α-Lipoic Acid Derivatives as Allosteric Modulators for Targeting AMPA-Type Glutamate Receptors' Gating Modules.

The ionotropic glutamate receptor subtype α-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid (AMPA) is responsible for most excitatory transmission in the brain. AMPA receptor function is altered in numerous neurological illnesses, making AMPA receptors appealing therapeutic targets for clinical intervention. Alpha-Lipoic acid (α-LA) is a naturally occurring compound, which functions as a co-factor in metabolism and energy production. α-LA is an antioxidant with various benefits in treating diabetes, including managing symptomatic diabetic neuropathy. This study will test a novel and innovative strategy to synthesize a new isomer of lipoic acid (R-LA) derivatives (bifunctional NO-donor/antioxidant) in one chemical on homomeric and heteromeric AMPA receptor subunits. We used patch-clamp electrophysiology to examine LA derivatives expressed in human embryonic kidney 293 cells (HEK293) for inhibition and changes in desensitization or deactivation rates. LA derivatives were shown to be potent antagonists of AMPA receptors, with an 8-11-fold reduction in AMPA receptor currents seen following the delivery of the compounds. Furthermore, the LA derivatives influenced the rates of desensitization and deactivation of AMPA receptors. Based on our results, especially given that α-LA is closely connected to the nervous system, we may better understand using AMPA receptors and innovative drugs to treat neurological diseases associated with excessive activation of AMPA receptors.

Prevalence and Determinants of Multidrug-Resistant Tuberculosis in Makkah, Saudi Arabia.

BACKGROUND AND OBJECTIVES: Tuberculosis (TB) is a global public health issue. The emergence of multidrug-resistant (MDR) TB has further complicated the situation in the form of poor treatment outcomes and costs to individuals and health-care systems. We therefore aimed to measure the prevalence and associated risk factors of MDR TB among TB patients in Makkah city. PATIENTS AND METHODS: This was a cross-sectional study conducted at Al-Noor Specialist Hospital, a public-sector hospital in Makkah. We included records of 158 confirmed TB patients from the list of all patients admitted in the hospital from January 2009 to January 2019 by systematic random sampling. Data were collected on socio-demographics, clinical profile and drug resistance patterns. Analysis was done in SPSS version 21.0. RESULTS: The mean age of the participants was 43.4 ± 18.7 years, and two-thirds (66.5%) were male. About 40% of the patients had chronic disease while lung disease other than TB was present in 5% patients. About 13% of cases were extrapulmonary infections. Prevalence of drug resistance was found to be 17.1% among TB patients. Among the resistant cases, streptomycin (25.9%) and isoniazid (11.1%) were the drugs most commonly affected by resistance. Prevalence of MDR TB was 5% among TB patients. Age, smoking, lung disease and previous TB were significant factors associated with MDR TB. CONCLUSION: Prevalence of MDR TB, although comparable to current national estimates, is higher compared to previous reports. There is a need to reduce this burden through strengthening TB control programs to prevent further emergence of a public health threat of MDR TB. History of previous TB was the strongest risk factor in this study. This calls physicians, program managers and policy makers to focus on counselling and support of TB patients for compliance with the regimen to complete treatment without interruption.