A drug repositioning success: The repositioned therapeutic applications and mechanisms of action of thalidomide.

BACKGROUND: Thalidomide is the most teratogenic human medicine ever marketed and was associated with birth defects in approximately 10,000 children in the 1960s. The pharmacological effects of thalidomide are attributed to its anti-angiogenic, anti-inflammatory and modulatory effect on cytokines principally tumor necrosis factor-α, while the teratogenic effects are linked to two molecular targets, namely cereblon and tubulin. Teratogenicity is the gravest adverse effect of thalidomide depending on the dose and time of exposure. Nonetheless, with System for Thalidomide Education and Prescribing Safety program, the possibility of teratogenicity can be completely avoided. The sensitive period during pregnancy for thalidomide teratogenicity in humans is approximately 20-34 days after fertilization. METHODS: Relevant articles were identified from Google scholar and PubMed (MEDLINE) using different search strategies. CONCLUSION: Clinical trials showed that thalidomide has been found effective in the treatment of advanced renal cancer, esophageal cancer, chemotherapy refractory endometrial cancer and pancreatic cancer, which can suggest its future therapeutic potential in cancer treatment. Thalidomide is also used in the treatment of inflammatory skin disorders and has shown promising effect in the treatment of autoimmune disorders and inflammatory bowel disease. Despite thalidomide being a renowned teratogen and neurotoxin, it has been successfully repositioned and FDA approved for the treatment of erythema nodosum leprosum and multiple myeloma under strict control.

Cytotoxicity of Mycobacterium indicus pranii on Mia-Pa-Ca2 cells

Background: MIP is a cultivable, non-pathogenic organism, which shares several antigens with Mycobacterium tuberculosis and Mycobacterium leprae. It has several proposed clinical applications. However, its cytotoxic effect on pancreatic cancer has not been documented. Hence, the study was conducted to investigate MIP induced cytotoxicity on Mia-Pa-Ca2 cells. To determine the cytotoxic potential of heat killed Mycobacterium indicus pranii (MIP) on pancreatic cancer cells in vitro along with gemcitabine & 5-fluorouracil (5-FU). Mitogen-activated protein kinase (MAPK) level was also studied post MIP treatment. Methods: Cytotoxic effect of MIP, gemcitabine and 5-FU on Mia-Pa-Ca2 cells was determined. We have analyzed extent of apoptosis using flow cytometry and changes in p38 levels, c-Jun N-terminal kinases (JNK) and extracellular signal­regulated kinase (ERK) using ELISA. Results: MIP not only exhibits cell cytotoxicity in dose dependent manner, but also enhances efficacy of gemcitabine and 5-FU when used in combination. Flow cytometry analyses reveals apoptosis of Mia-Pa-Ca2 cells post MIP treatment compared to untreated cells. MAPK pathway study using ELISA shows that p38 and JNK levels are suppressed while there is no change in ERK level. Conclusion: With these results we conclude that MIP is a cytotoxic agent. Cytotoxicity is exhibited by apoptosis. Combining MIP with gemcitabine and 5-FU shows synergistic effect (AU)

Health Care Costs Among Renal Cancer Patients Using Pazopanib and Sunitinib.

Publications that aim to assess the economics of different therapies are important because they complement clinical trial data and may aid in decision making. We therefore read with interest the study by Hansen et al. in the January 2015 issue of JMCP. This study compared  costs between pazopanib (PAZ) and sunitinib (SU) in the first-line treatment of patients with metastatic renal cell carcinoma (mRCC).1 The authors assessed health care costs through assignment of costs from the Truven Health MarketScan Databases to the self-reported health care resource utilization (HCRU) data from the population studied in the phase III noninferiority clinical trial COMPARZ (Pazopanib versus sunitinib in metastatic renal cell carcinoma).2 We are writing to comment on the conclusions drawn from the results presented, the methodology used, and to request additional information and clarification on data presented.

The promise of thalidomide: evolving indications.

Thalidomide was first used in the late 1950s but it was withdrawn from the market in the 1960s for its notorious teratogenic effects. This drug was more recently rediscovered as a powerful immunomodulatory and antiinflammatory agent and was approved by the FDA in 1998 for treatment of erythema nodosum leprosum. Thalidomide has shown great promise in advanced or refractory multiple myeloma either alone or in combination with other agents. It has also demonstrated benefits in a wide variety of disparate conditions such as aphthous and genital ulcers, cancer cachexia, HIV, tuberculosis and chronic graft versus host disease. Thalidomide is being investigated for treatment of renal cell carcinoma, and liver and thyroid cancers. Better understanding of its many mechanisms of action has provoked great interest in its potential use for treatment of various disorders. This review focuses on thalidomide's mechanisms of action, biochemistry, pharmacokinetics and its use in erythema nodosum leprosum as well as multiple myeloma, graft versus host disease, and renal cell carcinoma.

El citodiagnóstico en dermatología: alcances y limitaciones / Cytodiagnosis in dermatology: its' reaches and limitations

El citodiagnóstico, ampliamente difundido, virtualmente carece de aplicación práctica en dermatología. En parte, por las características inherentes al método y además por la particular histoarquitectura de la piel y membranas mucosas sanas y enfermas. Sin embargo, su técnica sencilla puede constituirse en un auxiliar valioso en ciertas dermatosis, en particular vesicoampollares y tumorales. Se revisa éste método diagnóstico y sus limitaciones y se rescatan aquellos casos en los que puede ofrecer utilidad

El citodiagnóstico en dermatología: alcances y limitaciones / Cytodiagnosis in dermatology: its reaches and limitations

El citodiagnóstico, ampliamente difundido, virtualmente carece de aplicación práctica en dermatología. En parte, por las características inherentes al método y además por la particular histoarquitectura de la piel y membranas mucosas sanas y enfermas. Sin embargo, su técnica sencilla puede constituirse en un auxiliar valioso en ciertas dermatosis, en particular vesicoampollares y tumorales. Se revisa éste método diagnóstico y sus limitaciones y se rescatan aquellos casos en los que puede ofrecer utilidad (AU)

[Characterization of phenolic glycolipid-I (PGL-I) like antigen in renal cell carcinoma].

BACKGROUND: We investigated whether phenolic glycolipid-I (PGL-I) produced by Mycobacterium leprae (M. leprae), can be used as a marker of renal tumors. METHODS: Using a preparted anti-PGL-I monoclonal antibody (SF-I), anti-PGL-I group antibodies and PGL-I group antigens were detected and PGL-I immunohistologic staining were performed. RESULTS: The titer of anti-PGL-I antibody in patients with renal cell carcinoma was 0.283 +/- 0.103, showing a trend of rising titer of anti-PGL-I group antibody with higher cytologic atypia. When compared by the extent of tumor infiltration, a high antibody titer was observed in stage 4 infiltration group. Regarding the PGL-I group antigen that was detected using SF-1 in the urine of patients with renal cell carcinoma, no relationships between the positive rte of the antigens with common antigenicity to PGL-I and the grade of carcinoma were observed. However, in terms of the extent of tumor infiltration, a trend that the positive rate for PGL-I group antigen increased with the progression of cancer stage was seen. The Western blot assay of the urine of patients with renal cell carcinoma following electrophoresis revealed a change around 40 KD. The immunohistologic stains with SF-1 disclosed a predominance in the proximal kidney tubule. CONCLUSION: Using PGL-I group antigen and PGL-I group antibody as markers of renal cell carcinoma, a rapid and precise measurement may be provided.

[Biological properties and therapeutic use of interleukin 2 (IL-2)]. / Wlasciwosci biologiczne i zastosowanie lecznicze interleukiny 2 (IL-2).

A cytokine produced by the subpopulation of activated helper lymphocytes T has been called interleukin-2 (IL-2). The obtaining of recombinant cytokine has facilitated the study of its biological properties and its application in the treatment of certain neoplastic and infectious diseases. IL-2 affects the target cells by means of a receptor of great affinity consisting of three independent chains: alpha, beta, gamma. The cytokine is the most important growth factor of lymphocytes T, conditioning their clonal expansion. Antigen stimulation is the condition for the expression of IL-2 does not, however, affect resting lymphocytes T. The expression of the receptor for this cytokine on NK cells is, however, continuous in character but only a very small percentage of these cells has receptors of great affinity. IL-2 plays a great role in adoptive immunotherapy consisting in intravenous administration of cells with cytotoxic properties. Cells obtained from peripheral blood and grown in vitro are called LAK cells (lymphocyte activated killer cells), while cells obtained from neoplasms and grown in similar conditions are named TIL cells (tumor infiltrated lymphocytes). LAK and TIL cells reveal a similar antineoplastic activity in vivo. At present, however, recombinant IL-2 alone is used more often, either intravenously or subcutaneously. The cytokine is effective in the treatment of patients with disseminate cancer of the kidney and melanoma, and in adjuvant therapy of acute myeloid leukemia. Attempts have been made to apply it in the treatment of AIDS and leprosy. The toxic effect of IL-2 depends on the dose and the mode of administration. In the majority of patients parainfluenza symptoms appear. Most undesirable effects are connected with multisystemic syndrome of capillary vessels hyperpermeability leading to the increased fluid retention into extravascular spaces, oedema, hypotonia and oliguria.