Severe Paraproteinemic Demyelinating Neuropathy With Impaired Excitability of the Distal Segments of the Peripheral Nerves.

ABSTRACT: We report clinical and detailed nerve conduction findings in case of polyneuropathy associated with kappa light chains monoclonal gammopathy of undetermined significance with progression to lymphoproliferative disorder. A 55-year-old man had a predominantly distal, chronic (5 years duration), slowly progressive, symmetric, predominantly sensory impairment with sensory ataxia, and mild weakness. M protein was identified by serum protein electrophoresis. The kappa/lambda ratio of free light chains was significantly elevated to 11.96. The cerebrospinal fluid protein level was elevated at 3.5 g/L. This case study has revealed 2 unusual electrophysiological phenomena-a very unusual prolongation of distal motor latencies of compound muscle action potentials (CMAP) up to 86.5 ms and impaired excitability of the distal segments of the peripheral nerves. The distal CMAP areas were considerably lower compared with the proximal CMAP areas. Radiography of the skull revealed osteolytic lesions.

Radial motor nerve conduction studies in the upper arm.

INTRODUCTION: The main goal of this study was to determine the contribution of the anterior forearm muscles to the compound muscle action potential (CMAP) recorded from the extensor digitorum (ED) after proximal stimulation. METHODS: Twenty-one healthy volunteers and 114 patients with compressive and traumatic radial neuropathies were examined. Stimulation was carried out at six different points: distal third of the upper arm; Erb's point; axilla; medial upper arm; antecubital fossa; and ulnar groove. RESULTS: In the control group, Erb's CMAP area was significantly greater than the distal CMAP area. In compressive neuropathy, there was conduction block, but no change in conduction velocity. There were no differences in Erb's CMAP latencies between the control group and the neuropathies group. DISCUSSION: CMAPs recorded over the ED with stimulation at the brachial plexus represent the sum of the motor unit action potentials of the posterior and anterior forearm muscles.

Effect of PEGylation on the biological properties of cationic carbosilane dendronized gold nanoparticles.

Heterofunctionalized gold nanoparticles (AuNPs) were obtained in a one pot reaction of gold precursor with cationic carbosilane dendrons (first to third generations, 1-3G) and (polyethylene)glycol (PEG) ligands in the presence of a reducing agent. The final dendron/PEG proportion on AuNPs depends on the initial dendron/PEG ratio (3/1, 1/1, 1/3) and dendron generation. AuNPs were characterized by transmission electron microscopy (TEM), dynamic light scattering (DLS), ultraviolet spectroscopy (UV-VIS), thermogravimetric analysis (TGA), nuclear magnetic resonance (1H NMR) and zeta potential (ZP). Several assays have been carried out to determine the relevance of PEG/dendron ratio and dendron generation in the biomedical properties of PEGylated AuNPs and the results have been compared with those obtained for non-PEGylated AuNPs. Finally, analyses of PEG recognition by anti-PEG antibodies were carried out. In general, haemolysis, platelet aggregation and toxicity were reduced after PEGylation of AuNPs, the effect being dependent on dendron generation and dendron/PEG ratio. Dendron generation determines the exposure of PEG ligand and the interaction of this ligand with AuNPs environment. On the other hand, increasing PEG proportion diminishes toxicity but also favors interaction with antibodies.

Hybrid metal-organic nanoflowers and their application in biotechnology and medicine.

Nanoflowers - new nanostructures - have aroused the interest of scientists due to the topographic features of nanolayers, the special location of which allows a higher surface-to-volume ratio compared to classic spherical nanoparticles, which significantly increases the efficiency of surface reactions for nanoflowers. The main purpose of these types of nanomaterials is their use as enzyme stabilizers. To facilitate the functioning of enzymes under different conditions, organic-inorganic hybrid nanomaterials have been developed, the name of which indicates that all components of inorganic nanoparticles are associated with organic materials. These nanoparticles have many promising applications in catalysis, as biosensors, and for drug delivery. Organic-inorganic hybrid nanoflowers have led to the development of a new branch of chemistry - the chemistry of hybrid nanomaterials - in which research is rapidly developing. Thus, studying organic-inorganic hybrid nanocrystals can lead to creative new solutions in the field of chemistry of enzyme systems and the rapid development of bionanomaterials and new biotechnology industries. Present review focuses on wide biomedical applications of nanoflowers including biocatalysis, detection of substances, electrochemical biosensors based on nanoflowers, photosensitizers, drug and gene carriers and detection of various diseases, photothermal and other treatments. It will be interesting for wide range of scientists focusing in topic of new kinds of nanoparticles.

Dendrimer-protein interactions versus dendrimer-based nanomedicine.

Dendrimers are hyperbranched polymers belonging to the huge class of nanomedical devices. Their wide application in biology and medicine requires understanding of the fundamental mechanisms of their interactions with biological systems. Summarizing, electrostatic force plays the predominant role in dendrimer-protein interactions, especially with charged dendrimers. Other kinds of interactions have been proven, such as H-bonding, van der Waals forces, and even hydrophobic interactions. These interactions depend on the characteristics of both participants: flexibility and surface charge of a dendrimer, rigidity of protein structure and the localization of charged amino acids at its surface. pH and ionic strength of solutions can significantly modulate interactions. Ligands and cofactors attached to a protein can also change dendrimer-protein interactions. Binding of dendrimers to a protein can change its secondary structure, conformation, intramolecular mobility and functional activity. However, this strongly depends on rigidity versus flexibility of a protein's structure. In addition, the potential applications of dendrimers to nanomedicine are reviwed related to dendrimer-protein interactions.

Effect of dendrimers on selected enzymes--Evaluation of nano carriers.

In the field of nanotechnology, dendrimers represent a new class of highly branched macromolecules that is receiving a stimulating and rising interest. The structural organization of these synthetic macromolecules provides promising opportunities for using them as nano-carriers of drugs or gene material to be delivered to the target cells. For applications of dendrimers as drug carriers, analysis of their specific interactions with biological structures at molecular level is very important. This paper describes the molecular interactions between cationic phosphorus dendrimers of third and fourth generation (CPD G3 and CPD G4) and 3 plasma regulatory proteins, namely aspartate transaminase, alkaline phosphatase and l-lactic dehydrogenase. Dendrimer-protein interactions were studied using spectrofluorimetric, circular dichroism and dynamic light scattering techniques. Their morphology in the presence or absence of dendrimers was examined by transmission electron microscopy. The results suggest that both dendrimers form positively charged complexes with HIV-derived peptides. The circular dichroism spectra show that these dendrimers can significantly change the secondary structure of proteins, indicating formation of protein/dendrimer complexes.

Nanoparticle corona for proteins: mechanisms of interaction between dendrimers and proteins.

Protein absorption at the surface of big nanoparticles and formation of 'protein corona' can completely change their biological properties. In contrast, we have studied the binding of small nanoparticles - dendrimers - to proteins and the formation of their 'nanoparticle corona'. Three different types of interactions were observed. (1) If proteins have rigid structure and active site buried deeply inside, the 'nanoparticle corona' is unaffected. (2) If proteins have a flexible structure and their active site is also buried deeply inside, the 'nanoparticle corona' affects protein structure, but not enzymatic activity. (3) The 'nanoparticle corona' changes both the structure and enzymatic activity of flexible proteins that have surface-based active centers. These differences are important in understanding interactions taking place at a bio-nanointerface.

Anticancer siRNA cocktails as a novel tool to treat cancer cells. Part (B). Efficiency of pharmacological action.

This paper examines a perspective to use newly engineered nanomaterials as effective and safe carriers for gene therapy of cancer. Three different groups of cationic dendrimers (PAMAM, phosphorus, and carbosilane) were complexed with anticancer siRNA and the biophysical properties of the dendriplexes created were analyzed. The potential of the dendrimers as nanocarriers for anticancer Bcl-xl, Bcl-2, Mcl-1 siRNAs and additionally a scrambled sequence siRNA has been explored. Dendrimer/siRNA complexes were characterised by various methods including fluorescence, zeta potential, dynamic light scattering, circular dichroism, gel electrophoresis and transmission electron microscopy. In this part of study, the transfection of complexes in HeLa and HL-60 cells was analyzed using both single apoptotic siRNAs and a mixture (cocktail) of them. Cocktails were more effective than single siRNAs, allowing one to decrease siRNAs concentration in treating cells. The dendrimers were compared as siRNA carriers, the most effective being the phosphorus-based ones. However, they were also the most cytotoxic on their own, so that in this regard the application of all dendrimers in anticancer therapy will be discussed.

Phosphorus-containing nanoparticles: biomedical patents review.

INTRODUCTION: The beginning of the nano-era started with the appearance of artificial nanosized supramolecular systems called nanomaterials and nanoparticles (NPs). AREAS COVERED: In the present review, we have analyzed the patents on phosphorus-based nanomaterials (fullerenes, quantum dots [QDs], graphene, liposomes, dendrimers, gold and silver NPs) in biology and medicine. Their impact in treatment of cancer, viral infections and cardiovascular diseases is discussed. EXPERT OPINION: Liposomes and dendrimers had the highest number of biomedical patents. The third candidates were QDs and the fourth and fifth were gold and silver NPs. Fullerenes and carbon nanotubes have the fewest applications in biology and medicine. Thus, our first conclusion was about the 'unifying nanotoxicology paradigm', that 'soft' NPs are significantly more biocompatible than 'hard' NPs. There has been a trend of these nanomaterials being applied in medicine drug and gene delivery, visualization of cells and pathologic processes, using them as antivirals and antimicrobials, contrast agents, antioxidants and photosensitizers. It was unexpected that no patents were found in which phosphorus NPs were used in 3D printing of bones and other biological tissues. The conclusion reached is that nanomaterials are promising tools in future medical applications.

Interference of cationic polymeric nanoparticles with clinical chemistry tests--clinical relevance.

The development of medical nanosystems requires knowledge of their behavior in vivo. Clinical chemistry tests are widely used to estimate the systemic toxicity of nanoparticles. In this paper we have explored the impact of small positively charged nanoparticles-poly(amidoamine), phosphorous and carbosilane dendrimers - on biochemical parameters of standardized serum in vitro. All the dendrimers could shift the main biochemical parameters. Thus, in the case of patients having the normal, but 'boundary', values of biochemical parameters, nanoparticle-induced changes can be wrongly interpreted as evidence of some dysfunctions (hepatic, renal, etc.). Moreover, the effects of nanoparticles of metals, carbon nanotubes, quantum dots, fullerenes, dendrimers having been sized up to 4000 nm and the hundreds of reactive groups, can be significantly higher. Thus, preliminary evaluation of any nanomaterial in vitro is required in clinical chemistry tests before its application in vivo to draw the correct conclusions and benefit animals.

How to study dendrimers and dendriplexes III. Biodistribution, pharmacokinetics and toxicity in vivo.

This paper reviews the biodistribution, toxicity and pharmacokinetics of pure dendrimers and their complexes with nucleic acids (dendriplexes) in animals, including mice, rats, rabbits, and guinea pigs. Methods and results will both be discussed. The paradigm about dendrimers' toxicity based on in vitro studies should be revised; almost all dendrimers of low and middle generations are non-toxic in vivo, despite showing some cytotoxic effects in vitro. Only the high generations of unmodified cationic dendrimers in high doses have some toxicity in vivo. Modifications of dendrimers decrease their toxicity, even when this has already been acceptable with regard to unmodified dendrimers. Several undesirable effects following administration of unmodified cationic dendrimers diminish during prolonged dosing because of the development of counteracting mechanisms. Disturbances tend to return to normal levels during the recovery period after dendrimers have ceased to be administered to animals. Neutralization of the surface charge of dendrimers in their dendriplexes leads to less toxicity in vivo. Although dendrimers and dendriplexes accumulate temporarily in liver, pancreas, heart, and kidneys, they do not do permanent damage to them, i.e. the risk of irreversible damage or malfunction of these internal organs is slight. Chemical modifications of dendrimers determine the desired location of multifunctional dendrimer-based conjugates and dendriplexes in a targeted organ. Clearance of dendrimers also strongly depends on their chemical structure. When nucleic acids are complexed with dendrimers (forming so-called dendriplexes), they are more stable, having longer circulation times than free and PEI-complexed ones. Dendrimers are highly efficient in transfection and can be targeted to any organ, e.g. brain, lung and kidneys. The vast majority of dendrimers and dendriplexes are non-immunogenic. To sum up, these promising results from in vivo studies open up the possibility of dendrimers being applied as a new generation of nano-therapeutic agents in medicine, especially in human gene therapy.