A PAI-1 antagonist ameliorates hypophosphatemia in the Hyp vitamin D-resistant rickets model mouse.

Congenital fibroblast growth factor 23 (FGF23)-related hypophosphatemic rickets/osteomalacia is a rare bone metabolism disorder characterized by hypophosphatemia and caused by genetic abnormalities that result in excessive secretion of FGF23. Hyp mice are a model of X-linked hypophosphatemia (XLH) caused by deletion of the PHEX gene and excessive production of FGF23. The purpose of this study was to investigate the potential of TM5614 as a therapeutic agent for the treatment of congenital FGF23-related hypophosphatemic rickets and osteomalacia in humans by administering TM5614 to Hyp mice and examining its curative effect on hypophosphatemia. After a single oral administration of TM5614 10 mg·kg-1 to female Hyp mice starting at 17 weeks of age, the serum phosphate concentration increased with a peak at 6 h after administration. ELISA confirmed that TM5614 administration decreased the intact FGF23 concentration in the blood. Expression of 25-hydroxyvitamin D-1α-hydroxylase protein encoded by Cyp27b1 mRNA in the kidney was suppressed in Hyp mice, and treatment with 10 mg·kg-1 of TM5614 normalized the expression of 25-hydroxyvitamin D-1α-hydroxylase protein and Cyp27b1 mRNA in the kidneys of these mice. Our data indicate that oral administration of TM5614 ameliorates hypophosphatemia in Hyp mice, suggesting that TM5614 may be an effective treatment for congenital FGF23-related hypophosphatemic rickets and osteomalacia.

Literature review of the role of hydroxyl radicals in chemically-induced mutagenicity and carcinogenicity for the risk assessment of a disinfection system utilizing photolysis of hydrogen peroxide.

We have developed a new disinfection system for oral hygiene, proving that hydroxyl radicals generated by the photolysis of 1 M hydrogen peroxide could effectively kill oral pathogenic microorganisms. Prior to any clinical testing, the safety of the system especially in terms of the risk of carcinogenicity is examined by reviewing the literature. Previous studies have investigated indirectly the kinds of reactive oxygen species involved in some sort of chemically-induced mutagenicity in vitro by using reactive oxygen species scavengers, suggesting the possible involvement of hydroxyl radicals. Similarly, possible involvement of hydroxyl radicals in some sort of chemically-induced carcinogenicity has been proposed. Notably, it is suggested that the hydroxyl radical can play a role in heavy metal-induced carcinogenicity that requires chronic exposure to the carcinogen. In these cases, hydroxyl radicals produced by Fenton-like reactions may be involved in the carcinogenicity. Meanwhile, potential advantages have been reported on the use of the hydroxyl radical, being included in host immune defense by polymorphonuclear leukocytes, and medical applications such as for cancer treatment and antibiotics. From these, we conclude that there would seem to be little to no risk in using the hydroxyl radical as a disinfectant for short-term treatment of the oral cavity.

New era for drug discovery and development in renal disease.

Drug discovery and development is a lengthy and expensive process. Testing new agents in humans at an early stage could reduce the time and costs involved in identifying drugs that are likely to succeed in clinical studies. New guidance has outlined the concept of exploratory clinical trials, which provide important information on a drug's distribution as well as its physiological and pharmacological effects in humans. This strategy reduces the need for preclinical testing by limiting the dose and duration of exposure to a new drug in humans to below those required by the traditional testing of investigational new drugs. Exploratory, first-in-man studies should provide insights into human physiology and pharmacology, identify therapeutic targets relevant to disease and increase our knowledge of a drug's characteristics. Implementation of a new drug also requires the development of useful biomarkers of disease and of the drug's efficacy, as well as sensitive molecular imaging techniques. In this Review, we outline the benefits of exploratory clinical trials, especially in academia, and provide an overview of the experimental tools necessary for rational drug discovery and development.