Abiraterone acetate treatment lowers 11-oxygenated androgens.

CONTEXT: The human adrenal is the dominant source of androgens in castration-resistant prostate cancer (CRPC) and classic 21-hydroxylase deficiency (21OHD). Abiraterone, derived from the prodrug abiraterone acetate (AA), inhibits the activity of cytochrome P450 17-hydroxylase/17,20-lyase (CYP17A1), the enzyme required for all androgen biosynthesis. AA treatment effectively lowers testosterone and androstenedione in 21OHD and CRPC patients. The 11-oxygenated androgens are major adrenal-derived androgens, yet little is known regarding the effects of AA administration on 11-oxygenated androgens. OBJECTIVE: To test the hypothesis that AA therapy decreases 11-oxygenated androgens. DESIGN: Samples were obtained from 21OHD or CRPC participants in AA or AA plus prednisone (AAP)-treatment studies, respectively. METHODS: We employed liquid chromatography-tandem mass spectrometry (LC-MS/MS) to measure the 11-oxygenated androgens, 11ß-hydroxyandrostenedione, 11-ketoandrostenedione, 11ß-hydroxytestosterone, and 11-ketotestosterone, in plasma or serum samples from six 21OHD and six CRPC patients before and after treatment with AA or AAP, respectively. RESULTS: In CRPC patients, administration of AAP (1000 mg/day AA with prednisone and medical castration) lowered all four 11-oxygenated androgens to below the lower limits of quantitation (<0.1-0.3 nmol/L), equivalent to 64-94% reductions from baseline. In 21OHD patients, administration of AA (100-250 mg/day for 6 days) reduced all 11-oxygenated androgens by on average 56-77% from baseline. CONCLUSIONS: We conclude that AA and AAP therapies markedly reduce the production of the adrenal-derived 11-oxygenated androgens, both in patients with high (21OHD) or normal (CRPC) 11-oxygenated androgens at baseline, respectively. Reduction of 11-oxygenated androgens is an important aspect of AA and AAP pharmacology.

Public knowledge and awareness about Parkinson's disease in Saudi Arabia.

BACKGROUND: Parkinson's disease (PD) is one of the most prevalent neurologic disorders, leading to progressive disability that can be slowed but not stopped by treatment. It is characterized by tremors, slow movements, stiffness in arms and legs, and balance impairment. Despite advancement in treatment, diagnosis, and care of PD patients, lack of adequate knowledge and associated beliefs among the community might have a key role in limiting access to proper treatment and care. OBJECTIVES: To identify the level of awareness of our population regarding PD in terms of causes, signs, symptoms, and treatment. MATERIALS AND METHODS: A cross-sectional study was conducted on Saudis, who have active Twitter accounts. Data were collected through a previously validated questionnaire, which tests recognition of PD symptoms and general knowledge regarding PD. The questionnaire was translated into Arabic. Part 1 of the questionnaire is the demographic data collection sheet, Part 2 of the questionnaire tests recognition of PD symptoms, and Part 3 of the questionnaire tests general knowledge regarding PD. RESULTS: The questionnaire was administered to 3,050 members of the public, of which 2,609 questionnaires (86.20%) were included in the analysis. The tremor was the most widely recognized symptom (86.10%), and weight loss was the most recognized non-motor symptom (24%). Most respondents (56%) were able to identify imbalance as a symptom of PD, whereas only 4.10% of them were able to identify the reduced sense of smell as a symptom of PD. Motor symptoms were significantly better recognized (range 31.30%-86.10%) than non-motor symptoms (range 4.10%-24%). CONCLUSION: Educational campaigns may be appropriate to improve public awareness of PD and individual knowledge about PD symptoms and treatment.