección de Medicamentos Antitumorales , Humanos , Concentración 50 Inhibidora , Isoenzimas/antagonistas & inhibidores , Isoenzimas/metabolismo , Fosfatidilinositol 3-Quinasas/metabolismo , Inhibidores de las Quinasa Fosfoinosítidos-3 , Rituximab , Transducción de Señal
6.
J Biol Chem ; 288(37): 26926-43, 2013 Sep 13.
Artículo en Inglés | MEDLINE | ID: mdl-23897821

RESUMEN

Histone deacetylases (HDACs) are critical in the control of gene expression, and dysregulation of their activity has been implicated in a broad range of diseases, including cancer, cardiovascular, and neurological diseases. HDAC inhibitors (HDACi) employing different zinc chelating functionalities such as hydroxamic acids and benzamides have shown promising results in cancer therapy. Although it has also been suggested that HDACi with increased isozyme selectivity and potency may broaden their clinical utility and minimize side effects, the translation of this idea to the clinic remains to be investigated. Moreover, a detailed understanding of how HDACi with different pharmacological properties affect biological functions in vitro and in vivo is still missing. Here, we show that a panel of benzamide-containing HDACi are slow tight-binding inhibitors with long residence times unlike the hydroxamate-containing HDACi vorinostat and trichostatin-A. Characterization of changes in H2BK5 and H4K14 acetylation following HDACi treatment in the neuroblastoma cell line SH-SY5Y revealed that the timing and magnitude of histone acetylation mirrored both the association and dissociation kinetic rates of the inhibitors. In contrast, cell viability and microarray gene expression analysis indicated that cell death induction and changes in transcriptional regulation do not correlate with the dissociation kinetic rates of the HDACi. Therefore, our study suggests that determining how the selective and kinetic inhibition properties of HDACi affect cell function will help to evaluate their therapeutic utility.


Asunto(s)
Regulación Enzimológica de la Expresión Génica , Regulación Neoplásica de la Expresión Génica , Inhibidores de Histona Desacetilasas/química , Histonas/química , Acetilación , Benzamidas/química , Unión Competitiva , Línea Celular Tumoral , Supervivencia Celular/efectos de los fármacos , Humanos , Ácidos Hidroxámicos/química , Concentración 50 Inhibidora , Cinética , Análisis de Secuencia por Matrices de Oligonucleótidos , Unión Proteica , Piridinas/química , Transcripción Genética , Vorinostat
7.
Nano Lett ; 13(11): 5070-4, 2013 Nov 13.
Artículo en Inglés | MEDLINE | ID: mdl-24124987

RESUMEN

We present a scanning antenna probe that provides 35 nm optical hotspots with a 16-fold excitation enhancement. A resonant optical antenna, tuned to operation in the visible, is carved into the aluminum-coated scanning probe. The antenna resonances, field localization, excitation, and polarization response are probed in the near-field by scanning over single fluorescent nanobeads. At the same time, the distance-dependent coupling of the emission to the antenna mode is mapped. Good agreement with theory is obtained. The presented scanning antenna approach is useful for both nanoscale plasmonic mode imaging and (bio)imaging.

8.
Nano Lett ; 12(11): 5972-8, 2012 Nov 14.
Artículo en Inglés | MEDLINE | ID: mdl-23098104

RESUMEN

We report on a novel design for the fabrication of ultrabright bowtie nanoaperture antenna (BNA) probes to breach the intrinsic trade-off between power transmission and field confinement of circular nanoapertures as in near-field scanning optical microscopy (NSOM) or planar zero mode waveguides. The approach relies on the nanofabrication of BNAs at the apex of tapered optical fibers tuned to diameters close to their cutoff region, resulting in 10(3)× total improvement in throughput over conventional NSOM probes of similar confinement area. By using individual fluorescence molecules as optical nanosensors, we show for the first time nanoimaging of single molecules using BNA probes with an optical confinement of 80 nm, measured the 3D near-field emanating from these nanostructures and determined a ~6-fold enhancement on the single molecule signal. The broadband field enhancement, nanoscale confinement, and background free illumination provided by these nanostructures offer excellent perspectives as ultrabright optical nanosources for a full range of applications, including cellular nanoimaging, spectroscopy, and biosensing.


Asunto(s)
Nanotecnología/métodos , Técnicas Biosensibles , Simulación por Computador , Electrones , Metales/química , Microscopía Electrónica de Rastreo/métodos , Nanopartículas/química , Nanoestructuras/química , Distribución Normal , Fibras Ópticas , Óptica y Fotónica , Espectrometría de Fluorescencia/métodos
9.
Commun Biol ; 6(1): 603, 2023 06 05.
Artículo en Inglés | MEDLINE | ID: mdl-37277510

RESUMEN

Targeting the PI3K isoform p110δ against B cell malignancies is at the mainstay of PI3K inhibitor (PI3Ki) development. Therefore, we generated isogenic cell lines, which express wild type or mutant p110δ, for assessing the potency, isoform-selectivity and molecular interactions of various PI3Ki chemotypes. The affinity pocket mutation I777M maintains p110δ activity in the presence of idelalisib, as indicated by intracellular AKT phosphorylation, and rescues cell functions such as p110δ-dependent cell viability. Resistance owing to this substitution consistently affects the potency of p110δ-selective in contrast to most multi-targeted PI3Ki, thus distinguishing usually propeller-shaped and typically flat molecules. Accordingly, molecular dynamics simulations indicate that the I777M substitution disturbs conformational flexibility in the specificity or affinity pockets of p110δ that is necessary for binding idelalisib or ZSTK474, but not copanlisib. In summary, cell-based and molecular exploration provide comparative characterization of currently developed PI3Ki and structural insights for future PI3Ki design.


Asunto(s)
Neoplasias , Fosfatidilinositol 3-Quinasas , Humanos , Fosfatidilinositol 3-Quinasas/genética , Fosfatidilinositol 3-Quinasas/metabolismo , Isoformas de Proteínas/genética , Inhibidores de las Quinasa Fosfoinosítidos-3 , Línea Celular
10.
Nano Lett ; 11(2): 355-60, 2011 Feb 09.
Artículo en Inglés | MEDLINE | ID: mdl-21175134

RESUMEN

Near-field scanning optical microscopy (NSOM) offers high optical resolution beyond the diffraction limit for various applications in imaging, sensing, and lithography; however, for many applications the very low brightness of NSOM aperture probes is a major constraint. Here, we report a novel NSOM aperture probe that gives a 100× higher throughput and 40× increased damage threshold than conventional near-field aperture probes. These brighter probes facilitate near-field imaging of single molecules with apertures as small as 45 nm in diameter. We achieve this improvement by nanostructuring the probe and by employing a novel variant of extraordinary optical transmission, relying solely on a single aperture and a coupled waveguide. Comprehensive electromagnetic simulations show good agreement with the measured transmission spectra. Due to their significantly increased throughput and damage threshold, these resonant configuration probes provide an important step forward for near-field applications.


Asunto(s)
Tecnología de Fibra Óptica/instrumentación , Iluminación/instrumentación , Microscopía Acústica/instrumentación , Nanotecnología/instrumentación , Diseño de Equipo , Análisis de Falla de Equipo
12.
RNA ; 14(3): 524-34, 2008 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-18230760

RESUMEN

G-protein-coupled receptors are desensitized by a two-step process. In a first step, G-protein-coupled receptor kinases (GRKs) phosphorylate agonist-activated receptors that subsequently bind to a second class of proteins, the arrestins. GRKs can be classified into three subfamilies, which have been implicated in various diseases. The physiological role(s) of GRKs have been difficult to study as selective inhibitors are not available. We have used SELEX (systematic evolution of ligands by exponential enrichment) to develop RNA aptamers that potently and selectively inhibit GRK2. This process has yielded an aptamer, C13, which bound to GRK2 with a high affinity and inhibited GRK2-catalyzed rhodopsin phosphorylation with an IC50 of 4.1 nM. Phosphorylation of rhodopsin catalyzed by GRK5 was also inhibited, albeit with 20-fold lower potency (IC50 of 79 nM). Furthermore, C13 reveals significant specificity, since almost no inhibitory activity was detectable testing it against a panel of 14 other kinases. The aptamer is two orders of magnitude more potent than the best GRK2 inhibitors described previously and shows high selectivity for the GRK family of protein kinases.


Asunto(s)
Inhibidores Enzimáticos/farmacología , Quinasa 2 del Receptor Acoplado a Proteína-G/antagonistas & inhibidores , ARN/farmacología , Aptámeros de Nucleótidos/química , Aptámeros de Nucleótidos/genética , Aptámeros de Nucleótidos/farmacología , Secuencia de Bases , Cartilla de ADN/genética , Quinasa 2 del Receptor Acoplado a Proteína-G/química , Quinasa 2 del Receptor Acoplado a Proteína-G/genética , Quinasa 2 del Receptor Acoplado a Proteína-G/metabolismo , Humanos , Técnicas In Vitro , Datos de Secuencia Molecular , Conformación de Ácido Nucleico , Estructura Terciaria de Proteína , ARN/química , ARN/genética , Proteínas Recombinantes/antagonistas & inhibidores , Proteínas Recombinantes/química , Proteínas Recombinantes/genética , Proteínas Recombinantes/metabolismo , Técnica SELEX de Producción de Aptámeros
13.
ACS Med Chem Lett ; 11(8): 1548-1554, 2020 Aug 13.
Artículo en Inglés | MEDLINE | ID: mdl-32832022

RESUMEN

Indoleamine-2,3-dioxygenase 1 (IDO1) inhibition and its combination with immune checkpoint inhibitors like pembrolizumab have drawn considerable attention from both academia and the pharmaceutical industry. Here, we describe the discovery of a novel class of highly potent IDO1 heme-displacing inhibitors featuring a unique bicyclo[1.1.1]pentane motif. Compound 1, evolving from an ALIS (automated ligand identification system) hit, exhibited excellent potency but lacked the desired pharmacokinetic profile due to extensive amide hydrolysis of the benzamide moiety. Replacing the central phenyl ring in 1 with a bicyclo[1.1.1]pentane bioisostere effectively circumvented the amide hydrolysis issue, resulting in the discovery of compound 2 with a favorable overall profile such as excellent potency, selectivity, pharmacokinetics, and a low predicted human dose.

14.
J Comput Aided Mol Des ; 23(8): 501-11, 2009 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-19533372

RESUMEN

For the detection of the precise and unambiguous binding of fragments to a specific binding site on the target protein, we have developed a novel reporter displacement binding assay technology. The application of this technology for the fragment screening as well as the fragment evolution process with a specific modelling based design strategy is demonstrated for inhibitors of the protein kinase p38alpha. In a fragment screening approach seed fragments were identified which were then used to build compounds from the deep-pocket towards the hinge binding area of the protein kinase p38alpha based on a modelling approach. BIRB796 was used as a blueprint for the alignment of the fragments. The fragment evolution of these deep-pocket binding fragments towards the fully optimized inhibitor BIRB796 included the modulation of the residence time as well as the affinity. The goal of our study was to evaluate the robustness and efficiency of our novel fragment screening technology at high fragment concentrations, compare the screening data with biochemical activity data and to demonstrate the evolution of the hit fragments with fast kinetics, into slow kinetic inhibitors in an in silico approach.


Asunto(s)
Descubrimiento de Drogas , Ligandos , Terapia Molecular Dirigida , Bibliotecas de Moléculas Pequeñas/química , Proteínas Quinasas p38 Activadas por Mitógenos , Sitios de Unión , Inhibidores Enzimáticos/química , Humanos , Cinética , Modelos Moleculares , Unión Proteica , Conformación Proteica , Bibliotecas de Moléculas Pequeñas/uso terapéutico , Relación Estructura-Actividad , Proteínas Quinasas p38 Activadas por Mitógenos/antagonistas & inhibidores , Proteínas Quinasas p38 Activadas por Mitógenos/química
15.
Clin Kidney J ; 11(5): 724-725, 2018 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-30288269

RESUMEN

Peripheral arterial disease and diabetic foot syndrome are common comorbidities in dialysis patients. These conditions are treated with intermittent vacuum therapy in order to increase angiogenesis and perfusion. Some devices encase the lower extremities up to the abdomen. Here we report the case of a patient who had performed peritoneal dialysis for 2 years without complications. Following postoperative intermittent vacuum therapy, he presented with extensive catheter leakage. Ultimately the patient had to be switched to haemodialysis and the catheter had to be removed. This case exemplifies that peritoneal dialysis patients have a substantial risk for noninfectious catheter-related complications using vacuum therapy.

16.
Biomed Res Int ; 2018: 1023490, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-29750146

RESUMEN

The antibody-dependent cell-mediated cytotoxicity (ADCC) of the anti-CD20 monoclonal antibodies (mAbs) rituximab and obinutuzumab against the cell line Raji and isolated CLL cells and its potential impairment by kinase inhibitors (KI) was determined via lactate dehydrogenase release or calcein retention, respectively, using genetically modified NK92 cells expressing CD16-176V as effector cells. Compared to peripheral blood mononuclear cells, recombinant effector cell lines showed substantial alloreactivity-related cytotoxicity without addition of mAbs but afforded determination of ADCC with reduced interassay variability. The cytotoxicity owing to alloreactivity was less susceptible to interference by KI than the ADCC of anti-CD20 mAbs, which was markedly diminished by ibrutinib, but not by idelalisib. Compared to rituximab, the ADCC of obinutuzumab against primary CLL cells showed approximately 30% higher efficacy and less interference with KI. Irreversible BTK inhibitors at a clinically relevant concentration of 1 µM only weakly impaired the ADCC of anti-CD20 mAbs, with less influence in combinations with obinutuzumab than with rituximab and by acalabrutinib than by ibrutinib or tirabrutinib. In summary, NK cell line-based assays permitted the sensitive detection of ADCC of therapeutic anti-CD20 mAbs against CLL cells and of the interference of KI with this important killing mechanism.


Asunto(s)
Anticuerpos Monoclonales/farmacología , Citotoxicidad Celular Dependiente de Anticuerpos/efectos de los fármacos , Antígenos CD20/metabolismo , Linfocitos B/efectos de los fármacos , Citotoxinas/farmacología , Células Asesinas Naturales/efectos de los fármacos , Receptores de Antígenos de Linfocitos B/metabolismo , Adenina/análogos & derivados , Anticuerpos Monoclonales Humanizados/farmacología , Benzamidas/farmacología , Línea Celular Tumoral , Humanos , Leucocitos Mononucleares/efectos de los fármacos , Leucocitos Mononucleares/metabolismo , Piperidinas , Inhibidores de Proteínas Quinasas/farmacología , Purinas/farmacología , Pirazinas/farmacología , Pirazoles/farmacología , Pirimidinas/farmacología , Quinazolinonas/farmacología , Rituximab/farmacología
17.
BMC Musculoskelet Disord ; 8: 76, 2007 Aug 04.
Artículo en Inglés | MEDLINE | ID: mdl-17683577

RESUMEN

BACKGROUND: The uncemented Nottingham Total Shoulder Replacement prosthesis system (Nottingham TSR) was developed from the previous BioModular shoulder prosthesis taking into consideration the causes of the initial implant's failure. We investigated the impact of changes in the design of Nottingham TSR prosthesis on its survivorship rate. METHODS: Survivorship analyses of three types of uncemented total shoulder arthroplasty prostheses (BioModular, initial Nottingham TSR and current Nottingham TSR systems with 11, 8 and 4 year survivorship data respectively) were compared. All these prostheses were implanted for the treatment of disabling pain in the shoulder due to primary and secondary osteoarthritis or rheumatoid arthritis. Each type of the prosthesis studied was implanted in consecutive group of patients--90 patients with BioModular system, 103 with the initial Nottingham TSR and 34 patients with the current Nottingham TSR system. The comparison of the annual cumulative survivorship values in the compatible time range between the three groups was done according to the paired t test. RESULTS: The 8-year and 11-year survivorship rates for the initially used modified BioModular uncemented prosthesis were relatively low (75.6% and 71.7% respectively) comparing to the reported survivorship of the conventional cemented implants. The 8-year survivorship for the uncemented Nottingham TSR prosthesis was significantly higher (81.8%), but still not in the desired range of above 90%, that is found in other cemented designs. Glenoid component loosening was the main factor of prosthesis failure in both prostheses and mainly occurred in the first 4 postoperative years. The 4-year survivorship of the currently re-designed Nottingham TSR prosthesis, with hydroxylapatite coating of the glenoid baseplate, was significantly higher, 93.1% as compared to 85.1% of the previous Nottingham TSR. CONCLUSION: The initial Nottingham shoulder prosthesis showed significantly higher survivorship than the BioModular uncemented prosthesis, but lower than expected. Subsequently re-designed Nottingham TSR system presented a high short term survivorship rate that encourages its ongoing use.


Asunto(s)
Artritis Reumatoide/cirugía , Artroplastia de Reemplazo/estadística & datos numéricos , Osteoartritis/cirugía , Prótesis e Implantes/estadística & datos numéricos , Articulación del Hombro/cirugía , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Diseño de Prótesis , Falla de Prótesis , Rango del Movimiento Articular , Resultado del Tratamiento
18.
J Shoulder Elbow Surg ; 16(5): 510-3, 2007.
Artículo en Inglés | MEDLINE | ID: mdl-17582790

RESUMEN

Disability caused by nonunited or malunited fracture of the midshaft clavicle is a rare condition that is expressed by local pain or neurovascular impairment. This condition is usually treated by reduction of the fracture and stable fixation with augmentation by autogenous bone graft. We evaluated the functional outcome in 13 patients who were treated by this method. The mean postsurgical follow-up was 41 months. In all patients, satisfactory osseous union was achieved. Only 46% of the patients returned to their previous professional and recreational activities. There was also evidence that the current Constant scores of the affected shoulders remained significantly lower than those of the normal contralateral side. Ten patients reported various degrees of pain, and only three patients were pain-free. We show that, although solid union after realignment of symptomatic nonunion or malunion of midshaft clavicle fractures is predictable, the patients can remain functionally impaired.


Asunto(s)
Clavícula/lesiones , Fijación Interna de Fracturas/métodos , Fracturas Óseas/cirugía , Fracturas Mal Unidas/cirugía , Fracturas no Consolidadas/cirugía , Adulto , Placas Óseas , Trasplante Óseo/métodos , Clavícula/cirugía , Estudios de Cohortes , Femenino , Estudios de Seguimiento , Curación de Fractura/fisiología , Fracturas Óseas/diagnóstico por imagen , Fracturas Mal Unidas/diagnóstico por imagen , Fracturas no Consolidadas/diagnóstico por imagen , Humanos , Puntaje de Gravedad del Traumatismo , Masculino , Persona de Mediana Edad , Radiografía , Recuperación de la Función , Medición de Riesgo , Dolor de Hombro/fisiopatología , Dolor de Hombro/cirugía , Resultado del Tratamiento
19.
J Mol Biol ; 324(5): 965-73, 2002 Dec 13.
Artículo en Inglés | MEDLINE | ID: mdl-12470952

RESUMEN

The ATP-binding cassette (ABC) transporter TAP plays an essential role in antigen processing and immune response to infected or malignant cells. TAP translocates proteasomal degradation products from the cytosol into the endoplasmic reticulum, where MHC class I molecules are loaded with these peptides. Kinetically stable peptide-MHC complexes are transported to the cell surface for inspection by cytotoxic T lymphocytes. The transport cycle of TAP is initiated by peptide binding, which is responsible for peptide selection and for stimulation of ATP-hydrolysis and subsequent translocation. Here we have analysed the driving forces for the formation of the peptide-TAP complex by kinetic and thermodynamic methods. First, the apparent peptide association and dissociation rates were determined at various temperatures. Strikingly, very high activation energies for apparent association (E(a)(ass)=106 kJmol(-1)) and dissociation (E(a)(diss)=80 kJmol(-1)) of the peptide-TAP complex were found. Next, the temperature-dependence of the peptide affinity constants was investigated by equilibrium-binding assays. Along with calculations of free enthalpy deltaG, enthalpy deltaH and entropy deltaS, a large positive change in heat capacity was resolved (deltaC degrees =23 kJmol(-1)K(-1)), indicating a fundamental structural reorganization of the TAP complex upon peptide binding. The inspection of the conformational entropy reveals that approximately one-fourth of all TAP residues is rearranged. These thermodynamic studies indicate that at physiological temperature, peptide binding is endothermic and driven by entropy.


Asunto(s)
Transportadoras de Casetes de Unión a ATP/química , Transportadoras de Casetes de Unión a ATP/metabolismo , Antígenos/metabolismo , Péptidos/metabolismo , Transportadoras de Casetes de Unión a ATP/inmunología , Presentación de Antígeno , Antígenos/química , Antígenos/inmunología , Cinética , Péptidos/química , Péptidos/inmunología , Unión Proteica , Temperatura , Termodinámica
20.
ChemMedChem ; 10(9): 1511-21, 2015 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-26259992

RESUMEN

Fragment-based lead discovery is gaining momentum in drug development. Typically, a hierarchical cascade of several screening techniques is consulted to identify fragment hits which are then analyzed by crystallography. Because crystal structures with bound fragments are essential for the subsequent hit-to-lead-to-drug optimization, the screening process should distinguish reliably between binders and non-binders. We therefore investigated whether different screening methods would reveal similar collections of putative binders. First we used a biochemical assay to identify fragments that bind to endothiapepsin, a surrogate for disease-relevant aspartic proteases. In a comprehensive screening approach, we then evaluated our 361-entry library by using a reporter-displacement assay, saturation-transfer difference NMR, native mass spectrometry, thermophoresis, and a thermal shift assay. While the combined results of these screening methods retrieve 10 of the 11 crystal structures originally predicted by the biochemical assay, the mutual overlap of individual hit lists is surprisingly low, highlighting that each technique operates on different biophysical principles and conditions.


Asunto(s)
Bioquímica/métodos , Biofisica/métodos , Ensayos Analíticos de Alto Rendimiento/métodos , Ácido Aspártico Endopeptidasas/antagonistas & inhibidores , Ácido Aspártico Endopeptidasas/metabolismo , Descubrimiento de Drogas/métodos , Espectroscopía de Resonancia Magnética , Inhibidores de Proteasas/química , Inhibidores de Proteasas/farmacología , Bibliotecas de Moléculas Pequeñas/química , Bibliotecas de Moléculas Pequeñas/farmacología , Espectrometría de Masa por Ionización de Electrospray/métodos
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