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1.
Proc Natl Acad Sci U S A ; 121(2): e2314101120, 2024 Jan 09.
Article in English | MEDLINE | ID: mdl-38165935

ABSTRACT

Mycobacterium abscessus (Mab), a nontuberculous mycobacterial (NTM) species, is an emerging pathogen with high intrinsic drug resistance. Current standard-of-care therapy results in poor outcomes, demonstrating the urgent need to develop effective antimycobacterial regimens. Through synthetic modification of spectinomycin (SPC), we have identified a distinct structural subclass of N-ethylene linked aminomethyl SPCs (eAmSPCs) that are up to 64-fold more potent against Mab over the parent SPC. Mechanism of action and crystallography studies demonstrate that the eAmSPCs display a mode of ribosomal inhibition consistent with SPC. However, they exert their increased antimicrobial activity through enhanced accumulation, largely by circumventing efflux mechanisms. The N-ethylene linkage within this series plays a critical role in avoiding TetV-mediated efflux, as lead eAmSPC 2593 displays a mere fourfold susceptibility improvement against Mab ΔtetV, in contrast to the 64-fold increase for SPC. Even a minor shortening of the linkage by a single carbon, akin to 1st generation AmSPC 1950, results in a substantial increase in MICs and a 16-fold rise in susceptibility against Mab ΔtetV. These shifts suggest that longer linkages might modify the kinetics of drug expulsion by TetV, ultimately shifting the equilibrium towards heightened intracellular concentrations and enhanced antimicrobial efficacy. Furthermore, lead eAmSPCs were also shown to synergize with various classes of anti-Mab antibiotics and retain activity against clinical isolates and other mycobacterial strains. Encouraging pharmacokinetic profiles coupled with robust efficacy in Mab murine infection models suggest that eAmSPCs hold the potential to be developed into treatments for Mab and other NTM infections.


Subject(s)
Anti-Infective Agents , Mycobacterium Infections, Nontuberculous , Mycobacterium abscessus , Humans , Animals , Mice , Spectinomycin/pharmacology , Mycobacterium Infections, Nontuberculous/drug therapy , Mycobacterium Infections, Nontuberculous/microbiology , Anti-Bacterial Agents/pharmacology , Nontuberculous Mycobacteria , Anti-Infective Agents/pharmacology , Ethylenes/pharmacology , Microbial Sensitivity Tests
2.
MMWR Morb Mortal Wkly Rep ; 71(36): 1141-1147, 2022 Sep 09.
Article in English | MEDLINE | ID: mdl-36074735

ABSTRACT

High prevalences of HIV and other sexually transmitted infections (STIs) have been reported in the current global monkeypox outbreak, which has affected primarily gay, bisexual, and other men who have sex with men (MSM) (1-5). In previous monkeypox outbreaks in Nigeria, concurrent HIV infection was associated with poor monkeypox clinical outcomes (6,7). Monkeypox, HIV, and STI surveillance data from eight U.S. jurisdictions* were matched and analyzed to examine HIV and STI diagnoses among persons with monkeypox and assess differences in monkeypox clinical features according to HIV infection status. Among 1,969 persons with monkeypox during May 17-July 22, 2022, HIV prevalence was 38%, and 41% had received a diagnosis of one or more other reportable STIs in the preceding year. Among persons with monkeypox and diagnosed HIV infection, 94% had received HIV care in the preceding year, and 82% had an HIV viral load of <200 copies/mL, indicating HIV viral suppression. Compared with persons without HIV infection, a higher proportion of persons with HIV infection were hospitalized (8% versus 3%). Persons with HIV infection or STIs are disproportionately represented among persons with monkeypox. It is important that public health officials leverage systems for delivering HIV and STI care and prevention to reduce monkeypox incidence in this population. Consideration should be given to prioritizing persons with HIV infection and STIs for vaccination against monkeypox. HIV and STI screening and other recommended preventive care should be routinely offered to persons evaluated for monkeypox, with linkage to HIV care or HIV preexposure prophylaxis (PrEP) as appropriate.


Subject(s)
HIV Infections , Mpox (monkeypox) , Pre-Exposure Prophylaxis , Sexual and Gender Minorities , Sexually Transmitted Diseases , Animals , HIV Infections/epidemiology , HIV Infections/prevention & control , Homosexuality, Male , Humans , Male , Mpox (monkeypox)/epidemiology , Sexually Transmitted Diseases/epidemiology , Sexually Transmitted Diseases/prevention & control
3.
J Neurooncol ; 122(3): 491-6, 2015 May.
Article in English | MEDLINE | ID: mdl-25758812

ABSTRACT

Recent small, retrospective series suggest bevacizumab may be a therapeutic option for recurrent pediatric low-grade glioma (LGG). Assessment of therapeutic responses is complicated by the unpredictable natural history of these tumors. Because diffusion-weighted imaging quantifies microscopic water motion affected by cellular density and histologic features, we hypothesized that it may be helpful in monitoring therapeutic response of LGG to bevacizumab. We retrospectively reviewed eight consecutive patients, median age 4.8 (range 2.3-12.3) years at initiation of bevacizumab therapy for recurrent or refractory LGG. Patients received 10 mg/kg/dose every 2 weeks (median 16 doses/therapy course). Mean apparent diffusion coefficient (ADC) was measured and analyzed in respect to tumor volume. Following the first treatment course, seven of eight patients had reduced tumor volume (≥25 %) and ADC. The median decrease in tumor volume was 47% (range -6 to 78 %) and the median decrease in ADC was 14 % (range -5 to 30 %). The ADC was significantly decreased during therapy, whereas the decrease in volume was seen only after therapy completion. There was a positive correlation between percent change in tumor volume and ADC (p < 0.05). We report a decrease in tumor ADC during initial bevacizumab therapy that is accompanied by a decrease in volume following therapy. Imaging changes in microscopic water motion associated with histology may be useful in monitoring the therapeutic response of LGG to bevacizumab.


Subject(s)
Angiogenesis Inhibitors/therapeutic use , Bevacizumab/therapeutic use , Brain Neoplasms/drug therapy , Brain Neoplasms/pathology , Glioma/drug therapy , Glioma/pathology , Adolescent , Brain/drug effects , Brain/pathology , Child , Child, Preschool , Diffusion Magnetic Resonance Imaging , Female , Humans , Image Processing, Computer-Assisted , Male , Retrospective Studies
4.
J Antibiot (Tokyo) ; 2024 Jun 18.
Article in English | MEDLINE | ID: mdl-38890386

ABSTRACT

Spectinomycin is an aminocyclitol antibiotic with a unique ribosomal binding site. Prior synthetic modifications of spectinomycin have enhanced potency and antibacterial spectrum through addition at the 6'-position to produce trospectomycin and to the 3'-position to produce spectinamides and aminomethyl spectinomycins. This study focused on the design, synthesis, and evaluation of three 3',6'-disubstituted spectinomycin analogs: trospectinamide, N-benzyl linked aminomethyl, and N-ethylene linked aminomethyl trospectomycins. Computational experiments predicted that these disubstituted analogs would be capable of binding within the SPC ribosomal binding site. The new analogs were synthesized from trospectomycin, adapting the previously established routes for the spectinamide and aminomethyl spectinomycin series. In a cell-free translation assay, the disubstituted analogs showed ribosomal inhibition similar to spectinomycin or trospectomycin. These disubstituted analogs demonstrated inhibitory MIC activity against various bacterial species with the 3'-modification dictating spectrum of activity, leading to improved activity against mycobacterium species. Notably, N-ethylene linked aminomethyl trospectomycins exhibited increased potency against Mycobacterium abscessus and trospectinamide displayed robust activity against M. tuberculosis, aligning with the selective efficacy of spectinamides. The study also found that trospectomycin is susceptible to efflux in M. tuberculosis and M. abscessus. These findings contribute to the understanding of the structure-activity relationship of spectinomycin analogs and can guide the design and synthesis of more effective spectinomycin compounds.

5.
J Proteome Res ; 12(12): 5867-77, 2013 Dec 06.
Article in English | MEDLINE | ID: mdl-24200290

ABSTRACT

We report the structural analysis of cap-binding proteins using a chemical probe/ultraviolet photodissociation (UVPD) mass spectrometry strategy for evaluating solvent accessibility of proteins. Our methodology utilized a chromogenic probe (NN) to probe the exposed amine residues of wheat eukaryotic translation initiation factor 4E (eIF4E), eIF4E in complex with a fragment of eIF4G ("mini-eIF4F"), eIF4E in complex with full length eIF4G, and the plant specific cap-binding protein, eIFiso4E. Structural changes of eIF4E in the absence and presence of excess dithiothreitol and in complex with a fragment of eIF4G or full-length eIF4G are mapped. The results indicate that there are particular lysine residues whose environment changes in the presence of dithiothreitol or eIF4G, suggesting that changes in the structure of eIF4E are occurring. On the basis of the crystal structure of wheat eIF4E and a constructed homology model of the structure for eIFiso4E, the reactivities of lysines in each protein are rationalized. Our results suggest that chemical probe/UVPD mass spectrometry can successfully predict dynamic structural changes in solution that are consistent with known crystal structures. Our findings reveal that the binding of m(7)GTP to eIF4E and eIFiso4E appears to be dependent on the redox state of a pair of cysteines near the m(7)GTP binding site. In addition, tertiary structural changes of eIF4E initiated by the formation of a complex containing a fragment of eIF4G and eIF4E were observed.


Subject(s)
Cysteine/chemistry , Eukaryotic Initiation Factor-4E/chemistry , Eukaryotic Initiation Factor-4F/chemistry , Eukaryotic Initiation Factor-4G/chemistry , Lysine/chemistry , Plant Proteins/chemistry , Amino Acid Sequence , Binding Sites , Cysteine/metabolism , Dithiothreitol/chemistry , Eukaryotic Initiation Factor-4E/metabolism , Eukaryotic Initiation Factor-4F/metabolism , Eukaryotic Initiation Factor-4G/metabolism , Guanosine Triphosphate/chemistry , Guanosine Triphosphate/metabolism , Lysine/metabolism , Mass Spectrometry/methods , Models, Molecular , Molecular Sequence Data , Plant Proteins/metabolism , Protein Binding , Protein Structure, Secondary , Protein Structure, Tertiary , Recombinant Proteins/chemistry , Recombinant Proteins/metabolism , Sequence Alignment , Triticum/chemistry
6.
Planta Med ; 79(3-4): 266-74, 2013 Mar.
Article in English | MEDLINE | ID: mdl-23408271

ABSTRACT

The use of Echinacea as a medicinal herb is prominent in the United States, and many studies have assessed the effectiveness of Echinacea as an immunomodulator. We hypothesized that Bauer alkamides 8, 10, and 11 and ketone 24 were absorbed similarly either as pure compounds or from Echinacea sanguinea and Echinacea pallida ethanol extracts, and that these Echinacea extracts could inhibit the P-glycoprotein transporter in Caco-2 human intestinal epithelial cells. Using HPLC analysis, the permeation rate of Bauer alkamides by passive diffusion across Caco-2 cells corresponded with compound hydrophilicity (alkamide 8 > 10 > 11), independent of the plant extract matrix. Both Echinacea ethanol extracts stimulated apparent glucuronidation and basolateral efflux of glucuronides of alkamides 8 and 10 but not alkamide 11. Bauer ketone 24 was totally metabolized to more hydrophilic metabolites when administered as a single compound, but was also glucuronidated when present in Echinacea extracts. Bauer alkamides 8, 10, and 11 (175-230 µM) and ethanol extracts of E. sanguinea (1 mg/mL, containing ~ 90 µM total alkamides) and E. pallida (5 mg/mL, containing 285 µM total alkamides) decreased the efflux of the P-glycoprotein transporter probe calcein-AM from Caco-2 cells. These results suggest that other constituents in these Echinacea extracts facilitated the metabolism and efflux of alkamides and ketones, which might improve therapeutic benefits. Alkamides and Echinacea extracts might be useful in potentiating some chemotherapeutics, which are substrates for the P-glycoprotein transporter.


Subject(s)
ATP Binding Cassette Transporter, Subfamily B, Member 1/antagonists & inhibitors , Alkynes/pharmacokinetics , Echinacea/chemistry , Plant Extracts/pharmacology , Polyunsaturated Alkamides/pharmacokinetics , ATP Binding Cassette Transporter, Subfamily B, Member 1/metabolism , Alkynes/metabolism , Caco-2 Cells/drug effects , Caco-2 Cells/metabolism , Chromatography, High Pressure Liquid , Dose-Response Relationship, Drug , Fluoresceins/metabolism , Glucuronides/metabolism , Humans , Hydrophobic and Hydrophilic Interactions , Ketones , Permeability/drug effects , Plant Extracts/chemistry , Plants, Medicinal/chemistry , Polyunsaturated Alkamides/chemistry , Polyunsaturated Alkamides/metabolism
7.
J Biol Chem ; 286(49): 42566-42574, 2011 Dec 09.
Article in English | MEDLINE | ID: mdl-21965660

ABSTRACT

The initiation of translation in eukaryotes requires a suite of eIFs that include the cap-binding complex, eIF4F. eIF4F is comprised of the subunits eIF4G and eIF4E and often the helicase, eIF4A. The eIF4G subunit serves as an assembly point for other initiation factors, whereas eIF4E binds to the 7-methyl guanosine cap of mRNA. Plants have an isozyme form of eIF4F (eIFiso4F) with comparable subunits, eIFiso4E and eIFiso4G. Plant eIF4A is very loosely associated with the plant cap-binding complexes. The specificity of interaction of the individual subunits of the two complexes was previously unknown. To address this issue, mixed complexes (eIF4E-eIFiso4G or eIFiso4E-eIF4G) were expressed and purified from Escherichia coli for biochemical analysis. The activity of the mixed complexes in in vitro translation assays correlated with the large subunit of the respective correct complex. These results suggest that the eIF4G or eIFiso4G subunits influence translational efficiency more than the cap-binding subunits. The translation assays also showed varying responses of the mRNA templates to eIF4F or eIFiso4F, suggesting that some level of mRNA discrimination is possible. The dissociation constants for the correct complexes have K(D) values in the subnanomolar range, whereas the mixed complexes were found to have K(D) values in the ∼10 nm range. Displacement assays showed that the correct binding partner readily displaces the incorrect binding partner in a manner consistent with the difference in K(D) values. These results show molecular specificity for the formation of plant eIF4F and eIFiso4F complexes and suggest a role in mRNA discrimination during initiation of translation.


Subject(s)
Eukaryotic Initiation Factor-4F/chemistry , Amino Acid Sequence , Animals , Base Sequence , Escherichia coli/metabolism , Eukaryotic Initiation Factor-4G/chemistry , Isoenzymes/chemistry , Kinetics , Mice , Models, Molecular , Molecular Sequence Data , Plants/metabolism , Protein Binding , Protein Biosynthesis , Protein Structure, Tertiary , Rabbits , Triticum/genetics , Triticum/metabolism
8.
Biometals ; 25(3): 553-61, 2012 Jun.
Article in English | MEDLINE | ID: mdl-22403011

ABSTRACT

Following our previous finding that the sulfhydryl-oxidising chemical diamide induced a marked elevation of cellular Al(3+) (Wu et al., Int J Mol Sci, 12:8119-8132, 2011), a further investigation into the underlying molecular mechanism was carried out, using the eukaryotic model organism Saccharomyces cerevisiae. The effects of non-toxic dose of diamide (0.8 mM) and a mild dose of aluminium sulphate (Al(3+)) (0.4 mM) were determined prior to the screening of gene deletion mutants. A total of 81 deletion mutants were selected for this study according to the available screening data against Al(3+) only (Kakimoto et al., BioMetals, 18: 467-474, 2005) and diamide only (Thorpe et al., Proc Natl Acad Sci USA, 101: 6564-6569, 2004). On the basis of our screening data and the cluster analysis, a cluster containing the gene deletions (rpe1∆, sec72∆, pdr5∆ and ric1∆) was found to be specifically sensitive to the mixture of diamide and Al(3+). However gnp1∆, mch5∆ and ccc1∆ mutants were resistant. Dithiothreitol (DTT) and ascorbate markedly reversed the diamide-induced Al(3+) toxicity. Inductively-coupled plasma optical emission spectrometry demonstrated that DTT reduced the intracellular Al(3+) content in diamide/Al(3+)-treated yeast cells six-fold compared to the non-DTT controls. These data together revealed that the pleiotropic drug resistance transporter (Pdr5p) and vacuolar/vesicular transport-related proteins (Ric1p and Sec72p) are the targets of diamide. A dysfunctional membrane-bound Pdr5p terminates the detoxification pathway for Al(3+) at the final step, leading to intracellular Al(3+) accumulation and hence toxicity. As Al(3+) toxicity has been a problem in agriculture and human health, this study has provided a significant step forward in understanding Al(3+) toxicity.


Subject(s)
Aluminum/pharmacology , Disulfides/pharmacology , Saccharomyces cerevisiae/drug effects , Diamide/pharmacology , Dithiothreitol/pharmacology , Saccharomyces cerevisiae/metabolism
9.
J Am Pharm Assoc (2003) ; 52(1): 67-70, 2012.
Article in English | MEDLINE | ID: mdl-22257618

ABSTRACT

OBJECTIVE: To demonstrate the extent to which a community pharmacy can provide influenza immunizations in communities designated as medically underserved. METHODS: This retrospective study examined the number of influenza immunizations administered and populations served in areas with limited access to health care by Walgreens pharmacies during the 2009-10 influenza season. RESULTS: More than 43% of the U.S. population resides in medically underserved areas (MUAs), and our results show that Walgreens pharmacies served nearly one-half of this population. Nationwide, more than one-third of influenza immunizations were administered by pharmacies located in MUAs. In states with the highest proportion of their population in MUAs, the percentage of influenza vaccines provided in MUAs was much greater (up to 77.1%). CONCLUSION: Community pharmacies are convenient and accessible venues at which patients can obtain seasonal influenza vaccines and other immunizations. They are well-positioned throughout the country, including in areas that are otherwise medically underserved. These factors help community pharmacists eliminate one of the most important barriers to vaccination: accessibility.


Subject(s)
Community Pharmacy Services/organization & administration , Immunization Programs/organization & administration , Influenza Vaccines/administration & dosage , Pharmacists/organization & administration , Health Services Accessibility , Humans , Influenza, Human/prevention & control , Medically Underserved Area , Professional Role , Retrospective Studies , United States
10.
J Neurooncol ; 103(3): 561-6, 2011 Jul.
Article in English | MEDLINE | ID: mdl-20859651

ABSTRACT

To assess the tolerability and efficacy of liposomal cytarabine (LC), an encapsulated, sustained-release, intrathecal (IT) formulation of cytosine arabinoside, in de novo and relapsed central nervous system (CNS) embryonal tumors in children and young adults. We studied retrospectively all patients less than age 30 at our institution treated consecutively with LC for medulloblastoma (MB), primitive neuroectodermal tumor (PNET), and atypical teratoid rhabdoid tumor (ATRT). Seventeen patients received LC (2 mg/kg up to 50 mg, every 2 weeks to monthly) at diagnosis of high-risk CNS embryonal tumor (2 PNET, 3 ATRT) or relapse of MB (12 MB; 9 had leptomeningeal metastases). Sixteen patients received concurrent systemic chemotherapy. A total of 108 doses were administered (IT 82, intraventricular 26) with a mean of six (range 1-16) treatments per patient. Only three administrations were associated with adverse effects of arachnoiditis or headache. None developed malignant cerebrospinal fluid (CSF) cytology while receiving LC. All the six evaluable patients with malignant CSF cytology and treated with at least two doses cleared their CSF (mean 3 doses, range 1-5). Median overall survival in relapse patients was 9.1 months. Five patients (4 de novo and 1 relapsed) remain alive in complete remission for a median 26.8 months from first LC. Liposomal cytarabine is an easily administered, well-tolerated, and active drug in patients with high-risk embryonal neoplasms. One-third of our cohort remains in remission from otherwise fatal diagnoses. Our findings warrant a phase II trial of LC in newly diagnosed or recurrent CNS embryonal tumors.


Subject(s)
Antimetabolites, Antineoplastic/administration & dosage , Central Nervous System Neoplasms/drug therapy , Cytarabine/administration & dosage , Neoplasms, Germ Cell and Embryonal/drug therapy , Adolescent , Adult , Antimetabolites, Antineoplastic/cerebrospinal fluid , Central Nervous System Neoplasms/cerebrospinal fluid , Central Nervous System Neoplasms/mortality , Child , Child, Preschool , Female , Humans , Infant , Kaplan-Meier Estimate , Liposomes/administration & dosage , Magnetic Resonance Imaging , Male , Neoplasms, Germ Cell and Embryonal/cerebrospinal fluid , Neoplasms, Germ Cell and Embryonal/mortality , Young Adult
11.
Int J Mol Sci ; 12(11): 8119-32, 2011.
Article in English | MEDLINE | ID: mdl-22174654

ABSTRACT

Elemental uptake and export of the cell are tightly regulated thereby maintaining the ionomic homeostasis. This equilibrium can be disrupted upon exposure to exogenous reactive oxygen species (ROS), leading to reduction or elevation of the intracellular metal ions. In this study, the ionomic composition in the eukaryotic model organism Saccharomyces cerevisiae was profiled using the inductively-coupled plasma optical emission spectrometer (ICP-OES) following the treatment with individual ROS, including hydrogen peroxide, cumen hydroperoxide, linoleic acid hydroperoxide (LAH), the superoxide-generating agent menadione, the thiol-oxidising agent diamide [diazine-dicarboxylic acid-bis(dimethylamide)], dimedone and peroxynitrite. The findings demonstrated that different ROS resulted in distinct changes in cellular metal ions. Aluminium (Al(3+)) level rose up to 50-fold after the diamide treatment. Cellular potassium (K(+)) in LAH-treated cells was 26-fold less compared to the non-treated controls. The diamide-induced Al(3+) accumulation was further validated by the enhanced Al(3+) uptake along the time course and diamide doses. Pre-incubation of yeast with individual elements including iron, copper, manganese and magnesium failed to block diamide-induced Al(3+) uptake, suggesting Al(3+)-specific transporters could be involved in Al(3+) uptake. Furthermore, LAH-induced potassium depletion was validated by a rescue experiment in which addition of potassium increased yeast growth in LAH-containing media by 26% compared to LAH alone. Taken together, the data, for the first time, demonstrated the linkage between ionomic profiles and individual oxidative conditions.


Subject(s)
Aluminum/metabolism , Ions/metabolism , Oxidative Stress , Reactive Oxygen Species/pharmacology , Saccharomyces cerevisiae/drug effects , Saccharomyces cerevisiae/growth & development , Benzene Derivatives/pharmacology , Copper/metabolism , Cyclohexanones/pharmacology , Diamide/pharmacology , Hydrogen Peroxide/pharmacology , Linoleic Acids/pharmacology , Lipid Peroxides/pharmacology , Magnesium/metabolism , Manganese/metabolism , Models, Molecular , Oxidants/pharmacology , Peroxynitrous Acid/pharmacology , Potassium/metabolism , Vitamin K 3/pharmacology
12.
Pharm Biol ; 47(8): 774-782, 2009.
Article in English | MEDLINE | ID: mdl-19907671

ABSTRACT

The Iowa Center for Research on Botanical Dietary Supplements seeks to optimize Echinacea, Hypericum, and Prunella botanical supplements for human-health benefit, emphasizing antiviral, anti-inflammatory and anti-pain activities. This mini-review reports on ongoing studies on Hypericum. The Center uses the genetically diverse, well-documented Hypericum populations collected and maintained at the USDA-ARS North Central Regional Plant Introduction Station (NCRPIS), and the strength of research in synthetic chemistry at Iowa State University to tap natural diversity, to help discover key constituents and interactions among constituents that impact bioactivity and toxicity. The NCRPIS has acquired more than 180 distinct populations of Hypericum, with a focus on Hypericum perforatum L. (Hypericaceae), representing about 13% of currently recognized taxa. Center chemists have developed novel synthetic pathways for key flavones, acyl phloroglucinols, hyperolactones and a tetralin that have been found in Hypericum, and these compounds are used as standards and for bioactivity studies. Both light-dependent and light-independent anti-viral activities have been identified by using bioactivity-guided fractionation of H. perforatum and a HIV-1 infection test system. Our Center has focused on light-independent activity, potentially due to novel chemicals, and polar fractions are undergoing further fractionation. Anti-inflammatory activity has been found to be light-independent, and fractionation of a flavonoid-rich extract revealed four compounds (amentoflavone, chlorogenic acid, pseudohypericin and quercetin) that interacted in the light to inhibit lipopolysaccharide-induced prostaglandin E(2) activity. The Center continues to explore novel populations of H. perforatum and related species to identify constituents and interactions of constituents that contribute to potential health benefits related to infection.

13.
Phys Med Rehabil Clin N Am ; 30(3): 589-598, 2019 08.
Article in English | MEDLINE | ID: mdl-31227134

ABSTRACT

This article discusses measuring quality of life (QOL) loss in litigation. Case examples are provided. The complexity challenge in QOL assessment is more easily addressed since the advent of computer adaptive testing, which is used by physicians and rehabilitationists in the administration of psychometric instruments to determine QOL loss. It is now possible to write algorithms to capture QOL data through text-mining. If QOL domains and their factors could be accessed through text-mining, it would make for an extraordinary opportunity for much needed doctoral level research in QOL issues for injured workers in workers' compensation programs.


Subject(s)
Jurisprudence , Quality of Life , Accidents, Traffic , Adult , Crime Victims , Disabled Persons/legislation & jurisprudence , Disabled Persons/psychology , Female , Humans , Male , Models, Theoretical , Sex Determination Analysis , United States , United States Social Security Administration
14.
Am J Clin Nutr ; 87(2): 488S-92S, 2008 Feb.
Article in English | MEDLINE | ID: mdl-18258644

ABSTRACT

Ongoing studies have developed strategies for identifying key bioactive compounds and chemical profiles in Echinacea with the goal of improving its human health benefits. Antiviral and antiinflammatory-antipain assays have targeted various classes of chemicals responsible for these activities. Analysis of polar fractions of E. purpurea extracts showed the presence of antiviral activity, with evidence suggesting that polyphenolic compounds other than the known HIV inhibitor, cichoric acid, may be involved. Antiinflammatory activity differed by species, with E. sanguinea having the greatest activity and E. angustifolia, E. pallida, and E. simulata having somewhat less. Fractionation and studies with pure compounds indicate that this activity is explained, at least in part, by the alkamide constituents. Ethanol extracts from Echinacea roots had potent activity as novel agonists of TRPV1, a mammalian pain receptor reported as an integrator of inflammatory pain and hyperalgesia and a prime therapeutic target for analgesic and antiinflammatory drugs. One fraction from E. purpurea ethanol extract was bioactive in this system. Interestingly, the antiinflammatory compounds identified to inhibit prostaglandin E(2) production differed from those involved in TRPV1 receptor activation.


Subject(s)
Analgesics, Non-Narcotic/pharmacology , Anti-Inflammatory Agents/pharmacology , Antiviral Agents/pharmacology , Echinacea , Animals , Anti-HIV Agents/pharmacology , Flavonoids/pharmacology , Humans , Nonprescription Drugs/pharmacology , Phenols/pharmacology , Phytotherapy , Plant Roots , Plants, Medicinal , Polyphenols , TRPV Cation Channels/agonists
15.
J Agric Food Chem ; 56(5): 1766-71, 2008 Mar 12.
Article in English | MEDLINE | ID: mdl-18251501

ABSTRACT

Oleosomes, with their unique structural proteins, the oleosins, are known to be useful in cosmetics and other emulsion applications. A procedure to fractionate intact oleosomes to produce soybean oil without the use of organic solvents was investigated. Process parameters, enzyme treatment, filtration, cell lysis, and centrifugation, were studied. Successive extractions of the residue, eliminating the filtration step, pressurization, or ultrasonication of soybean flour prior to enzyme treatment and enzyme treatment on the residue, were the key steps. A mixture of Multifect Pectinase FE, Cellulase A, and Multifect CX 13L in equal proportion gave 36.42-63.23% of the total soybean oil from oleosomes, respectively, for 45 and 180 s of blending time, compared to the conventional method with lower yields (34.24 and 28.65%, respectively, for 45 and 180 s of blending time). Three successive extractions of the residue increased the oil yield to a maximum of 84.65% of the total soybean oil recovered in intact oleosomes. The percentage of lipid in the supernatant fraction decreased to a minimum value of 0.33% with the use of the enzymes at a 3% dosage. The results are considered to be useful for developing large-scale and efficient extraction of oleosomes from soybean.


Subject(s)
Glycine max/chemistry , Soybean Oil , Soybean Proteins/isolation & purification , Soybean Proteins/metabolism , Cellulase/metabolism , Flour , Glycoside Hydrolases/metabolism , Membrane Proteins , Plant Proteins , Polygalacturonase/metabolism
16.
J Trauma ; 64(6): 1587-93, 2008 Jun.
Article in English | MEDLINE | ID: mdl-18545128

ABSTRACT

BACKGROUND: Ten percent to 20% of trauma patients admitted to the intensive care unit (ICU) will die from their injuries. Providing appropriate end-of-life care in this setting is difficult and often late in the patients' course. Patients are young, prognosis uncertain, and conflict common around goals of care. We hypothesized that early, structured communication in the trauma ICU would improve end-of-life care practice. METHODS: Prospective, observational, prepost study on consecutive trauma patients admitted to the ICU before and after a structured palliative care intervention was integrated into standard ICU care. The program included part I, early (at admission) family bereavement support, assessment of prognosis, and patient preferences, and part II (within 72 hours) interdisciplinary family meeting. Data on goals of care discussions, do-not-resuscitate (DNR) orders and withdrawal of life support (W/D) were collected from physician rounds, family meetings, and medical records. RESULTS: Eighty-three percent of patients received part I and 69% part II intervention. Discussion of goals of care by physicians on rounds increased from 4% to 36% of patient-days. During intervention, rates of mortality (14%), DNR (43%), and W/D (24%) were unchanged, but DNR orders and W/D were instituted earlier in hospital course. ICU length of stay was decreased in patients who died. CONCLUSIONS: Structured communication between physician and families resulted in earlier consensus around goals of care for dying trauma patients. Integration of early palliative care alongside aggressive trauma care can be accomplished without change in mortality and has the ability to change the culture of care in the trauma ICU.


Subject(s)
Critical Care/standards , Intensive Care Units/standards , Life Support Care/standards , Palliative Care/standards , Wounds and Injuries/therapy , Adolescent , Adult , Aged , Analysis of Variance , Attitude of Health Personnel , Critical Care/trends , Critical Illness/mortality , Critical Illness/therapy , Decision Making , Female , Forecasting , Hospital Mortality/trends , Humans , Intensive Care Units/trends , Life Support Care/trends , Logistic Models , Male , Middle Aged , Palliative Care/trends , Physician-Patient Relations , Professional-Family Relations , Prospective Studies , Resuscitation Orders , Risk Assessment , Statistics, Nonparametric , Survival Analysis , Trauma Centers , Wounds and Injuries/diagnosis , Wounds and Injuries/mortality
17.
J Interferon Cytokine Res ; 27(5): 425-36, 2007 May.
Article in English | MEDLINE | ID: mdl-17523874

ABSTRACT

Echinacea spp. phytomedicines are popular for treating upper respiratory infections. The purpose of this investigation was to examine the immunomodulatory properties of Echinacea tinctures from seven species after being stored at -20 degrees C for 2 years. Two experimental techniques were employed using human peripheral blood mononuclear cells (PBMC). In the first set of experiments, PBMCs were stimulated in vitro with tinctures alone and assayed for proliferation and production of interleukin-10 (IL-10), IL-12, and tumor necrosis factor-alpha (TNF-alpha). In the second set of experiments, subjects were immunized with influenza vaccine. PBMCs from vaccinated individuals were stimulated in vitro with Echinacea tinctures and influenza virus; cytokine production (IL-2, IL-10, and interferon-gamma [IFN-gamma]) was compared prevaccination and postvaccination. In the first experiments, (1) tinctures from E. angustifolia, E. pallida, E. paradoxa, and E. tennesseensis stimulated proliferation and tended to increase IL-10, (2) E. sanguinea and E. simulata stimulated only proliferation, (3) E. purpurea stimulated only IL-10, and (4) none of the extracts influenced IL-12 or TNF-alpha. In the second experiments, (1) tinctures from E. pallida, E. paradoxa, E. sanguinea, and E. simulata diminished influenza-specific IL-2, and (2) none of the extracts influenced influenza-specific IL-10 or IFN-gamma. For in vitro models using Echinacea, immune response may vary based on stimulus (Echinacea alone vs. Echinacea + recall stimulation with virus).


Subject(s)
Cryopreservation , Cytokines/biosynthesis , Echinacea/anatomy & histology , Interferon-gamma/metabolism , Plant Extracts/pharmacology , Alcohols/chemistry , Alcohols/classification , Cell Proliferation/drug effects , Cells, Cultured , Cytokines/metabolism , Drug Storage , Echinacea/genetics , Humans , Interleukin-10/biosynthesis , Interleukin-12/metabolism , Leukocytes, Mononuclear/drug effects , Leukocytes, Mononuclear/physiology , Plant Roots/chemistry , Species Specificity , Time Factors , Tumor Necrosis Factor-alpha/metabolism
18.
Methods Enzymol ; 430: 397-408, 2007.
Article in English | MEDLINE | ID: mdl-17913646

ABSTRACT

Protein synthesis initiation factors from wheat germ were cloned into E. coli expression vectors for expression and purification. The ability to obtain large amounts of functional initiation factors and mutants of the factors will facilitate the biophysical and biochemical analysis of the process of initiation in plants. The initiation factors, eIF1, eIF1A, eIF4A, eIF4B, eIF4F, eIF(iso)4F, and eIF5, were successfully expressed and purified from E. coli. In most cases, the use of 6X-histidine tags was avoided to prevent any possible artifacts of folding or activity because of the presence of the tag. The amounts of highly purified wheat initiation factors obtained ranged from 0.5 to 24mg of protein per liter of culture, depending on the particular initiation factor. The initiation factors were of very high purity, and the activities of the wheat recombinant factors purified from E. coli were found to be comparable to or better than those purified from wheat germ.


Subject(s)
Eukaryotic Initiation Factors , Plant Proteins , Recombinant Proteins , Triticum , Animals , Eukaryotic Initiation Factors/chemistry , Eukaryotic Initiation Factors/genetics , Eukaryotic Initiation Factors/metabolism , Plant Proteins/chemistry , Plant Proteins/genetics , Plant Proteins/metabolism , Protein Biosynthesis , Rabbits , Recombinant Proteins/chemistry , Recombinant Proteins/genetics , Recombinant Proteins/metabolism , Triticum/chemistry , Triticum/genetics
19.
J Agric Food Chem ; 55(1): 120-6, 2007 Jan 10.
Article in English | MEDLINE | ID: mdl-17199322

ABSTRACT

Degradation of the major alkamides in E. purpurea extracts was monitored under four different accelerated storage conditions, phenolic-depleted and phenolic-rich dry E. purpurea extracts and phenolic-depleted and phenolic-rich DMSO E. purpurea extracts at 70, 80, and 90 degrees C. Degradation of alkamides followed apparent first-order reaction rate kinetics. Alkamides degraded faster in dry films than in DMSO solution. The phenolic acids acted as antioxidants by limiting the loss of the alkamides in dry E. purpurea extracts. In contrast, E. purpurea alkamides in DMSO degraded faster when the phenolic fraction was absent. The overall order of degradation rate constants was alkamides 1 approximately 2 approximately 6 > 9 approximately 8 > 3 approximately 5 approximately 7. The energy of activation (Ea) predicted for alkamide degradation averaged 101 +/- 12 kJ/mol in dry films +/- phenolic acids, suggesting the oxidation mechanism was the same under both conditions. In DMSO solutions, Ea values were about one-half of those in dry films (61 +/- 14 kJ/mol), suggesting a different mechanism for alkamide oxidation in solution compared to dry. Predicted half-lives for alkamides in extracts suggested very good stability.


Subject(s)
Echinacea/chemistry , Hydroxybenzoates/chemistry , Plant Extracts/chemistry , Polyunsaturated Alkamides/chemistry , Dimethyl Sulfoxide , Drug Stability , Kinetics , Oxidation-Reduction , Solutions , Thermodynamics
20.
J Agric Food Chem ; 55(26): 11063-7, 2007 Dec 26.
Article in English | MEDLINE | ID: mdl-18038972

ABSTRACT

The soybean isoflavones, daidzein, genistein, and glycitein, were hypothesized to act as cholesterol-lowering components, separate from soy protein. Pure synthetic daidzein, genistein, or glycitein (0.9 mmol/kg diet) or a casein-based control diet was fed to groups of 10 female Golden Syrian hamsters for 4 weeks. Hamsters fed glycitein had significantly lower plasma total (by 15%) and non-HDL (by 24%) cholesterol compared with those fed casein (P<0.05). Daidzein and genistein's effects on these lipids did not differ from the effects of either casein or glycitein. Plasma HDL cholesterol and triglyceride concentrations were not significantly affected by dietary treatments. The percentage of urinary recovery of the ingested dose of each isoflavone was glycitein>daidzein>genistein (33.2%, 4.6%, 2.2%, respectively), with the apparent absorption of glycitein significantly greater than that of the other isoflavones. These data suggest that glycitein's greater cholesterol-lowering effect was due to its greater bioavailability, as reflected in its urinary recovery compared with that of the other isoflavones.


Subject(s)
Cholesterol/blood , Isoflavones/administration & dosage , Animals , Biological Availability , Cholesterol, HDL/blood , Cholesterol, LDL/blood , Cricetinae , Diet , Female , Genistein/administration & dosage , Genistein/pharmacokinetics , Isoflavones/pharmacokinetics , Mesocricetus , Triglycerides/blood
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