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1.
Diabetes Res Clin Pract ; 126: 54-59, 2017 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-28209549

RESUMO

AIMS: Sufficient consultation time is important for establishing good doctor-patient relationship. We examined the factors that affect consultation length in Japanese diabetes practice. METHODS: This was a cross-sectional study performed at a diabetes clinic in central Tokyo, Japan. Regular diabetes consultations of 1197 patients with 22 physicians were analyzed. Consultation time and clinical characteristics were obtained from the electronic records. A negative binomial model, which included patient and physician characteristics, was constructed to examine the association of the variables with consultation length. RESULTS: Of the 1197 patients (mean age, 66; women, 25%; type 1 diabetes, 10%), the mean consultation time was 10.1min. In the multivariate model, longer consultation time was recorded in patients with type 1 diabetes, higher glycated hemoglobin (HbA1c), use of insulin injections, and use of hypnotics/anxiolytics. The consultation time was longer in patients with HbA1c of ⩾7.0 to <8.0% (⩾53 to <64mmol/mol), ⩾8.0 to <9.0% (⩾64 to <75mmol/mol) and ⩾9.0% (⩾75mmol/mol), compared to those with HbA1c of <7.0% (<53mmol/mol) with the ratios of 1.03 (95% confidence interval (CI)=0.96-1.10), 1.16 (95% CI=1.07-1.26) and 1.17 (95% CI=1.06-1.29), respectively. Body mass index was also associated with long consultation. Older and female physicians provided longer consultation. CONCLUSIONS: Clinical consultation length in diabetes practice was associated with certain patient and physician characteristics. The findings can be used for making diabetes consultation more efficacious, which could eventually lead to the provision of the most appropriate consultation time for individual patients.


Assuntos
Diabetes Mellitus Tipo 1/terapia , Relações Médico-Paciente , Encaminhamento e Consulta , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Diabetes Mellitus Tipo 1/sangue , Diabetes Mellitus Tipo 1/epidemiologia , Feminino , Hemoglobinas Glicadas/metabolismo , Humanos , Insulina/sangue , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Encaminhamento e Consulta/estatística & dados numéricos , Fatores de Tempo , Tóquio/epidemiologia
2.
Cardiovasc Intervent Radiol ; 40(1): 125-129, 2017 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-27558115

RESUMO

PURPOSE: To retrospectively describe the feasibility and efficacy of CT fluoroscopy-guided transsacral intervertebral drainage for pyogenic spondylodiscitis at the lumbosacral junction with a combination of two interventional radiological techniques-CT-guided bone biopsy and abscess drainage. MATERIALS AND METHODS: Three patients with pyogenic spondylodiscitis at the lumbosacral junction were enrolled in this study between July 2013 and December 2015. The procedure of CT fluoroscopy-guided transsacral intervertebral drainage for pyogenic spondylodiscitis at the lumbosacral junction was as follows: the sacrum at S1 pedicle was penetrated with an 11-gauge (G) bone biopsy needle to create a path for an 8-French (F) pigtail drainage catheter. The bone biopsy needle was withdrawn, and an 18-G needle was inserted into the intervertebral space of the lumbosacral junction. Then, a 0.038-inch guidewire was inserted into the intervertebral space. Finally, the 8-F pigtail drainage catheter was inserted over the guidewire until its tip reached the intervertebral space. All patients received six-week antibiotics treatment. RESULTS: Successful placement of the drainage catheter was achieved for each patient without procedural complications. The duration of drainage was 17-33 days. For two patients, specific organisms were isolated; thus, definitive medical therapy was possible. All patients responded well to the treatment. CONCLUSIONS: CT fluoroscopy-guided transsacral intervertebral drainage for pyogenic spondylodiscitis at the lumbosacral junction is feasible and can be effective with a combination of two interventional techniques-CT fluoroscopy-guided bone biopsy and abscess drainage.


Assuntos
Discite/terapia , Drenagem/métodos , Radiografia Intervencionista/métodos , Tomografia Computadorizada por Raios X/métodos , Idoso , Idoso de 80 Anos ou mais , Estudos de Viabilidade , Feminino , Humanos , Região Lombossacral , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
3.
Tokai J Exp Clin Med ; 41(4): 203-209, 2016 Dec 20.
Artigo em Inglês | MEDLINE | ID: mdl-27988919

RESUMO

OBJECTIVE: The present study investigated the association of having diabetes with length of stay and hospital costs for elderly patients with pneumonia who were admitted to an acute-care hospital in Japan. METHODS: Based on the inpatient administrative claims database of an acute-care hospital in central Tokyo between 2010 and 2013, 753 patients aged ≥ 65 years who were admitted to the hospital presenting with pneumonia and discharged alive were analyzed. The association was analyzed using a negative binomial model, having adjusted for age, sex, body mass index, dyspnea grade, functional evaluation of feeding, use of mechanical ventilation, and use of renal replacement therapy. A log-linear regression model adjusted for the same variables was used in the analysis of hospital costs. RESULTS: Of the 753 patients (mean age, 82.5 years; men, 58.2%), 225 patients had diabetes. The negative binomial regression revealed that those with diabetes had a 1.19 times longer length of stay (95% CI = 1.06-1.33) compared to those without. The log-linear regression revealed that hospital costs were 1.14 times higher (95% CI = 1.04-1.25) in patients with diabetes. CONCLUSION: The presence of diabetes significantly correlated with longer length of stay and higher hospital costs for elderly patients with pneumonia.


Assuntos
Bases de Dados Factuais , Complicações do Diabetes/economia , Administração Hospitalar , Custos Hospitalares/estatística & dados numéricos , Tempo de Internação/estatística & dados numéricos , Pneumonia/economia , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Modelos Lineares , Masculino
4.
Nutrition ; 28(11-12): 1109-14, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-23044162

RESUMO

OBJECTIVE: We assessed whether disease activity was associated with dietary habits, nutritional status, adipokines, and oxidative stress in patients with rheumatoid arthritis. METHODS: The subjects were 37 patients with RA. The assessment of the nutritional status included anthropometric and biochemical parameters. A food-frequency questionnaire and a 3-d diet record to assess dietary intake were used. The serum levels of adipokines and oxidative stress markers in sera and saliva were measured. The disease activity was determined using the 28 Disease Activity Score (DAS28). We divided the subjects into high (DAS28 ≥3.2) and low (DAS28 <3.2) disease activity groups. RESULTS: The serum leptin and albumin levels were significantly lower, whereas the inflammatory markers were increased, in the high disease activity group. The dietary intake assessment showed a lower intake of fish oil and a lower ratio of monounsaturated fatty acid intake in the high disease activity group. There was a negative correlation between the DAS28 and the dietary intake of the ratio of monounsaturated fatty acid to total fatty acid intake. The serum oxidative stress marker (reactive oxygen metabolites) showed a positive correlation to the DAS28. The salivary reactive oxygen metabolites also correlated with C-reactive protein and serum reactive oxygen metabolites. CONCLUSION: Altered serum adipokine levels with decreased albumin may reflect the deterioration that is associated with rheumatoid arthritis. An increased oxidative stress was observed in sera and saliva. Intakes of ω-3 polyunsaturated fatty acids, fish oil, and monounsaturated fatty acid seem to affect disease activity and may have beneficial effects by decreasing inflammation.


Assuntos
Adipocinas/metabolismo , Artrite Reumatoide/metabolismo , Artrite Reumatoide/fisiopatologia , Dieta/efeitos adversos , Mediadores da Inflamação/metabolismo , Estado Nutricional , Estresse Oxidativo , Adipocinas/sangue , Idoso , Artrite Reumatoide/dietoterapia , Artrite Reumatoide/etnologia , Biomarcadores/sangue , Biomarcadores/metabolismo , Dieta/etnologia , Ácidos Graxos Monoinsaturados/administração & dosagem , Ácidos Graxos Monoinsaturados/uso terapêutico , Ácidos Graxos Ômega-3/administração & dosagem , Ácidos Graxos Ômega-3/uso terapêutico , Comportamento Alimentar/etnologia , Feminino , Óleos de Peixe/administração & dosagem , Óleos de Peixe/uso terapêutico , Humanos , Hipoalbuminemia/etiologia , Hipoalbuminemia/prevenção & controle , Mediadores da Inflamação/sangue , Japão , Masculino , Pessoa de Meia-Idade , Estado Nutricional/etnologia , Espécies Reativas de Oxigênio/sangue , Espécies Reativas de Oxigênio/metabolismo , Saliva/metabolismo , Índice de Gravidade de Doença
5.
Invest Ophthalmol Vis Sci ; 52(3): 1516-21, 2011 Mar 18.
Artigo em Inglês | MEDLINE | ID: mdl-21178146

RESUMO

PURPOSE: The therapeutic effects of betamethasone phosphate (BP) encapsulated in biocompatible and biodegradable blended nanoparticles of poly(lactic acid) (PLA) homopolymers and PEG-block-PLA copolymers (stealth nanosteroids) were examined in an experimental autoimmune uveoretinitis (EAU) model in Lewis rats. METHODS: EAU was induced by S-antigen peptide in Lewis rats. Accumulation of systemically administered Cy7-labeled stealth nanoparticles in inflamed eyes of rats with EAU was assessed using in vivo fluorescence imaging, and the therapeutic effect of stealth nanosteroids, nonstealth nanosteroids, or saline on EAU was examined. The eyes were obtained 7 days after the treatment, and the histologic score was determined using pathologic findings. The expression of inflammatory cytokines including IL-6, IL-17, and VEGF was determined immunohistochemically. RESULTS: Cy7-stealth nanoparticles accumulated in inflamed eyes of rats with EAU and remained in situ for a 3-day period. Systemically administered stealth nanosteroids (100 µg of BP) reduced the clinical scores of rats with EAU within 1 day and maintained the effect for 2 weeks. This treatment also decreased the histologic scores and the expression of inflammatory cytokines in the retina of EAU. CONCLUSIONS: The strong therapeutic benefit on EAU obtained with the stealth nanosteroids may have been due to prolonged blood circulation and targeting to the inflamed uvea and retina, in addition to sustained release in situ.


Assuntos
Doenças Autoimunes/tratamento farmacológico , Betametasona/análogos & derivados , Ácido Láctico/administração & dosagem , Polietilenoglicóis/administração & dosagem , Polímeros/administração & dosagem , Retinite/tratamento farmacológico , Uveíte/tratamento farmacológico , Animais , Doenças Autoimunes/metabolismo , Doenças Autoimunes/patologia , Betametasona/administração & dosagem , Betametasona/farmacocinética , Materiais Biocompatíveis , Disponibilidade Biológica , Preparações de Ação Retardada , Portadores de Fármacos , Composição de Medicamentos , Injeções Intravenosas , Ácido Láctico/farmacocinética , Masculino , Microscopia Confocal , Nanopartículas , Poliésteres , Polietilenoglicóis/farmacocinética , Polímeros/farmacocinética , Ratos , Ratos Endogâmicos Lew , Retinite/metabolismo , Retinite/patologia , Distribuição Tecidual , Uveíte/metabolismo , Uveíte/patologia
6.
Nanomedicine (Lond) ; 5(9): 1331-40, 2010 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-21128717

RESUMO

AIMS: This study aimed to investigate the efficacy of encapsulating steroids, which is a primary choice for the treatment of sensorineural hearing loss, in polyethylene glycol-coated polylactic acid nanoparticles for drug delivery to the cochlea. MATERIALS & METHODS: We prepared polyethylene glycol-coated polylactic acid nanoparticles encapsulating rhodamine or betamethasone phosphate (BP), and administered them systemically to CBA/N mice previously exposed to intense noise. We assessed nanoparticle distribution using rhodamine fluorescence, BP concentrations in tissues, nuclear translocation of glucocorticoid receptors and the function and histology of the mouse cochleae. RESULTS & CONCLUSION: Polyethylene glycol-coated polylactic acid nanoparticles delivered BP to cochleae over a sustained period, resulting in significant reductions in histological and functional damage to cochleae and indicating the potential therapeutic benefits of these nanoparticles for enhancing the delivery of BP in acute sensorineural hearing loss.


Assuntos
Perda Auditiva Provocada por Ruído/tratamento farmacológico , Nanopartículas/efeitos adversos , Nanopartículas/química , Esteroides/farmacocinética , Esteroides/uso terapêutico , Animais , Betametasona/administração & dosagem , Betametasona/análogos & derivados , Betametasona/farmacocinética , Betametasona/uso terapêutico , Cóclea/metabolismo , Células Ciliadas Auditivas/metabolismo , Perda Auditiva Provocada por Ruído/metabolismo , Perda Auditiva Provocada por Ruído/fisiopatologia , Imuno-Histoquímica , Ácido Láctico/química , Fígado/metabolismo , Masculino , Camundongos , Poliésteres , Polietilenoglicóis/química , Polímeros/química , Receptores de Glucocorticoides/metabolismo , Rodaminas/administração & dosagem , Rodaminas/metabolismo , Esteroides/administração & dosagem
7.
Hepatol Res ; 40(4): 251-60, 2010 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-20070391

RESUMO

AIM: Early disappearance of serum hepatitis C virus (HCV) RNA is the prerequisite for achieving sustained virological response (SVR) in peg-interferon (PEG-IFN) plus ribavirin (RBV) therapy for chronic hepatitis C. This study aimed to develop a decision tree model for the pre-treatment prediction of response. METHODS: Genotype 1b chronic hepatitis C treated with PEG-IFN alpha-2b and RBV were studied. Predictive factors of rapid or complete early virological response (RVR/cEVR) were explored in 400 consecutive patients using a recursive partitioning analysis, referred to as classification and regression tree (CART) and validated. RESULTS: CART analysis identified hepatic steatosis (<30%) as the first predictor of response followed by low-density-lipoprotein cholesterol (LDL-C) (>/=100 mg/dL), age (<50 and <60 years), blood sugar (<120 mg/dL), and gamma-glutamyltransferase (GGT) (<40 IU/L) and built decision tree model. The model consisted of seven groups with variable response rates from low (15%) to high (77%). The reproducibility of the model was confirmed by the independent validation group (r(2) = 0.987). When reconstructed into three groups, the rate of RVR/cEVR was 16% for low probability group, 46% for intermediate probability group and 75% for high probability group. CONCLUSIONS: A decision tree model that includes hepatic steatosis, LDL-C, age, blood sugar, and GGT may be useful for the prediction of response before PEG-IFN plus RBV therapy, and has the potential to support clinical decisions in selecting patients for therapy and may provide a rationale for treating metabolic factors to improve the efficacy of antiviral therapy.

8.
Int J Pharm ; 385(1-2): 170-5, 2010 Jan 29.
Artigo em Inglês | MEDLINE | ID: mdl-19837147

RESUMO

We have prepared polymeric nanoparticles using a blend of poly(lactic acid) and monomethoxy-polyethyleneglycol(PEG)-polylactide block copolymer along with betamethasone disodium phosphate (BP). Nanoparticles have been screened for anti-inflammatory activity using experimental rat models of inflammation. In the present study, we examined the degradation of nanoparticles in vitro during incubation. We found that the nanoparticles lost the PEG chains present on their surfaces within a few days, and subsequently gradually released BP. Furthermore, we found that these nanoparticles preferentially accumulated in the inflammatory lesion in adjuvant arthritis rat models, and that the amount of BP gradually depleted from the lesion over 14 days. These results suggested the mechanism underlying the anti-inflammatory effect of the nanoparticles in vivo: the initial accumulation of BP in the lesion due to the enhanced permeability and retention effect, the subsequent internalization in inflammatory macrophages due to the loss of PEG, and the release of BP in cells during the hydrolysis of polymers. The nanoparticles were successfully prepared on a large-scale and stably stored in the form of a freeze-dried formulation for at least 69 weeks below 25 degrees C. These results suggest that the nanoparticles can be used as an anti-inflammatory pharmaceutical formulation in a clinical setting.


Assuntos
Anti-Inflamatórios/farmacologia , Artrite Experimental/tratamento farmacológico , Betametasona/análogos & derivados , Portadores de Fármacos , Lactatos/química , Nanopartículas , Polietilenoglicóis/química , Animais , Anti-Inflamatórios/química , Anti-Inflamatórios/metabolismo , Artrite Experimental/induzido quimicamente , Artrite Experimental/metabolismo , Artrite Experimental/microbiologia , Betametasona/química , Betametasona/metabolismo , Betametasona/farmacologia , Química Farmacêutica , Preparações de Ação Retardada , Estabilidade de Medicamentos , Armazenamento de Medicamentos , Liofilização , Adjuvante de Freund , Hidrólise , Masculino , Mycobacterium , Nanotecnologia , Permeabilidade , Ratos , Ratos Endogâmicos Lew , Solubilidade , Tecnologia Farmacêutica/métodos , Temperatura , Fatores de Tempo
9.
Cell Immunol ; 260(1): 33-8, 2009.
Artigo em Inglês | MEDLINE | ID: mdl-19716124

RESUMO

Although inhaled steroids are the treatment of first choice to control asthma, administration of systemic steroids is required for treatment of asthmatic exacerbation and intractable asthma. To improve efficacy and reduce side effects, we examine the effects of betamethasone disodium phosphate (BP) encapsulated in biocompatible, biodegradable blended nanoparticles (stealth nanosteroids) on a murine model of asthma. These stealth nanosteroids were found to accumulate at the site of airway inflammation and exhibit anti-inflammatory activity. Significant decreases in BALF eosinophil number were maintained for 7 days with a single injection of nanosteroids containing 40 microg BP. Airway responsiveness was also attenuated by the injection of stealth nanosteroids. A single injection of 40 microg of free BP and 8 microg of free BP once daily for 5 days did not show any significant effects. We conclude that stealth nanosteroids achieve prolonged and higher benefits at the site of airway inflammation compared to free steroids.


Assuntos
Asma/tratamento farmacológico , Betametasona/análogos & derivados , Sistemas de Liberação de Medicamentos/métodos , Glucocorticoides/administração & dosagem , Nanopartículas/administração & dosagem , Animais , Betametasona/administração & dosagem , Líquido da Lavagem Broncoalveolar/imunologia , Modelos Animais de Doenças , Feminino , Interleucina-13/biossíntese , Interleucina-4/biossíntese , Ácido Láctico , Camundongos , Camundongos Endogâmicos BALB C , Ovalbumina/imunologia , Poliésteres , Polietilenoglicóis , Polímeros
10.
Int J Pharm ; 375(1-2): 148-54, 2009 Jun 22.
Artigo em Inglês | MEDLINE | ID: mdl-19481700

RESUMO

The purpose of this study was to engineer nanoparticles with various sustained profiles of drug release and prolonged circulation by blending poly(D,L-lactic acid)/poly(D,L-lactic/glycolic acid) (PLA/PLGA) homopolymers and poly(ethylene glycol) (PEG)-block-PLA/PLGA copolymers encapsulating betamethasone disodium 21-phosphate (BP). Nanoparticles of different sizes, drug encapsulation/release profiles, and cellular uptake levels were obtained by mixing homopolymers and block copolymers with different compositions/molecular weights at various blend ratios by an oil-in-water solvent diffusion method. The in vitro release of BP increased with nanoparticles of smaller size or of PLGA homopolymers instead of PLA homopolymers. Furthermore, the uptake of nanoparticles by macrophage-like cells decreased with nanoparticles of higher PEG content, and nanoparticles of PEG-PLGA block copolymers were taken up earlier than those of PEG-PLA block copolymers after incubation with serum. In addition, prolonged blood circulation was observed with nanoparticles of smaller size with higher PEG content, and nanoparticles of PEG-PLA block copolymers remained longer in circulation than those of PEG-PLGA block copolymers. Analysis of BP concentration in organs revealed reduced liver distribution of blended nanoparticles compared with PLA nanoparticles. This is the first study to systematically design and characterize biodegradable PLA/PLGA and PEG-PLA/PLGA-blended nanoparticles encapsulating BP with different release profiles and stealthiness.


Assuntos
Betametasona/análogos & derivados , Glucocorticoides/administração & dosagem , Nanopartículas , Polímeros/química , Animais , Betametasona/administração & dosagem , Betametasona/farmacocinética , Preparações de Ação Retardada , Feminino , Glucocorticoides/farmacocinética , Ácido Láctico/química , Macrófagos/metabolismo , Camundongos , Óleos/química , Tamanho da Partícula , Polietilenoglicóis/química , Ácido Poliglicólico/química , Copolímero de Ácido Poliláctico e Ácido Poliglicólico , Solventes/química , Distribuição Tecidual , Água/química
11.
Drug Deliv ; 16(3): 153-9, 2009 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-19514975

RESUMO

To achieve the effective intracellular delivery of siRNA and silence specific genes, various types of conjugates between cell-penetrating peptides (CPPs; Transportan, Penetratin, Tat) and cationic peptides were developed. Uptake, intracellular localization, cytotoxicity, and biological activity of siRNA were significantly dependent on the kind of CPP used and the length of the cationic peptides in the conjugate. Transportan-based conjugates yielded both high internalization of siRNA and strong gene silencing activity, while Penetratin- and Tat-based conjugates did not. These different properties of CPPs emphasize the importance of careful peptide selection and design when attempting the application of CPP technology.


Assuntos
Proteínas de Transporte/química , Oligopeptídeos/química , Peptídeos/química , RNA Interferente Pequeno/administração & dosagem , Permeabilidade da Membrana Celular/efeitos dos fármacos , Sobrevivência Celular/efeitos dos fármacos , Peptídeos Penetradores de Células , Sistemas de Liberação de Medicamentos , Galanina/química , Inativação Gênica , Células HeLa , Humanos , Luciferases/antagonistas & inibidores , Luciferases/genética , Microscopia de Fluorescência , Oligopeptídeos/síntese química , Transporte Proteico/efeitos dos fármacos , Proteínas Recombinantes de Fusão/química , Células Tumorais Cultivadas , Venenos de Vespas/química
12.
Pharm Res ; 26(7): 1792-800, 2009 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-19415470

RESUMO

PURPOSE: Prostaglandin E(1) (PGE(1)) is an effective treatment for peripheral vascular diseases. The encapsulation of PGE(1) in nanoparticles for its sustained-release would improve its therapeutic effect and quality of life (QOL) of patients. METHODS: In order to encapsulate PGE(1) in nanoparticles prepared with a poly(lactide) homopolymer (PLA) and monomethoxy poly(ethyleneglycol)-PLA block copolymer (PEG-PLA), we synthesized a series of PGE(1) phosphate derivatives and tested their efficacy. RESULTS: Among them, PGE(1) 2-(phosphonooxy)ethyl ester sodium salt (C2) showed the most efficient hydrolysis to yield PGE(1) in human serum. An in vitro platelet aggregation assay showed that C2 inhibited aggregation only after pre-incubation in serum, suggesting that C2 is a prodrug of PGE(1). In vivo, intravenous administration of C2 caused increase in cutaneous blood flow. In the presence of zinc ions, all of the synthesized PGE(1) phosphate derivatives could be encapsulated in PLA-nanoparticles. Use of L-PLA instead of D,L-PLA, and high molecular weight PLA resulted in a slower release of C2 from the nanoparticles. CONCLUSIONS: We consider that C2-encapsulated nanoparticles prepared with L-PLA and PEG-D,L-PLA have good sustained-release profile of PGE(1), which is useful clinically.


Assuntos
Alprostadil/administração & dosagem , Alprostadil/síntese química , Portadores de Fármacos/química , Nanopartículas/química , Fosfatos/química , Alprostadil/metabolismo , Alprostadil/farmacologia , Animais , Humanos , Hidrólise , Ácido Láctico/química , Tamanho da Partícula , Fosfatos/síntese química , Agregação Plaquetária/efeitos dos fármacos , Poliésteres , Polietilenoglicóis/química , Polímeros/química , Pró-Fármacos/metabolismo , Ratos , Ratos Wistar , Fluxo Sanguíneo Regional/efeitos dos fármacos , Soro/metabolismo , Pele/irrigação sanguínea , Zinco/química
13.
J Dermatol ; 36(3): 144-9, 2009 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-19335688

RESUMO

Psoriasis is a chronic inflammatory skin disease characterized by epidermal hyperproliferation and infiltration of inflammatory leukocytes. The aim of this study was to clarify the role of innate immunity involving dendritic cells (DC) and keratinocytes in psoriasis. We immunohistochemically examined the expression of DC markers such as CD1a, CD83, CD207 (Langerin), CD208 (DC-LAMP) and CD209 (DC-SIGN) in psoriatic skin and gamma-interferon (IFN-gamma)/12-O-tetradecanoylphorbol-13-acetate (TPA)-stimulated keratinocytes in vitro. CD208 was strongly expressed in basal and suprabasal layer keratinocytes in addition to DC in the perivascular lesions of the psoriatic dermis. Furthermore, the enhanced expression of CD208 in the perinuclear lesions of IFN-gamma-/TPA-stimulated keratinocytes was observed in vitro. Because a defect of the granular layer in psoriatic lesions has been recognized, increased expression of lysosome-related CD208 in the basal and suprabasal keratinocytes of psoriatic lesions might represent aberrant epidermal differentiation. Additionally, these CD208-positive keratinocytes possessing putative antigen-processing activity might play a key role as antigen-presenting cells in psoriatic skin.


Assuntos
Queratinócitos/metabolismo , Proteínas de Membrana Lisossomal/metabolismo , Proteínas de Neoplasias/metabolismo , Psoríase/metabolismo , Adulto , Células Apresentadoras de Antígenos/efeitos dos fármacos , Células Apresentadoras de Antígenos/imunologia , Células Apresentadoras de Antígenos/metabolismo , Células Apresentadoras de Antígenos/patologia , Antígenos CD/metabolismo , Antígenos CD1/metabolismo , Estudos de Casos e Controles , Moléculas de Adesão Celular/metabolismo , Diferenciação Celular , Células Cultivadas , Feminino , Antígenos HLA-DR/metabolismo , Humanos , Imunoglobulinas/metabolismo , Imuno-Histoquímica , Interferon gama/farmacologia , Queratinócitos/efeitos dos fármacos , Queratinócitos/imunologia , Queratinócitos/patologia , Lectinas Tipo C/metabolismo , Masculino , Lectinas de Ligação a Manose/metabolismo , Glicoproteínas de Membrana/metabolismo , Pessoa de Meia-Idade , Psoríase/imunologia , Psoríase/patologia , Receptores de Superfície Celular/metabolismo , Proteínas Recombinantes , Acetato de Tetradecanoilforbol/farmacologia , Antígeno CD83
14.
J Pharmacol Exp Ther ; 329(2): 412-7, 2009 May.
Artigo em Inglês | MEDLINE | ID: mdl-19244548

RESUMO

We examined the therapeutic activity of betamethasone disodium 21-phosphate (BP) encapsulated in biocompatible and biodegradable blended nanoparticles of poly (D,L-lactic/glycolic acid) (PLGA)/poly(D,L-lactic acid) (PLA) homopolymers and polyethylene glycol (PEG)-block-PLGA/PLA copolymers (stealth nanosteroid) in experimental arthritis models. Various stealth nanosteroids with a size of 45 to 115 nm were prepared and then intravenously administered to rats with adjuvant arthritis (AA) rats and mice with anti-type II collagen antibody-induced arthritis (AbIA). The accumulation of stealth nanoparticles with Cy7 in inflamed joints was determined using an in vivo imaging system. The type A stealth nanosteroid, composed of PLA (2.6 kDa) and PEG (5 kDa)-PLA (3 kDa), with a PEG content of 10% and a diameter of 115 nm, exhibited the highest anti-inflammatory activity. In AA rats, a 35% decrease in paw inflammation was obtained in 1 day and maintained for 9 days with a single injection of the type A stealth nanosteroid (40 microg of BP), whereas the same does of nonstealth nanosteroid and 3 times higher free BP showed a significantly weaker response. In AbIA mice, a single injection of the type A stealth nanosteroid (3 microg of BP) resulted in complete remission of the inflammatory response after 1 week. Furthermore, in AbAI mice, the accumulation of type A stealth nanoparticles in inflamed joints was shown to parallel the severity of inflammation. The observed strong therapeutic benefit obtained with the type A stealth nanosteroid in experimental arthritis may have been due to prolonged blood circulation and targeting to the inflamed joint in addition to its sustained release in situ.


Assuntos
Artrite Experimental/tratamento farmacológico , Betametasona/análogos & derivados , Portadores de Fármacos/química , Glucocorticoides/uso terapêutico , Ácido Láctico/química , Nanopartículas/química , Polietilenoglicóis/química , Ácido Poliglicólico/química , Animais , Betametasona/administração & dosagem , Betametasona/farmacocinética , Betametasona/uso terapêutico , Composição de Medicamentos , Feminino , Glucocorticoides/administração & dosagem , Glucocorticoides/farmacocinética , Injeções Intravenosas , Masculino , Camundongos , Camundongos Endogâmicos BALB C , Copolímero de Ácido Poliláctico e Ácido Poliglicólico , Ratos , Ratos Endogâmicos Lew , Distribuição Tecidual , Resultado do Tratamento
15.
J Pharm Sci ; 98(7): 2357-63, 2009 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-18979534

RESUMO

Polymeric micelles consisting of amphiphilic block copolymers have emerged as a promising carrier of various drugs, but unfortunately show a limited potential for encapsulating (solubilizing) such drugs. In this study, hybrid nanoparticles consisting of monomethoxypolyethyleneglycol-polylactide block copolymer (PEG-PLA) and oleic acid calcium salt were prepared to enhance the solubilization of poorly water-soluble drugs. Micelles made of a mixture of sodium oleate and PEG-PLA at various ratios were used as the template for preparation of the nanoparticles. These mixed micelles could efficiently solubilize poorly water-soluble drugs in aqueous media, when compared with polymeric micelles made of PEG-PLA alone. Addition of calcium to the mixed micelles induced the formation of oleic acid calcium salt, resulting in hybrid nanoparticles. These hybrid nanoparticles had a high colloidal stability, neutral zeta potential, and high drug entrapment efficiency. Drugs entrapped in nanoparticles made at a high PEG-PLA ratio were protected from enzymatic degradation in serum, while drugs entrapped in the mixed micelles were not, indicating that the hybrid nanoparticles show good drug retention. These results suggested that such hybrid nanoparticles may be used to expand the availability of poorly water-soluble drugs for various therapeutic applications.


Assuntos
Nanopartículas/química , Ácido Oleico/química , Preparações Farmacêuticas/química , Polietilenoglicóis/química , Animais , Cálcio/química , Bovinos , Micelas , Preparações Farmacêuticas/metabolismo , Soro/enzimologia , Solubilidade , Água/química
16.
Int J Pharm ; 365(1-2): 200-5, 2009 Jan 05.
Artigo em Inglês | MEDLINE | ID: mdl-18804157

RESUMO

Solid nanoparticles consisting of biodegradable polymers have emerged as a promising carrier for various drugs, but unfortunately the encapsulation of drugs remains challenging. In this study, a technique for encapsulation of water-soluble drugs in solid nanoparticles was developed. Nanoparticles were prepared from a blend of biodegradable polymers, including poly(lactic acid) (PLA) and poly(lactic/glycolic acid) (PLGA), and monomethoxypolyethyleneglycol-polylactide block copolymer by an oil-in-water solvent diffusion method. Betamethasone sodium phosphate (BP) was not encapsulated by the nanoparticles due to its hydrophilicity, but it was effectively encapsulated in the presence of appropriate amounts of zinc and diethanolamine. It was found that BP formed an ionic complex with zinc at a certain pH range obtained by addition of diethanolamine. Furthermore, a carboxyl group located at the end of PLA/PLGA was shown to be essential for encapsulation of BP in nanoparticles, and the molar ratio among BP, zinc, and carboxyl groups in various nanoparticles was almost constant. These results strongly suggested that the encapsulation was promoted by zinc creating an ionic bridge between a carboxyl group on PLA/PLGA and a phosphate group on BP. This technique for entrapment of water-soluble drugs in solid biodegradable nanoparticles may expand the use of nanoparticles for various therapeutic applications.


Assuntos
Betametasona/análogos & derivados , Portadores de Fármacos/química , Glucocorticoides/química , Polímeros/química , Betametasona/química , Química Farmacêutica , Cloretos/química , Etanolaminas/química , Concentração de Íons de Hidrogênio , Ácido Láctico/química , Nanopartículas , Poliésteres/química , Polietilenoglicóis/química , Ácido Poliglicólico/química , Copolímero de Ácido Poliláctico e Ácido Poliglicólico , Solubilidade , Compostos de Zinco/química
17.
Pharm Res ; 25(7): 1686-95, 2008 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-18293063

RESUMO

PURPOSE: Prostaglandins have potent and diverse biologic activities, but their clinical application is severely restricted, mainly due to rapid inactivation in vivo. In order to modulate the pharmacokinetics of prostaglandin E(1) (PGE(1)), we prepared biodegradable nanoparticles as a drug carrier. METHODS: Nanoparticles encapsulating PGE(1) were prepared from a blend of poly(lactic acid) homopolymer and poly(ethylene glycol)-poly(lactide) block copolymer by the solvent diffusion method in the presence of iron. RESULTS: PGE(1) was efficiently and stably embedded in the nanoparticles through interaction with iron, despite being relatively hydrophilic and having unstable chemical properties. Depending on the isomers and molecular weight of poly(lactic acid) selected, PGE(1) was gradually released from the nanoparticles at various rates into diluted serum in vitro. Both stable retention of PGE(1) in the nanoparticles and coating of the nanoparticles with poly(ethylene glycol) led to an extremely extended blood residence time of PGE(1), as well as preferential accumulation in vascular lesions. CONCLUSIONS: These results suggest that the present strategy is useful to advance the clinical application of PGE(1) as a therapeutic agent for vascular disorders.


Assuntos
Alprostadil/administração & dosagem , Alprostadil/farmacocinética , Vasodilatadores/administração & dosagem , Vasodilatadores/farmacocinética , Implantes Absorvíveis , Animais , Área Sob a Curva , Vasos Sanguíneos/metabolismo , Vasos Sanguíneos/patologia , Linhagem Celular , Fenômenos Químicos , Físico-Química , Preparações de Ação Retardada , Composição de Medicamentos , Meia-Vida , Ferro/química , Macrófagos/metabolismo , Masculino , Camundongos , Nanopartículas , Tamanho da Partícula , Poliésteres , Polietilenoglicóis , Ratos , Ratos Wistar , Solubilidade
18.
Diabetes Technol Ther ; 8(3): 369-74, 2006 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-16800758

RESUMO

BACKGROUND: This study evaluates the pharmacokinetic and pharmacodynamic effects of a transdermally delivered insulin using novel CaCO(3)-nanoparticles in normal mice and those with diabetes. METHODS: CaCO3-nanoparticles encapsulating insulin (nanoinsulin) were transdermally applied to the back skin of normal ddY mice and dB/dB and kkAy mice with diabetes after fasting for 1 h. Serum insulin levels of ddY mice were analyzed by enzyme immunoassay, and blood glucose of normal mice and those with diabetes was monitored. RESULTS: Maximum serum insulin was 67.1 +/- 25.9 microIU/mL at 4 h with 200 microg of transdermal nanoinsulin in ddY mice, whereas that after subcutaneous injection of 3 microg of monomer insulin was 462 +/- 20.9 microIU/mL at 20 min. Transdermal nanoinsulin decreased glucose levels in a dose-dependent manner. A maximum decrease in blood glucose of 48.3 +/- 3.9% (ddY), 32.5 +/- 9.8% (dB/dB), and 26.2 +/- 7.6% (kkAy) after 6 h was observed with 200 microg of transdermal nanoinsulin, compared with 64.1+/-1.0% (ddY), 57.9 +/-3.4% (dB/dB), and 24.1 +/- 6.7% (kkAy) after 1 h with 3 microg of subcutaneous monomer insulin. Insulin bioavailability until 6 h with transdermal nanoinsulin in ddY mice was 0.9% based on serum insulin level and 2.0% on pharmacodynamic blood glucose-lowering effects. CONCLUSIONS: This CaCO(3)-nanoparticle system successfully delivered insulin transdermally, as evidenced by a significant sustained decrease in blood glucose in normal mice and those with diabetes. These results support the feasibility of developing transdermal nanoinsulin for human applications.


Assuntos
Carbonato de Cálcio/administração & dosagem , Insulina/administração & dosagem , Insulina/sangue , Administração Cutânea , Animais , Insulina/farmacocinética , Camundongos , Camundongos Endogâmicos , Nanoestruturas , Proteínas Recombinantes/administração & dosagem , Proteínas Recombinantes/sangue
19.
Biosens Bioelectron ; 22(3): 409-14, 2006 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-16759845

RESUMO

To detect dioxin using a quartz crystal microbalance (QCM) immunosensor, anti-2,3,7,8-tetrachloro-p-dibenzodioxin (TCDD) monoclonal antibodies (MAbs) were produced as types of IgG1 and IgM, with mono 6-(2,3,6,7-tetrachloroxanthene-9-ylidene) hexyl succinate (as a hapten) conjugated with bovine serum albumin (dioxin-BSA). Furthermore, ScFv was generated from hybridoma-producing IgG1 MAb. Among these antibodies, ScFv showed excellent capability for dioxin detection using QCM immunosensors.


Assuntos
Anticorpos Monoclonais/química , Técnicas Biossensoriais/instrumentação , Dioxinas/análise , Imunoensaio/instrumentação , Succinatos/química , Animais , Anticorpos Monoclonais/imunologia , Técnicas Biossensoriais/métodos , Dioxinas/química , Dioxinas/imunologia , Desenho de Equipamento , Análise de Falha de Equipamento , Haptenos/química , Haptenos/imunologia , Imunoensaio/métodos , Camundongos , Camundongos Endogâmicos BALB C , Dibenzodioxinas Policloradas/química , Dibenzodioxinas Policloradas/imunologia , Succinatos/imunologia , Poluentes Químicos da Água/análise
20.
Exp Eye Res ; 82(4): 657-63, 2006 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-16360654

RESUMO

We have developed nanoparticles (NPs), which are capable of targeting a specific lesion and gradually releasing the agent at the site over a prolonged time period after a single intravenous administration. In this study, we evaluated the effects of intravenously administered poly(lactic acid) nanoparticles encapsulating betamethasone phosphate (BP-PLA NPs) on experimental autoimmune uveoretinitis (EAU) in Lewis rats. To determine the localization of NPs within the retina and choroid of rats with EAU, rhodamine (Rh)-encapsulated PLA NPs were injected intravenously and visualized by confocal microscopy. After the disease onset of EAU induced by S-antigen peptide in Lewis rats, either BP-PLA NPs, BP, or saline was injected intravenously, and the eyes were obtained 7 days following treatment and the histological score was determined. The clinical course of EAU was examined using pathological findings and the expression of the glial fibrillary acidic protein, rod opsin, and the surface markers of inflammatory cells (ED1 and pan T-cell) were immunohistochemically determined. Furthermore, T-cell proliferation and delayed-type hypersensitivity (DTH) to S-antigen were assessed. Intravenously injected Rh-PLA NPs accumulated in the retina and choroid of rats with EAU within 3 hr and remained over the succeeding 7-day-period. Furthermore, systemically administered BP-PLA NPs reduced the clinical scores of rats with EAU in 1 day, which were maintained for 2 weeks and decreased the histological scores. In addition, the ocular infiltration of activated T-cells and macrophages in addition to the hypertrophy of Müller cells were markedly reduced with this treatment. Meanwhile, T-cell proliferation and DTH of BP-PLA NPs-treated rats against S-antigen peptide were not significantly different from those of saline-treated rats. Systemically administered BP-PLA NPs inhibit the development of EAU due to the targeting and the sustained release of steroids in situ. The results of these studies suggest that the systemic administration of BP-PLA NPs may lead to a new therapeutic strategy in controlling intraocular inflammation.


Assuntos
Anti-Inflamatórios/administração & dosagem , Doenças Autoimunes/tratamento farmacológico , Betametasona/análogos & derivados , Ácido Láctico/administração & dosagem , Nanoestruturas , Polímeros/administração & dosagem , Retinite/tratamento farmacológico , Uveíte/tratamento farmacológico , Animais , Doenças Autoimunes/imunologia , Doenças Autoimunes/patologia , Betametasona/administração & dosagem , Corioide/química , Corioide/patologia , Preparações de Ação Retardada/administração & dosagem , Modelos Animais de Doenças , Composição de Medicamentos/métodos , Imunidade Celular/efeitos dos fármacos , Imuno-Histoquímica/métodos , Injeções Intravenosas , Ácido Láctico/análise , Masculino , Microscopia Confocal/métodos , Nanoestruturas/análise , Poliésteres , Polímeros/análise , Ratos , Ratos Endogâmicos Lew , Retina/química , Retina/patologia , Retinite/imunologia , Retinite/patologia , Rodaminas/administração & dosagem , Rodaminas/análise , Resultado do Tratamento , Uveíte/imunologia , Uveíte/patologia
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