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1.
J Mater Sci Mater Med ; 29(2): 18, 2018 Jan 16.
Artigo em Inglês | MEDLINE | ID: mdl-29340853

RESUMO

Biodegradable and bioresorbable polyesters (BBPEs) are a widespread class of aliphatic polymers with a plethora of applications in the medical field. Some reports speculate that these polymers have intrinsic antibacterial activity as a consequence of their acidic degradation by-products. The release of organic acids as a result of the hydrolytic degradation of BBPEs in vivo and the resulting pH drop could be an effective inhibitor of the growth of pathogens in the local environment adjacent to BBPE-based devices. However, there is no clear and conclusive evidence in the literature concerning the antibacterial activity of BBPE to support or refute this hypothesis. In this communication we address this point through an assessment of the antibacterial properties of six well-established commercially available BBPEs. Agar diffusion assays and optical density measurements at 600 nm were performed on all the polymer samples to characterize the growth of bacteria and any potential inhibition over an incubation period of 24 h. The results indicated that BBPEs do not possess an intrinsic and immediate antibacterial activity, which is consistent with the clear mismatch between the time-scales for bacterial growth and the rate of degradation of the polyesters.


Assuntos
Implantes Absorvíveis , Antibacterianos/farmacologia , Materiais Biocompatíveis/farmacologia , Poliésteres/farmacologia , Antibacterianos/química , Materiais Biocompatíveis/química , Escherichia coli , Hidroxibutiratos/química , Hidroxibutiratos/farmacologia , Ácido Láctico/química , Ácido Láctico/farmacologia , Testes de Sensibilidade Microbiana , Poliésteres/química , Ácido Poliglicólico/química , Ácido Poliglicólico/farmacologia , Copolímero de Ácido Poliláctico e Ácido Poliglicólico , Staphylococcus aureus
2.
Polymers (Basel) ; 16(19)2024 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-39408428

RESUMO

This research concerns the development and implementation of ground-breaking strategies for improving the sorting, separation, and recycling of common flexible laminate packaging materials. Such packaging laminates incorporate different functional materials in order to achieve the desired mechanical performance and barrier properties. Common components include poly(ethylene) (PE), poly(propylene) (PP), and poly(ethylene terephthalate) (PET), as well as valuable barrier materials such as poly(vinyl alcohol) (PVOH) and aluminium (Al) foils. Although widely used for the protection and preservation of food produce, such packaging materials present significant challenges for established recycling infrastructure and, therefore, to our future ambitions for a circular economy. Experience from the field of ionic liquids (ILs) and deep eutectic solvents (DESs) has been leveraged to develop novel green solvent systems that delaminate multilayer packaging materials to facilitate the separation and recovery of high-purity commodity plastics and aluminium. This research focuses on the development of a hydrophobic DES and the application of a Design of Experiments (DoE) methodology to investigate the effects of process parameters on the delamination of PE/Al/PET laminate packaging films. Key variables including temperature, time, loading, flake size, and perforations were assessed at laboratory scale using a 1 L filter reactor vessel. The results demonstrate that efficient separation of PE, Al, and PET can be achieved with high yields for material and solvent recovery. Recovered plastic films were subsequently characterised via Fourier-transform infra-red (FTIR) spectroscopy, Differential Scanning Calorimetry (DSC) and Thermogravimetric Analysis (TGA) to qualify the quality of plastics for reuse.

3.
Polymers (Basel) ; 16(19)2024 Sep 30.
Artigo em Inglês | MEDLINE | ID: mdl-39408493

RESUMO

Deep Eutectic Solvents (DESs) show promising abilities for the delamination of multilayer packaging films that are used in food packaging and in pharmaceutical blister packs. Due to the complexity of their structure, the recycling of such materials is a challenging task, leading to the easiest or cheapest disposal option of either landfill or incineration. Towards the development of 'green' solvents for efficient waste management and recycling, this research focuses on the preparation of a range of hydrophobic and hydrophilic DESs based on carboxylic acids in combination with various naturally derived aliphatic and aromatic organic compounds as well as amino acids. Chemical and physical characterization of the solvents was undertaken using differential scanning calorimetry, rheometry, and density measurements for the determination of their properties. Subsequently, batches of solvent were tested against different types of consumer packaging to evaluate the ability of the DES to delaminate these structures into their component materials. The laminate packaging waste products tested were Al/PE, PE/Al/PET, Al/PE/paper, and PVC/PE/Al. Separated films were collected and studied to further examine the effect of solvent delamination on the materials. Depending on the DES formulation, the results showed either partial or full delamination of one or more of the packaging materials, albeit there were challenges for certain solvent systems in the context of delivering a broad delamination efficiency. Variables including temperature, agitation rate, mixing time, and solvent ratios were investigated via a Design of Experiments process to assess the effects of these parameters on the delamination outcome. The results showed that the DESs presented in this research can offer an efficient, low-energy, affordable, and green option for the delamination of laminate packaging materials.

4.
Open Res Eur ; 4: 122, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39403450

RESUMO

During the most active period of star formation in galaxies, which occurs in the redshift range 1 < z < 3, strong bursts of star formation result in significant quantities of dust, which obscures new stars being formed as their UV/optical light is absorbed and then re-emitted in the infrared, which redshifts into the mm/sub-mm bands for these early times. To get a complete picture of the high- z galaxy population, we need to survey a large patch of the sky in the sub-mm with sufficient angular resolution to resolve all galaxies, but we also need the depth to fully sample their cosmic evolution, and therefore obtain their redshifts using direct mm spectroscopy with a very wide frequency coverage. This requires a large single-dish sub-mm telescope with fast mapping speeds at high sensitivity and angular resolution, a large bandwidth with good spectral resolution and multiplex spectroscopic capabilities. The proposed 50-m Atacama Large Aperture Submillimeter Telescope (AtLAST) will deliver these specifications. We discuss how AtLAST allows us to study the whole population of high-z galaxies, including the dusty star-forming ones which can only be detected and studied in the sub-mm, and obtain a wealth of information for each of these up to z ∼ 7: gas content, cooling budget, star formation rate, dust mass, and dust temperature. We present worked examples of surveys that AtLAST can perform, both deep and wide, and also focused on galaxies in proto-clusters. In addition we show how such surveys with AtLAST can measure the growth rate f σ 8 and the Hubble constant with high accuracy, and demonstrate the power of the line-intensity mapping method in the mm/sub-mm wavebands to constrain the cosmic expansion history at high redshifts, as good examples of what can uniquely be done by AtLAST in this research field.


Galaxies come in a wide variety of shapes, sizes, and colours, despite all of them having originated from similar initial conditions in the early Universe. Understanding this diversity by tracing back the evolutionary pathways of different types of galaxies is a major endeavour in modern astrophysics. Galaxies build their stellar mass over time by converting gas into stars through various episodes of star formation. Understanding exactly when, where, and how this star formation process is triggered or suppressed is therefore a crucial question to answer. Current observations reveal that the Universe was at its most active (in terms of star formation rate per unit volume) in the distant past, about 10 billion years ago. By measuring the amount of gas and dust in galaxies at that epoch, we also know that the reason for this very high star formation activity is large reservoirs of gas (the fuel for star formation) and the higher efficiency of galaxies at converting their gas into stars. However, recent work also reveals that we are missing significant numbers of distant actively star-forming galaxies in current samples because these are obscured by dust, and therefore our picture is still very incomplete. In this paper, we explore how a new proposed telescope, the Atacama Large Aperture Submillimeter Telescope (AtLAST: http://atlast-telescope.org), can provide us with the very important missing pieces of this puzzle. AtLAST will allow us to map large areas of the sky at unprecedented depth, resolution and multiplex spectroscopic capabilities. This telecope would provide us with a complete, homogeneous and unbiased picture of the star-forming galaxy population in the early Universe. Not only will we be able to discover these galaxies, but also measure their distances, the composition of their gas and dust content, and the rate at which they convert gas into stars.

5.
Biomacromolecules ; 11(11): 2927-35, 2010 Nov 08.
Artigo em Inglês | MEDLINE | ID: mdl-20923202

RESUMO

Solutions of microcrystalline cellulose in 1-ethyl-3-methyl-imidazolium acetate have been investigated using pulsed-field gradient (1)H NMR. In all cases the geometrically larger cation was found to diffuse faster than the smaller anion. Arrhenius temperature analysis has been applied to the ion diffusivities giving activation energies. The diffusion and published viscosity data for these solutions were shown to follow the Stokes-Einstein relationship, giving hydrodynamic radii of 1.6 Š(cation) and 1.8 Š(anion). Theories for obstruction, free-volume and hydrodynamic effects on solvent diffusion have been applied. The Mackie-Meares and Maxwell-Fricke obstruction models provided a correct trend only when assuming a certain fraction of ions are bound to the polymer. From this fraction it was shown that the maximum dissolvable cellulose concentration is ∼27% w/w, which is consistent with the highest known prepared concentration of cellulose in this ionic liquid. The Phillies' hydrodynamic model is found to give the best description for the cellulose concentration dependence of the ion diffusivities.


Assuntos
Celulose/química , Imidazóis/química , Difusão , Íons/química , Soluções
6.
Contact Dermatitis ; 63(3): 140-5, 2010 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-20690936

RESUMO

BACKGROUND: Patch testing is essential to diagnose allergic contact dermatitis. Dermatologists in many countries use a baseline (standard) series covering the major allergens responsible for allergic contact dermatitis in their population, with the addition of relevant allergens for the individual patient. However, a baseline series has not yet been developed for Ethiopia. Our objective in this study is to identify common contact allergens to form the basis of a future baseline series in Ethiopia. METHODOLOGY: We patch tested 514 subjects with dermatitis according to the recommended procedure using the European baseline series for 1 year. RESULTS: 52.7% of the tested subjects showed positive reaction for at least one allergen tested. The top five contact allergens identified were nickel sulfate, fragrance mix I, cobalt chloride, p-tert-butylphenolformaldehyde (PTBP) resin and potassium dichromate. Positive reactions to nickel and PTBP were commoner in females. PTBP positivity was strongly associated with foot eczema. Positive test reactions were commoner in cement workers, notably to potassium dichromate, which was also a commoner allergen in patients presenting with hand dermatitis. There were no reactions to several allergens, including neomycin, benzocaine, budesonide, primin and quaternium-15. CONCLUSION: Comparable patch test results with other countries have been shown and the European baseline series can be used as a baseline series in Ethiopia with some modification.


Assuntos
Alérgenos/imunologia , Dermatite Alérgica de Contato/diagnóstico , Testes do Emplastro/normas , Adolescente , Adulto , Idoso , Etiópia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
7.
J Mech Behav Biomed Mater ; 110: 103968, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32745973

RESUMO

Biomedical scaffolds with a high degree of porosity are known to facilitate the growth of healthy functioning tissues. In this study, scaffolds with hierarchical porosity are manufactured and their mechanical and thermal properties are characterised. Multi-scale porosity is achieved in scaffolds fabricated by Fused Deposition Modelling (FDM) in a novel way. Random intrinsic porosity at micron length scale obtained from particulate leaching is combined with the structured extrinsic porosity at millimeter length scales afforded by controlling the spacing between the struts. Polylactic acid (PLA) is blended with Polyvinyl alcohol (PVA) and an inorganic sacrificial phase, sodium chloride (NaCl), to produce pores at length scales of up to two orders of magnitude smaller than the inter-filament voids within 3D printed lattices. The specific elastic modulus and specific strength are maximised by optimising the polymer blends. The porosity level and pore size distribution of the foamy filaments within lattices are quantified statistically. Compression tests are performed on the porous samples and the observed mechanical response is attributed to the microstructure and density. Simple cellular solid models that possess power law are used to explain the measured trends and the dependence is associated with various mechanisms of elastic deformation of the cell walls. The relationship between pore architecture, pore connectivity, the blend material composition, and mechanical response of produced foams is brought out. Foams obtained using the PLA:PVA:NaCl 42%-18%-40% material blends show relatively high specific elastic modulus, specific strength and strain at failure. A quadratic power law relating the Young's modulus with the relative density is experimentally obtained, which is consistent with theoretical models for open-cell foams. 3D printing with blends, followed by leaching, produces structures with cumulative intrinsic and extrinsic porosity as high as 80%, in addition to good mechanical integrity.


Assuntos
Impressão Tridimensional , Engenharia Tecidual , Bioengenharia , Módulo de Elasticidade , Porosidade , Alicerces Teciduais
8.
Macromol Biosci ; 20(3): e1900355, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32022997

RESUMO

Inducing the formation of new blood vessels (angiogenesis) is an essential requirement for successful tissue engineering. Approaches have been proposed to enhance angiogenesis using growth factors and other biomolecules; however, this approaches present drawbacks in terms of high cost and patient safety. Copper is known to effectively regulate angiogenesis and can offer a more cost-effective alternative than the direct use of growth factors. With this study, a strategy to incorporate copper in electrospun fibrous scaffolds with pro-angiogenic properties is presented. Polycaprolactone (PCL) and copper(II)-chitosan are electrospun using benign solvents. The morphological and physicochemical properties of the fiber mats are investigated through scanning electron microscopy (SEM), static contact angle measurements, energy dispersive X-ray, and Fourier-transform infrared spectroscopies. Scaffold stability in phosphate buffered saline at 37 °C is monitored over 1 week. A bone marrow stromal cell line (ST-2) is cultured for 7 days and its behavior is evaluated using SEM, fluorescence microscopy and a tetrazolium salt-based colorimetric assay. Results confirm that PCL/copper(II)-chitosan is suitable for electrospinning. The fiber mats are biocompatible and favor cell colonization and infiltration. Most notably, the angiogenic potential of PCL/copper(II)-chitosan blends is confirmed by a three-fold increase in VEGF secretion by ST-2 cells in the presence of copper(II)-chitosan.


Assuntos
Quitosana/química , Cobre/química , Teste de Materiais , Células-Tronco Mesenquimais/metabolismo , Poliésteres/química , Alicerces Teciduais/química , Fator A de Crescimento do Endotélio Vascular/metabolismo , Animais , Linhagem Celular , Células-Tronco Mesenquimais/citologia , Camundongos
10.
J Dermatolog Treat ; 30(8): 796-801, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30717601

RESUMO

Background: Treatment with isotretinoin has been associated with adverse mood changes. However, even though a number of studies support this association, others refute it, and a concrete causal link has yet to be proven. Acne itself is associated with depressive symptoms, thus making studies on the topic difficult to design and interpret. Objectives and methods: Using validated tools, we performed a prospective study in order to assess the effects of treatment with isotretinoin on the mood of patients with acne vulgaris. Results: Fifty-six patients were included with a mean age of 21 years. At baseline, questionnaire scores for all measured parameters were indicative of lower mood than published norms. During and after treatment, values of either stable or improving mood were displayed across all questionnaires. Three patients developed significantly deteriorating moods, two of whom also experienced severe physical adverse effects. Conclusion: The relationship between isotretinoin and depression is the most debated aspect of isotretinoin therapy. Our results link isotretinoin to an overall improvement in psychological wellbeing, even in patients suffering with stable mental illness. However, we also found that a small minority of patients are susceptible to severe mood deterioration, particularly in conjunction with severe physical side effects.


Assuntos
Acne Vulgar/tratamento farmacológico , Fármacos Dermatológicos/uso terapêutico , Isotretinoína/uso terapêutico , Acne Vulgar/patologia , Adolescente , Adulto , Ansiedade/etiologia , Estudos de Coortes , Depressão/etiologia , Fármacos Dermatológicos/efeitos adversos , Feminino , Humanos , Isotretinoína/efeitos adversos , Masculino , Estudos Prospectivos , Inquéritos e Questionários , Adulto Jovem
11.
J Mater Chem B ; 7(40): 6109-6124, 2019 10 16.
Artigo em Inglês | MEDLINE | ID: mdl-31549696

RESUMO

Therapeutic metal ions are a family of metal ions characterized by specific biological properties that could be exploited in bone tissue engineering, avoiding the use of expensive and potentially problematic growth factors and other sensitive biomolecules. In this work, we report the successful preparation and characterization of two material platforms containing therapeutic ions: a copper(ii)-chitosan derivative and a strontium-substituted hydroxyapatite. These biomaterials showed ideal ion release profiles, offering burst release of an antibacterial agent together with a more sustained release of strontium in order to achieve long-term osteogenesis. We combined copper(ii)-chitosan and strontium-hydroxyapatite into freeze-dried composite scaffolds. These scaffolds were characterized in terms of morphology, mechanical properties and bioactivity, defined here as the ability to trigger the deposition of novel calcium phosphate in contact with biological fluids. In addition, a preliminary biological characterization using cell line osteoblasts was performed. Our results highlighted that the combination of chitosan and hydroxyapatite in conjunction with copper and strontium has great potential in the design of novel scaffolds. Chitosan/HA composites can be an ideal technology for the development of tissue engineering scaffolds that deliver a complex arrays of therapeutic ions in both components of the composite, leading to tailored biological effects, from antibacterial activity, to osteogenesis and angiogenesis.


Assuntos
Quitosana/química , Cobre/química , Durapatita/química , Osteoblastos/citologia , Osteogênese , Osteossarcoma/patologia , Estrôncio/química , Materiais Biocompatíveis/química , Neoplasias Ósseas/patologia , Regeneração Óssea , Diferenciação Celular , Humanos , Engenharia Tecidual , Células Tumorais Cultivadas
12.
J Rheumatol ; 46(9): 1097-1102, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-30824637

RESUMO

OBJECTIVE: To assess whether the association between psoriatic nail dystrophy and radiographic damage in the hands of patients with psoriatic arthritis (PsA) is specific to the distal interphalangeal (DIP) joints. METHODS: A convenience sample of patients was collated from the Bath longitudinal PsA cohort. All patients had PsA according to the ClASsification for Psoriatic ARthritis criteria (CASPAR) criteria, scored radiographs of their hands, and documented nail scores as measured by the Psoriatic Nail Severity Score. Chi-square tests were performed to examine for association between features of nail dystrophy and radiographic damage in the DIP joints, and proximal interphalangeal or metacarpophalangeal (non-DIP) joints of the corresponding digits. RESULTS: There were 134 patients included, with a median age of 53 years (interquartile range; IQR 44-61) and disease duration of 7 years (IQR 3-17). The presence of any form of psoriatic nail dystrophy was associated with erosion at the DIP joints of the corresponding digit (OR 1.9, 95% CI 1.23-2.83; p < 0.004) and this association was primarily driven by the presence of nail onycholysis (OR 1.72; 95% CI 1.12-2.62; p = 0.02). Nail subungual hyperkeratosis was more strongly associated with joint space narrowing, erosions, and osteoproliferation at the corresponding DIP joint compared to non-DIP joints (p < 0.001). Nail pitting was not associated with erosions or osteoproliferation. CONCLUSION: The presence of psoriatic nail dystrophy, particularly onycholysis, is associated with erosive disease at the DIP joints. Subungual hyperkeratosis is more strongly associated with erosive damage at the DIP than non-DIP joints. These findings support the anatomical and pathological link between nail and DIP joint disease.


Assuntos
Artrite Psoriásica/patologia , Articulações dos Dedos/patologia , Doenças da Unha/patologia , Unhas/patologia , Articulação do Dedo do Pé/patologia , Adulto , Artrite Psoriásica/diagnóstico por imagem , Articulações dos Dedos/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Doenças da Unha/diagnóstico por imagem , Unhas/diagnóstico por imagem , Radiografia , Estudos Retrospectivos , Índice de Gravidade de Doença , Articulação do Dedo do Pé/diagnóstico por imagem
13.
Carbohydr Polym ; 179: 370-378, 2018 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-29111063

RESUMO

We produced and characterized copper(II)-chitosan complexes fabricated via in-situ precipitation as antibiotic-free antibacterial biomaterials. Copper was bound to chitosan from a dilute acetic acid solution of chitosan and copper(II) chloride exploiting the ability of the polysaccharide to chelate metal ions. The influence of copper(II) ions on the morphology, structure and hydrophobicity of the complexes was evaluated using scanning electron microscopy, energy-dispersive X-ray spectroscopy, attenuated total reflectance Fourier transform infrared spectroscopy and static contact-angle measurements. To assess the biological response to the materials, cell viability and antibacterial assays were performed using mouse embryonic fibroblasts and both Gram-positive and -negative bacteria. Combined analysis of cell and bacterial studies identified a threshold concentration at which the material shows outstanding antibacterial properties without significantly affecting fibroblast viability. This key outcome sets copper(II)- chitosan as a promising biomaterial and encourages further investigation on similar systems toward the development of new antibiotic-free antibacterial technologies.


Assuntos
Antibacterianos/farmacologia , Materiais Biocompatíveis/farmacologia , Precipitação Química , Quitosana/química , Cobre/química , Ácido Acético/química , Animais , Antibacterianos/química , Materiais Biocompatíveis/química , Sobrevivência Celular/efeitos dos fármacos , Quelantes/química , Escherichia coli/efeitos dos fármacos , Fibroblastos/efeitos dos fármacos , Camundongos , Staphylococcus/efeitos dos fármacos , Molhabilidade
17.
Arthritis Care Res (Hoboken) ; 66(9): 1410-6, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-24470406

RESUMO

OBJECTIVE: Several questionnaires have been developed to screen for psoriatic arthritis (PsA), but head-to-head studies have found limitations. This study aimed to develop new questionnaires encompassing the most discriminative questions from existing instruments. METHODS: Data from the CONTEST study, a head-to-head comparison of 3 existing questionnaires, were used to identify items with a Youden index score of ≥0.1. These were combined using 4 approaches: CONTEST (simple additions of questions), CONTESTw (weighting using logistic regression), CONTESTjt (addition of a joint manikin), and CONTESTtree (additional questions identified by classification and regression tree [CART] analysis). These candidate questionnaires were tested in independent data sets. RESULTS: Twelve individual questions with a Youden index score of ≥0.1 were identified, but 4 of these were excluded due to duplication and redundancy. Weighting for 2 of these questions was included in CONTESTw. Receiver operating characteristic (ROC) curve analysis showed that involvement in 6 joint areas on the manikin was predictive of PsA for inclusion in CONTESTjt. CART analysis identified a further 5 questions for inclusion in CONTESTtree. CONTESTtree was not significant on ROC curve analysis and discarded. The other 3 questionnaires were significant in all data sets, although CONTESTw was slightly inferior to the others in the validation data sets. Potential cut points for referral were also discussed. CONCLUSION: Of 4 candidate questionnaires combining existing discriminatory items to identify PsA in people with psoriasis, 3 were found to be significant on ROC curve analysis. Testing in independent data sets identified 2 questionnaires (CONTEST and CONTESTjt) that should be pursued for further prospective testing.


Assuntos
Artrite Psoriásica/diagnóstico , Programas de Rastreamento , Inquéritos e Questionários , Humanos , Sensibilidade e Especificidade
19.
J Phys Chem B ; 116(42): 12810-8, 2012 Oct 25.
Artigo em Inglês | MEDLINE | ID: mdl-23020276

RESUMO

Mixtures of 1-ethyl-3-methyl-imidazolium acetate ([C2mim][OAc]) and water across the entire composition range, from pure [C2mim][OAc] to pure water, have been investigated using density, viscosity, and NMR spectroscopy, relaxometry, and diffusion measurements. These results have been compared to ideal mixing laws for the microscopic data obtained from the NMR results and macroscopic data through the viscosity and density. It was also found that the mixing of the two fluids is exothermal. The proton spectra indicate though that [C2mim][OAc] and water are interacting without the formation of new compounds. The maximal deviations of experimental data from theoretical mixing rules were all found to occur within the range 0.74 ± 0.06 mol fraction of water, corresponding to approximately three water molecules per [C2mim][OAc] molecule.


Assuntos
Imidazóis/química , Água/química , Difusão , Espectroscopia de Ressonância Magnética , Viscosidade
20.
J Invest Dermatol ; 131(10): 1981-6, 2011 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-21734714

RESUMO

The recommended systemic therapy of choice for discoid lupus erythematosus (DLE) is the 4-aminoquinolone antimalarial hydroxychloroquine. There is limited published information on the likelihood of clinical response and, in particular, what factors influence outcome. We conducted a multicenter observational and pharmacogenetic study of 200 patients with DLE treated with hydroxychloroquine. The primary outcome was clinical response to hydroxychloroquine. We investigated the effects of disease attributes and metabolizing cytochrome P450 (CYP) polymorphisms on clinical outcome. Although the majority of patients responded to hydroxychloroquine, a significant proportion (39%) either failed to respond or was intolerant of the drug. Cigarette smoking and CYP genotype did not have any significant influence on response to hydroxychloroquine. Moreover, multivariate analysis indicated that disseminated disease (odds ratio (OR): 0.21; 95% confidence interval (CI): 0.08-0.52; P<0.001) and concomitant systemic lupus erythematosus (SLE; OR: 0.06; 95% CI: 0.01-0.49; P = 0.009) were significantly associated with lack of response to hydroxychloroquine. These findings suggest that baseline lupus severity and SLE are predictors of response to hydroxychloroquine. A prospective study is now required to further investigate the relationship between disease activity and response to hydroxychloroquine. This will have the potential to further inform the clinical management of this disfiguring photosensitive disease.


Assuntos
Hidroxicloroquina/uso terapêutico , Lúpus Eritematoso Discoide/tratamento farmacológico , Lúpus Eritematoso Discoide/genética , Farmacogenética/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Sistema Enzimático do Citocromo P-450/genética , Feminino , Genótipo , Humanos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Polimorfismo Genético , Estudos Retrospectivos , Fumar , Resultado do Tratamento
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