Geographical and temporal assessment of the photochemical decontamination potential of river waters from agrochemicals: A first application to the Piedmont region (NW Italy).

This work shows the potential of using photochemical modelling to assess the river-water ability to photodegrade agrochemicals on a geographic and temporal scale. The case of flowing water requires different data treatment compared to more stationary water bodies (e.g., lakes), but it could allow for the identification of particularly vulnerable environments. Five pesticides were considered here, and the photodegradation rate followed the order bentazon > isoproturon > dimethomorph âˆ¼ chlortoluron > atrazine. The modelled photodegradation kinetics was particularly fast in the river Po, which receives significant input of agricultural nitrate from groundwater and features higher steady-state [•OH] than most other rivers in the region. The fact that the Po eventually collects all river waters in Piedmont is positive, from the point of view of comprehensive photodegradation of pesticides. However, this paradoxical situation of agricultural pollution (nitrate) helping fight pollution from the same source (pesticides) has two important limitations: (i) when compared to the parent compounds, some intermediates deriving from •OH reactions are either more harmful (N-formyl derivatives of phenylureas), or about as harmful (desethyl atrazine); (ii) banned atrazine is no longer sprayed over fields during the plant growth season, but it reaches surface waters from legacy groundwater inputs. The latter are operational also during winter, when photochemistry is least active. Therefore, photochemistry might not ensure considerable attenuation of atrazine during wintertime. Overall, bentazon would be the safest among the studied pesticides because of fast degradation by direct photolysis, and of low ecotoxicological impact of its phototransformation intermediates.

Environmental photodegradation of emerging contaminants: A re-examination of the importance of triplet-sensitised processes, based on the use of 4-carboxybenzophenone as proxy for the chromophoric dissolved organic matter.

The photoreactions sensitised by the excited triplet states of chromophoric dissolved organic matter (3CDOM*) are very important in the photochemical attenuation of emerging contaminants in natural waters. Until quite recently, anthraquinone-2-sulphonate (AQ2S) was the only available CDOM proxy molecule to estimate the contaminant reaction kinetics with 3CDOM*, under steady-state irradiation conditions. Unfortunately, the AQ2S triplet state (3AQ2S*) is considerably more reactive than average 3CDOM*. We have recently developed an alternative protocol based on 4-carboxybenzophenone (CBBP), the triplet state of which (3CBBP*) is less reactive compared to 3AQ2S*. Here we show that in the case of ibuprofen (IBP), paracetamol (APAP) and clofibric acid (CLO), the reaction rate constants with 3CBBP* are more reasonable as 3CDOM* reactivity estimates than those obtained by using AQ2S. In contrast, similar rate constants are measured for the reaction of atrazine (ATZ) with either 3AQ2S* or 3CBBP*. Moreover, the reactivity of ATZ with both 3AQ2S* and 3CBBP* is very similar to that with 3CDOM*, available through a literature estimate. The possibility to validate the ATZ-3CBBP* reactivity estimate against the 3CDOM* data, and to accurately predict the reported IBP and CLO field lifetime, support the suitability of CBBP as CDOM proxy. The replacement of AQ2S with CBBP as proxy molecule does not reverse the qualitative prediction, according to which 3CDOM* would be the main process involved in the photodegradation of the studied contaminants in waters with high dissolved organic carbon (DOC). However, the CBBP-based data prompt for an important reconsideration of the estimated lifetimes at high DOC.

TOSCA - first international registry to address knowledge gaps in the natural history and management of tuberous sclerosis complex.

BACKGROUND: Tuberous sclerosis complex (TSC) is a rare, multisystem, genetic disorder with an estimated prevalence between 1/6800 and 1/15000. Although recent years have seen huge progress in understanding the pathophysiology and in the management of TSC, several questions remain unanswered. A disease registry could be an effective tool to gain more insights into TSC and thus help in the development of improved management strategies. METHODS: TuberOus SClerosis registry to increase disease Awareness (TOSCA) is a multicentre, international disease registry to assess manifestations, interventions, and outcomes in patients with TSC. Patients of any age diagnosed with TSC, having a documented visit for TSC within the preceding 12 months, or newly diagnosed individuals are eligible. Objectives include mapping the course of TSC manifestations and their effects on prognosis, identifying patients with rare symptoms and co-morbidities, recording interventions and their outcomes, contributing to creation of an evidence-base for disease assessment and therapy, informing further research on TSC, and evaluating the quality of life of patients with TSC. The registry includes a 'core' section and subsections or 'petals'. The 'core' section is designed to record general information on patients' background collected at baseline and updated annually. Subsections will be developed over time to record additional data related to specific disease manifestations and will be updated annually. The registry aimed to enrol approximately 2000 patients from about 250 sites in 31 countries. The initial enrolment period was of 24 months. A follow-up observation period of up to 5 years is planned. RESULTS: A pre-planned administrative analysis of 'core' data from the first 100 patients was performed to evaluate the feasibility of the registry. Results showed a high degree of accuracy of the data collection procedure. Annual interim analyses are scheduled. Results of first interim analysis will be presented subsequent to data availability in 2014. IMPLICATIONS: The results of TOSCA will assist in filling the gaps in understanding the natural history of TSC and help in planning better management and surveillance strategies. This large-scale international registry to study TSC could serve as a model to encourage planning of similar registries for other rare diseases.

Influence of pharmacogenetic variability on the pharmacokinetics and toxicity of the aurora kinase inhibitor danusertib.

OBJECTIVES: Danusertib is a serine/threonine kinase inhibitor of multiple kinases, including aurora-A, B, and C. This explorative study aims to identify possible relationships between single nucleotide polymorphisms in genes coding for drug metabolizing enzymes and transporter proteins and clearance of danusertib, to clarify the interpatient variability in exposure. In addition, this study explores the relationship between target receptor polymorphisms and toxicity of danusertib. METHODS: For associations with clearance, 48 cancer patients treated in a phase I study were analyzed for ABCB1, ABCG2 and FMO3 polymorphisms. Association analyses between neutropenia and drug target receptors, including KDR, RET, FLT3, FLT4, AURKB and AURKA, were performed in 30 patients treated at recommended phase II dose-levels in three danusertib phase I or phase II trials. RESULTS: No relationships between danusertib clearance and drug metabolizing enzymes and transporter protein polymorphisms were found. Only, for the one patient with FMO3 18281AA polymorphism, a significantly higher clearance was noticed, compared to patients carrying at least 1 wild type allele. No effect of target receptor genotypes or haplotypes on neutropenia was observed. CONCLUSIONS: As we did not find any major correlations between pharmacogenetic variability in the studied enzymes and transporters and pharmacokinetics nor toxicity, it is unlikely that danusertib is highly susceptible for pharmacogenetic variation. Therefore, no dosing alterations of danusertib are expected in the future, based on the polymorphisms studied. However, the relationship between FMO3 polymorphisms and clearance of danusertib warrants further research, as we could study only a small group of patients.

A phase I dose-escalation study of danusertib (PHA-739358) administered as a 24-hour infusion with and without granulocyte colony-stimulating factor in a 14-day cycle in patients with advanced solid tumors.

PURPOSE: This study was conducted to assess the safety, tolerability, pharmacokinetics, and pharmacodynamics of the i.v. pan-aurora kinase inhibitor PHA-739358, danusertib, in patients with advanced solid tumors. EXPERIMENTAL DESIGN: In part 1, patients received escalating doses of danusertib (24-hour infusion every 14 days) without filgrastim (granulocyte colony-stimulating factor, G-CSF). Febrile neutropenia was the dose-limiting toxicity without G-CSF. Further dose escalation was done in part 2 with G-CSF. Blood samples were collected for danusertib pharmacokinetics and pharmacodynamics. Skin biopsies were collected to assess histone H3 phosphorylation (pH3). RESULTS: Fifty-six patients were treated, 40 in part 1 and 16 in part 2. Febrile neutropenia was the dose-limiting toxicity in part 1 without G-CSF. Most other adverse events were grade 1 to 2, occurring at doses >or=360 mg/m(2) with similar incidence in parts 1 and 2. The maximum tolerated dose without G-CSF is 500 mg/m(2). The recommended phase 2 dose in part 2 with G-CSF is 750 mg/m(2). Danusertib showed dose-proportional pharmacokinetics in parts 1 and 2 with a median half-life of 18 to 26 hours. pH3 modulation in skin biopsies was observed at >or=500 mg/m(2). One patient with refractory small cell lung cancer (1,000 mg/m(2) with G-CSF) had an objective response lasting 23 weeks. One patient with refractory ovarian cancer had 27% tumor regression and 30% CA125 decline. CONCLUSIONS: Danusertib was well tolerated with target inhibition in skin at >or=500 mg/m(2). Preliminary evidence of antitumor activity, including a partial response and several occurrences of prolonged stable disease, was seen across a variety of advanced refractory cancers. Phase II studies are ongoing.