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1.
Hu Li Za Zhi ; 70(4): 67-76, 2023 Aug.
Artigo em Chinês | MEDLINE | ID: mdl-37469321

RESUMO

BACKGROUND & PROBLEMS: Post-operation hypothermia tends to induce complications. Sixty percent of robotic-assisted mitral valve surgery patients experienced hypothermia while admitted to our intensive care unit (ICU), resulting in prolonged ICU stays and 57% (eight) of those patients with hypothermia also experiencing cardiac arrhythmia. The causes of hypothermia in our ICU included low temperature in the operating room, delayed initiation of blanket coverage after surgery, and lack of postoperative thermal blankets, insufficient cardiopulmonary bypass rewarming time, cold ICU beds, lack of in-service training for hypothermia, and lack of procedure auditing. PURPOSE: This intervention was designed to reduce the incidence of hypothermia in ICU patients undergoing robotic-assisted mitral valve surgery upon ICU admission from 60% to 36% and the one-hour hypothermia rate from 43.3% to 26%. RESOLUTIONS: We implemented several measures including increasing the room temperature, pre-heating the ICU bed, achieving team consensus regarding prolonging the rewarming time after cardiopulmonary bypass, establishing a blanket warming area for postoperative patient use, and holding in-service training to enhance the awareness of the nurses were implemented. RESULTS: The incidence of hypothermia in ICU patients receiving robotic-assisted mitral valve surgery upon ICU admission decreased from 60% to 19.4%, while the one-hour hypothermia rate decreased from 43.3% to 19.4%. CONCLUSIONS: Using systemic interprofessional collaboration, combined thermal care can be achieved to significantly reduce the incidence of postoperative hypothermia in patients undergoing robotic-assisted mitral valve surgeries resulting in higher patient care quality and shorter ICU stays. We recommend applying this combined method to improve the quality of perioperative care for long-duration and major surgical procedures that involve large postoperative wounds and for patients who may require wider exposure during their operation.


Assuntos
Hipotermia , Procedimentos Cirúrgicos Robóticos , Humanos , Hipotermia/prevenção & controle , Valva Mitral/cirurgia , Procedimentos Cirúrgicos Robóticos/efeitos adversos , Incidência , Reaquecimento/efeitos adversos , Reaquecimento/métodos , Complicações Pós-Operatórias/prevenção & controle
2.
J Clin Med ; 8(11)2019 Nov 07.
Artigo em Inglês | MEDLINE | ID: mdl-31703305

RESUMO

(1) Background: Knee osteoarthritis causes pain, weakness, muscle atrophy, and disability. The application of whole-body vibration in patients with knee osteoarthritis can improve strength, balance, and functional activities. The purpose of the study is to evaluate the effects of early whole-body vibration intervention in patients after total knee arthroplasty. (2) Method: A single-blinded randomized control trial. Fifty-two patients with knee osteoarthritis post total knee replacement from a medical center in southern Taiwan were randomly assigned to either a whole-body vibration group or control group. Main outcome measures included pain severity, leg circumference, knee range of motion, knee extensor strength, a five-times sit to stand test, and a timed up and go test. (3) Results: Immediately post treatment, the patients in the vibration group showed a significant increase in knee extensor strength and improvement in calf swelling compared to the control group. A trend toward decrease in pain severity and improvement in functional performance were observed in both groups without a significant difference between the groups. There was no significant difference in knee range of motion (ROM) and functional performance between the groups. (4) Conclusions: The whole-body vibration intervention in patients early post total knee arthroplasty showed significant immediate effect in increasing knee extensor strength and decreasing calf swelling.

4.
Eur J Pharm Biopharm ; 136: 102-107, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30660691

RESUMO

The intravitreal route faces many challenges in rapidly and effectively reaching posterior eye pathology, with administered therapeutics experiencing non-specific distribution around and premature clearance from ocular tissues. Nanobubbles and ultrasound may improve outcomes of intravitreally administered drugs by influencing the directionality of drug-containing particle migration. In this study, we assessed the impact of trans-scleral or corneal ultrasound application on the distribution of intravitreally-injected nanobubbles. Rhodamine-tagged gas entrapped nanobubble formulations were prepared and injected into ex vivo bovine and porcine eyes and subjected to ultrasound (1 MHz, 0-2.5 W/cm2, 50-100% duty, 60 s). Bovine eyes were partially dissected to visualize the vitreous humor and particle migration was evaluated via optical fluorescence spectroscopy. Directional migration in porcine eyes was evaluated using a snap freezing protocol complemented by quantification of regional fluorescence. The impact on nanobubble migration following pars-plana injection and sequential ultrasound cycle application from scleral or corneal-surface positions was also assessed. Administration of ultrasound significantly enhanced the directional migration of nanobubbles in both ex vivo models, with multiple corneal ultrasound cycles promoting greater migration of dye-filled nanobubbles to posterior regions of the vitreous. Moreover, particles moved in a directional manner away from the ultrasound wave source demonstrating an ability to effectively control the rate and path of nanobubble migration. These findings establish an encouraging new and safe modality enabling rapid distribution of intravitreally-injected therapeutics where expeditious therapeutic intervention is warranted.


Assuntos
Sistemas de Liberação de Medicamentos/métodos , Corantes Fluorescentes/análise , Injeções Intravítreas/métodos , Nanocápsulas/análise , Ondas Ultrassônicas , Corpo Vítreo/química , Animais , Bovinos , Corantes Fluorescentes/administração & dosagem , Corantes Fluorescentes/metabolismo , Nanocápsulas/administração & dosagem , Espectrometria de Fluorescência/métodos , Suínos , Corpo Vítreo/efeitos dos fármacos , Corpo Vítreo/metabolismo
5.
World J Gastroenterol ; 24(31): 3488-3499, 2018 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-30131655

RESUMO

Hepatitis B virus (HBV) infection is a global public health concern. HBV causes chronic infection in patients and can lead to liver cirrhosis, hepatocellular carcinoma, and other severe liver diseases. Thus, understanding HBV-related pathogenesis is of particular importance for prevention and clinical intervention. HBV surface antigens are indispensable for HBV virion formation and are useful viral markers for diagnosis and clinical assessment. During chronic HBV infection, HBV genomes may acquire and accumulate mutations and deletions, leading to the expression of defective HBV surface antigens. These defective HBV surface antigens have been found to play important roles in the progression of HBV-associated liver diseases. In this review, we focus our discussion on the nature of defective HBV surface antigen mutations and their contribution to the pathogenesis of fulminant hepatitis B. The relationship between defective surface antigens and occult HBV infection are also discussed.


Assuntos
Antígenos de Superfície da Hepatite B/imunologia , Vírus da Hepatite B/imunologia , Hepatite B Crônica/imunologia , Falência Hepática Aguda/imunologia , DNA Viral/genética , DNA Viral/isolamento & purificação , Progressão da Doença , Genoma Viral/genética , Antígenos de Superfície da Hepatite B/genética , Antígenos de Superfície da Hepatite B/metabolismo , Vírus da Hepatite B/genética , Hepatite B Crônica/patologia , Hepatite B Crônica/prevenção & controle , Hepatite B Crônica/virologia , Humanos , Fígado/imunologia , Fígado/patologia , Fígado/virologia , Falência Hepática Aguda/patologia , Falência Hepática Aguda/prevenção & controle , Falência Hepática Aguda/virologia , Mutação , Replicação Viral/genética , Replicação Viral/imunologia
6.
Invest Ophthalmol Vis Sci ; 59(8): 3682-3693, 2018 07 02.
Artigo em Inglês | MEDLINE | ID: mdl-30029255

RESUMO

Purpose: To evaluate the long-term effect on inflammation and inflammasome activation of intravitreally delivered connexin43 mimetic peptide (Cx43MP) in saline or incorporated within nanoparticles (NPs) for the treatment of the light-damaged rat eye. Methods: Light-induced damage to the retina was created by exposure of adult albino Sprague-Dawley rats to intense light for 24 hours. A single dose of Cx43MP, Cx43MP-NPs, or saline was injected intravitreally at 2 hours after onset of light damage. Fluorescein isothiocyanate (FITC)-labelled Cx43MP-NPs were intravitreally injected to confirm delivery into the retina. Electroretinogram (ERG) recordings were performed at 24 hours, 1 week, and 2 weeks post cessation of light damage. The retinal and choroidal layers were analyzed in vivo using optical coherence tomography (OCT) and immunohistochemistry was performed on harvested tissues using glial fibrillary acidic protein (GFAP), leukocyte common antigen (CD45), and Cx43 antibodies. Results: FITC was visualized 30 minutes after injection in the ganglion cell layer and in the choroid. Cx43MP and Cx43MP-NP treatments improved a-wave and b-wave function of the ERG compared with saline-injected eyes at 1 week and 2 weeks post treatment, and prevented photoreceptor loss by 2 weeks post treatment. Inflammation was also reduced and this was in parallel with downregulation of Cx43 expression. Conclusions: The slow release of Cx43MP incorporated into NPs is more effective at treating retinal injury than a single dose of native Cx43MP in solution by reducing inflammation and maintaining both retinal structure and function. This NP preparation has clinical relevance as it reduces possible ocular complications associated with repeated intravitreal injections.


Assuntos
Doenças da Coroide/tratamento farmacológico , Corioide/patologia , Conexina 43/administração & dosagem , Nanopartículas , Retina/patologia , Doenças Retinianas/tratamento farmacológico , Tomografia de Coerência Óptica/métodos , Animais , Corioide/metabolismo , Doenças da Coroide/patologia , Conexina 43/farmacocinética , Modelos Animais de Doenças , Eletrorretinografia , Feminino , Imuno-Histoquímica , Injeções Intravítreas , Masculino , Ratos , Ratos Sprague-Dawley , Retina/metabolismo , Doenças Retinianas/metabolismo , Doenças Retinianas/patologia
7.
Biomaterials ; 168: 10-23, 2018 06.
Artigo em Inglês | MEDLINE | ID: mdl-29597134

RESUMO

Recent studies have shown that Connexin43 mimetic peptide (Cx43 MP) can prevent secondary damage following retinal ischaemic and inflammatory disorders by blocking uncontrolled Cx43 hemichannel opening. However, limitations in peptide stability and the presence of various intraocular barriers limit efficient retinal delivery in the clinical setting. The present study aimed to achieve targeted and sustained peptide delivery to the retina by encapsulating Cx43 MP into hyaluronic acid (HA) coated albumin nanoparticles (NPs). Intraocular biodistribution, particle retention, retinal targeting, and therapeutic efficacy of intravitreally injected NPs encapsulating Cx43 MP were evaluated in a rat model of retinal ischaemia-reperfusion injury. NPs rapidly diffused through the vitreous and specifically targeted CD44-expressing retinal cells. NPs remained at the target site for extended periods enabling sustained peptide release and thus prolonged therapeutic action. Compared to free Cx43 MP, Cx43 MP loaded NPs enabled enhanced therapeutic efficacy preventing thinning of retinal layers and disruption of retinal blood vessels. Immunohistochemical results confirm that Cx43 MP loaded NPs efficiently reduced Cx43 expression, thereby suppressing ongoing inflammation and preventing the loss of retinal ganglion cells. Overall, HA coated NPs could have great potential as a peptide delivery platform in the treatment of chronic retinal degenerative and inflammatory disorders.


Assuntos
Albuminas , Portadores de Fármacos , Ácido Hialurônico , Nanopartículas , Peptídeos/uso terapêutico , Doenças Retinianas/tratamento farmacológico , Animais , Linhagem Celular , Conexina 43/química , Conexina 43/metabolismo , Conexina 43/uso terapêutico , Isquemia/tratamento farmacológico , Masculino , Ratos , Ratos Wistar , Doenças Retinianas/metabolismo
8.
Eur J Pharm Sci ; 118: 124-133, 2018 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-29574081

RESUMO

Intravitreal mobility of nanocarriers may have implications on the efficacy of the encapsulated drug in the treatment of vitreo-retinal diseases, with any changes in the integrity of the vitreous microstructure influencing nanoparticle biodistribution. This study investigated enzymatically digested vitreous models to mimic the aging eye. Collagenase, hyaluronidase, or trypsin was employed to selectively digest the structural components of the vitreous. Physical properties of digested bovine vitreous were initially assessed via texture analysis and oscillatory shear testing. Morphological changes in bovine vitreous microstructure were visualized by scanning electron microscopy and diffusion dynamics of hyaluronic acid coated nanoparticles through degraded porcine and bovine vitreous were examined using fluorescence spectroscopy and multiple particle tracking microscopy, respectively. After enzymatic treatment, the vitreous liquefied and its dynamic mechanical properties significantly changed with a decrease in stiffness and an increase in damping capacity. Micrographs confirmed specific digestion of each of the structural vitreous components. Furthermore, enzymatic degradation reduced steric hindrance and enhanced convective flow within the vitreous, resulting in increased intravitreal nanoparticle mobility which could alter the drug pharmacokinetics.


Assuntos
Colagenases/metabolismo , Hialuronoglucosaminidase/metabolismo , Nanopartículas/administração & dosagem , Tripsina/metabolismo , Corpo Vítreo/metabolismo , Animais , Bovinos , Colágeno/metabolismo , Ácido Hialurônico/administração & dosagem , Injeções Intravítreas , Microscopia Eletrônica de Varredura , Proteoglicanas/metabolismo , Albumina Sérica/administração & dosagem , Suínos , Corpo Vítreo/ultraestrutura
9.
Adv Drug Deliv Rev ; 126: 96-112, 2018 02 15.
Artigo em Inglês | MEDLINE | ID: mdl-28916492

RESUMO

Overcoming the physiological barriers in the eye remains a key obstacle in the field of ocular drug delivery. While ocular barriers naturally have a protective function, they also limit drug entry into the eye. Various pharmaceutical strategies, such as novel formulations and physical force-based techniques, have been investigated to weaken these barriers and transport therapeutic agents effectively to both the anterior and the posterior segments of the eye. This review summarizes and discusses the recent research progress in the field of ocular drug delivery with a focus on the application of physical methods, including electrical fields, sonophoresis, and microneedles, which can enhance penetration efficiency by transiently disrupting the ocular barriers in a minimally or non-invasive manner.


Assuntos
Sistemas de Liberação de Medicamentos , Oftalmopatias/metabolismo , Preparações Farmacêuticas/química , Farmacocinética , Oftalmopatias/tratamento farmacológico , Humanos
11.
Eur J Pharm Biopharm ; 119: 125-136, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-28602870

RESUMO

Intravitreal injection is the most common administration route for the treatment of retinal diseases. However, the vitreous and some of the retinal layers themselves act as significant barriers to efficient delivery of drugs administered intravitreally. This study aimed to improve the diffusive mobility of nanoparticles (NPs) in the vitreous and enhance their permeation across the retina after intravitreal injection by application of ultrasound (US). Ex vivo posterior bovine eye cups were used and the vitreous was either left intact or removed gently from the neural retina. Hyaluronic acid coated human serum albumin NPs were administered into the eye cups and continuous US with a frequency of 1MHz, an intensity of 0.5W/cm2, and a duration of 30s was applied once or repeatedly via the transscleral route. After pre-determined time points, fluorescence intensities in the vitreous and the retina were analyzed. Short pulses of US significantly improved the diffusive mobility of NPs through the vitreous as well as their penetration across the neural retina into the retinal pigment epithelium and choroid without causing any detectable damage to the ocular tissues. Therefore, transscleral US could be a powerful and safe tool to enhance retinal delivery of intravitreally injected NPs.


Assuntos
Sistemas de Liberação de Medicamentos/métodos , Nanopartículas/administração & dosagem , Nanopartículas/metabolismo , Retina/efeitos dos fármacos , Retina/metabolismo , Ondas Ultrassônicas , Animais , Bovinos , Injeções Intravítreas , Técnicas de Cultura de Órgãos , Suínos
12.
Mol Pharm ; 14(2): 533-545, 2017 02 06.
Artigo em Inglês | MEDLINE | ID: mdl-27997199

RESUMO

Recent studies have shown that Connexin43 mimetic peptide (Cx43 MP) can prevent secondary damage following several retinal ischemic and inflammatory disorders by blocking the pathological opening of gap junction hemichannels. However, the poor stability of peptides and the presence of various intraocular barriers limit efficient retinal delivery in the clinical setting. The present study aimed to prolong the bioactivity of Cx43 MP and achieve targeted delivery to the retina by loading the peptide into hyaluronic acid (HA) coated human serum albumin nanoparticles (HSA NPs). Two different loading methods, adsorption and incorporation, were used with the peptide released slowly over a period of up to four months. Compared to uncoated particles, HA coated HSA NPs exhibited enhanced in vitro cellular uptake and ex vivo retinal penetration via HA-CD44 receptor mediated interactions. Furthermore, cell viability and Cx43 MP functionality assays showed that NPs protected Cx43 MP from degradation, sustained its release, and thus prolonged its bioactivity without reducing cell viability at concentrations used for Cx43 hemichannel blocking. Therefore, HA coated HSA NPs could have great potential for sustained and targeted delivery of Cx43 MP to treat various retinal inflammatory conditions.


Assuntos
Albuminas/administração & dosagem , Albuminas/química , Ácido Hialurônico/administração & dosagem , Ácido Hialurônico/química , Nanopartículas/administração & dosagem , Nanopartículas/química , Retina/efeitos dos fármacos , Animais , Bovinos , Linhagem Celular , Sobrevivência Celular/efeitos dos fármacos , Conexina 43/metabolismo , Junções Comunicantes/efeitos dos fármacos , Junções Comunicantes/metabolismo , Humanos , Receptores de Hialuronatos/metabolismo , Injeções Intravítreas/métodos , Peptídeos/administração & dosagem , Peptídeos/química , Retina/metabolismo
13.
Expert Opin Drug Deliv ; 13(7): 953-62, 2016 07.
Artigo em Inglês | MEDLINE | ID: mdl-26967153

RESUMO

INTRODUCTION: Frequent intravitreal injections are currently the preferred treatment method for diseases affecting the posterior segment of the eye. However, these repeated injections have been associated with pain, risk of infection, hemorrhages, retinal detachment and high treatment costs. To overcome these limitations, light-responsive in situ forming injectable implants (ISFIs) may emerge as novel systems providing site-specific controlled drug delivery to the retinal tissues with great accuracy, safety, minimal invasiveness and high cost efficiency. AREA COVERED: Complex ocular barriers, routes for drug delivery, types of injectable implants, ocular application of light and benefits of light-responsive systems are discussed with regards to challenges and strategies employed for effective drug delivery to the posterior segment of the eye. In particular, we have highlighted photoresponsive moieties, photopolymerization mechanisms and different development strategies with their limitations as well as recent advancements in the field. EXPERT OPINION: Biodegradable light-responsive ISFIs are promising drug delivery systems that have shown a high degree of biocompatibility with sustained drug release in a number of applications. However, their use in intravitreal drug delivery is still in the very early stages. Issues related to the biocompatibility of the photoinitiator and the elimination of photo-degraded by-products from the ocular tissues need careful consideration, not only from a chemistry standpoint, but also from a biological perspective to improve the suitability of these systems for clinical applications.


Assuntos
Sistemas de Liberação de Medicamentos , Oftalmopatias/tratamento farmacológico , Olho/metabolismo , Preparações de Ação Retardada/administração & dosagem , Implantes de Medicamento , Humanos , Injeções Intravítreas
14.
Drug Deliv Transl Res ; 5(5): 480-8, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26238242

RESUMO

Optic neuropathy is associated with retinal ganglion cell (RGC) loss leading to optic nerve damage and visual impairment. Recent research has shown that transient block of connexin43 (Cx43) hemichannels by a Cx43 mimetic peptide (MP), Peptide5, delivered systemically or by intravitreal injection after retinal ischemia inhibits uncontrolled hemichannel opening to provide significantly reduced vessel leak and inflammation as well as significantly enhanced RGC survival. We have previously shown, in vitro, that a chemically modified C12-C12-Cx43 MP has a twofold greater half-life in bovine vitreous (ex vivo) than the native peptide. The present study investigated the ability of intravitreally injected, chemically modified C12-C12-Cx43 MP to further enhance RGC survival in a rat retinal ischemia-reperfusion model. Intravitreally injected native Cx43 MP or C12-C12-Cx43 MP both minimized vessel leak, reduced inflammation, and protected RGC after ischemic injury. However, the modified C12-C12-Cx43 MP, with its prolonged vitreous stability, showed significantly lower levels of Cx43 expression post-injury, with a trend towards a greater reduction in vessel leak and further RGC protection, suggesting that these molecules may be a clinically relevant neuroprotective tool in the treatment of optic neuropathy.


Assuntos
Conexina 43/química , Isquemia/tratamento farmacológico , Fármacos Neuroprotetores/administração & dosagem , Peptídeos/administração & dosagem , Peptidomiméticos , Doenças Retinianas/tratamento farmacológico , Vasos Retinianos/patologia , Animais , Injeções Intravítreas , Masculino , Neuroproteção , Fármacos Neuroprotetores/uso terapêutico , Peptídeos/uso terapêutico , Ratos Wistar , Doenças Retinianas/patologia , Vasos Retinianos/efeitos dos fármacos
15.
Eur J Pharm Biopharm ; 95(Pt B): 182-93, 2015 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-25676338

RESUMO

Glaucoma is a form of optic neuropathy and a common cause of blindness, affecting over 60 million people worldwide with an expected rise to 80 million by 2020. Successful treatment is challenging due to the various causes of glaucoma, undetectable symptoms at an early stage and inefficient delivery of drugs to the back of the eye. Conventional glaucoma treatments focus on the reduction of elevated intraocular pressure (IOP) using topical eye drops. However, their efficacy is limited to patients who suffer from high IOP glaucoma and do not address the underlying susceptibility of retinal ganglion cells (RGC) to degeneration. Glaucoma is known as a neurodegenerative disease which starts with RGC death and eventually results in damage of the optic nerve. Neuroprotective strategies therefore offer a novel treatment option for glaucoma by not only preventing neuronal loss but also disease progression. This review firstly gives an overview of the pathophysiology of glaucoma as well as current treatment options including conventional and novel delivery strategies. It then summarizes the rational for neuroprotection as a novel therapy for glaucomatous neuropathies and reviews current potential neuroprotective strategies to preserve RGC, with a focus on connexin43 (Cx43) gap junction channel blockers.


Assuntos
Conexina 43/antagonistas & inibidores , Glaucoma/tratamento farmacológico , Fármacos Neuroprotetores/farmacologia , Animais , Progressão da Doença , Sistemas de Liberação de Medicamentos , Glaucoma/fisiopatologia , Humanos , Pressão Intraocular/efeitos dos fármacos , Fármacos Neuroprotetores/administração & dosagem , Hipertensão Ocular/complicações , Hipertensão Ocular/tratamento farmacológico , Nervo Óptico/patologia , Células Ganglionares da Retina/patologia
16.
Eur J Pharm Biopharm ; 95(Pt B): 378-86, 2015 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-25497487

RESUMO

Recent research has shown that transient block of connexin43 (Cx43) hemichannels by mimetic peptides (MP) after retinal ischaemia inhibits uncontrolled hemichannel opening causing blood-brain barrier permeability and endothelial cell loss, and consequently provides improved retinal ganglion cell (RGC) survival. However, the highly hydrophilic character and potentially poor stability of native peptides can limit efficient delivery in a clinical setting. The present study investigated the ability of intravitreally injected Cx43 MP encapsulated into slow-release poly(lactic-co-glycolic) acid (PLGA) nano-(Nps) and microparticles (Mps) to promote RGC survival in a retinal ischaemia-reperfusion rat model. The particle size was around 113 nm (Nps) and 9 µm (Mps), respectively, with Cx43 MP entrapment efficiencies of 70% (Nps) and 97% (Mps). A triphasic in vitro release profile was observed with an initial burst of surface-bound Cx43 MP followed by slow release due to polymer erosion and further drug release at the point of complete particle breakdown, with 100% release achieved after 63 (Nps) and 112 (Mps) days, respectively. Nps showed the most promising results on both Cx43 down-regulation and RGC rescue in this acute injury model. Mps treatment, on the other hand, was unable to down regulate the initial inflammatory response possibly due to trapping of the bigger particles in the vitreous and the much slower release of Cx43 MP from these particles, but displayed a delayed effect on Cx43 regulation and RGC preservation due to the sustained release.


Assuntos
Conexina 43/química , Isquemia/tratamento farmacológico , Peptidomiméticos/administração & dosagem , Doenças Retinianas/tratamento farmacológico , Animais , Conexina 43/genética , Preparações de Ação Retardada , Modelos Animais de Doenças , Regulação para Baixo , Portadores de Fármacos/química , Liberação Controlada de Fármacos , Injeções Intravítreas , Isquemia/patologia , Ácido Láctico/química , Masculino , Microesferas , Nanopartículas , Tamanho da Partícula , Peptidomiméticos/química , Ácido Poliglicólico/química , Copolímero de Ácido Poliláctico e Ácido Poliglicólico , Ratos , Ratos Wistar , Doenças Retinianas/patologia , Vasos Retinianos/efeitos dos fármacos , Vasos Retinianos/patologia
17.
J Pharm Sci ; 102(7): 2322-31, 2013 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-23696181

RESUMO

Optic neuropathy is associated with retinal ganglion cell (RGC) loss leading to optic nerve damage and visual impairment. Unregulated connexin (Cx) hemichannel opening plays a role in RGC loss. Thus, inhibition via Cx43-specific mimetic peptides (MP) may prevent further cell death. However, the highly hydrophilic character and poor stability of native peptides prevent their efficient delivery across biological membranes. The present study aimed to improve the stability of Cx43 MP by conjugation to C12-lipoamino acid (C12-Laa) or sugar groups. Unmodified and modified Cx43 MP were synthesized using solid-phase peptide synthesis. Their functionality was assessed by propidium iodide (PI) uptake into NT2 cells, a human testicular carcinoma progenitor cell line able to differentiate into astrocytes, whereas the stability in ocular vitreous was measured by reversed-phase high-performance liquid chromatography. PI uptake studies showed inhibition of hemichannel opening for unmodified and modified Cx43 MP. Stability measurements revealed improved stability of modified Cx43 MP, with two Laa groups increasing the peptide half-life in bovine vitreous more than twofold. Conjugation to C12 -Laa or sugar did not affect the functionality of Cx43 MP, but addition of two C12-Laa groups significantly improved peptide stability. Laa-modifications may therefore offer improved stability and retinal delivery of peptides in vivo.


Assuntos
Conexina 43/química , Doenças do Nervo Óptico/tratamento farmacológico , Peptidomiméticos/química , Peptidomiméticos/farmacologia , Animais , Bovinos , Linhagem Celular , Sobrevivência Celular/efeitos dos fármacos , Humanos , Peptidomiméticos/síntese química , Peptidomiméticos/farmacocinética , Técnicas de Síntese em Fase Sólida , Corpo Vítreo/metabolismo
18.
Chin Med J (Engl) ; 126(7): 1213-9, 2013 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-23557546

RESUMO

BACKGROUND: The prevalence of chronic kidney disease (CKD) and prediabetes has increased in China, and at different rates in different locations. Therefore a community-based screening research was conducted in order to determine the prevalence of CKD and prediabetes, and to analyze associated risk factors of CKD and prediabetes in a city of Southern China. METHODS: A total of 7801 community residents aged 18 year and older from 6 communities were screened by a stratified random cluster sampling method. An estimated glomerular filtration rate (eGFR), albuminuria, fasting plasma glucose (FPG), and homeostatic model assessment of insulin resistance (HOMA-IR) were measured. Age-standardized prevalence was calculated by the direct method with the use of data on the population distribution in China in 2006. Multivariate logistic analysis was used to analyze the risk factors of CKD and prediabetes, and association of insulin resistance (IR) with CKD and prediabetes was analyzed. RESULTS: The age-standardized prevalence of CKD was 12.5%, eGFR < 60 ml×min(-1)×1.73 m(-2) was 2.7% and ACR (albumin to creatinine ratio) > 30 mg/g was 10.3%. The age-standardized prevalence of prediabetes was 12.1%. Logistic regression suggests that IR was a common independent risk factor of CKD and prediabetes. Further analysis show that HOMA-IR was increased with the aggravation of kidney injury and FPG. CONCLUSION: CKD and prediabetes have become a major public health problem in Zhuhai, Southern China; insulin resistance may be an important risk factor.


Assuntos
Estado Pré-Diabético/epidemiologia , Insuficiência Renal Crônica/epidemiologia , Adulto , China/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Inquéritos e Questionários
19.
Mol Vis ; 17: 1946-56, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-21850169

RESUMO

PURPOSE: Hyperhomocysteinemia is known to cause degeneration of retinal ganglion cells, but its influence on photoreceptors remains largely unknown. In particular, the role of homocysteine-thiolactone (Hcy-T)--the physiologic metabolite of homocysteine that has been proven to be more cytotoxic than homocysteine itself--as a factor that causes retinopathy, has not been defined. This study aimed to investigate the toxic effects of excessive Hcy-T in a mouse model. METHODS: A total of 60 six-week-old female ICR mice were used in this study. The mice were divided into 3 experimental groups and 2 control groups. The mice in the experimental groups were subjected to intravitreal injections of Hcy-T to reach final estimated intravitreal concentrations at 5, 25, and 200 µM, respectively. Mice without injection (blank) and with 0.9 NaCl injections (sham injection) were used as controls. The mice with 200 µM Hcy-T were sacrificed at days 7, 15, 45, and 90 after injection and the mice with 5 or 25 µM Hcy-T were sacrificed at day 90, with the controls sacrificed at day 15 or 90 for comparison. Semi-quantitative dot-blot analysis was performed for confirmation of retinal homocysteinylation. The mouse retinas were evaluated microscopically, with the thickness of total and specific retinal layers determined. Immunohistochemical analysis was performed and the labeled cells were quantified to determine the effects of excessive Hcy-T on specific retinal cells. RESULTS: Dose-dependent retinal homocysteinylation after Hcy-T injection was confirmed. The homocysteinylation was localized in the outer and inner segments of photoreceptors and the ganglion cell layer (GCL). Retinal cell degenerations were found in the GCL, inner nuclear layer, and outer nuclear layer at day 90 after 200 µM Hcy-T injection. Significant thickness reduction was found in the total retina, outer nuclear layer, and the outer and inner segment layers. A trend of thickness reduction was also found in the GCL and inner nuclear layer, although this was not statistically significant. The rhodopsin⁺ photoreceptors and the calbindin⁺ horizontal cells were significantly reduced at day 15, and were nearly ablated at day 90 after 200 µM Hcy-T injection (p<0.001 for both day 15 and day 90), which was not seen in the sham injection controls. The Chx-10⁺ or the Islet-1⁺ bipolar cells and the Pax-6⁺ amacrine cells were severely misarranged at day 90, but no significant reduction was found for both cell types. The GFAP⁺ Müller cells were activated at day 15, but were not significantly increased at day 90 after the injection. CONCLUSIONS: Excessive retinal homocysteinylation by Hcy-T, a condition of hyperhomocysteinemia, could lead to degeneration of photoreceptors, which might lead to retinopathies associated with severe hyperhomocysteinemia or diabetes mellitus.


Assuntos
Homocisteína/análogos & derivados , Células Fotorreceptoras/patologia , Retina/patologia , Degeneração Retiniana , Células Ganglionares da Retina/patologia , Animais , Calbindinas , Retinopatia Diabética/metabolismo , Retinopatia Diabética/patologia , Relação Dose-Resposta a Droga , Proteínas do Olho/análise , Proteínas do Olho/biossíntese , Feminino , Proteína Glial Fibrilar Ácida , Proteínas de Homeodomínio/análise , Proteínas de Homeodomínio/biossíntese , Homocisteína/administração & dosagem , Homocisteína/efeitos adversos , Hiper-Homocisteinemia/metabolismo , Hiper-Homocisteinemia/patologia , Immunoblotting , Imuno-Histoquímica , Injeções Intravítreas , Proteínas com Homeodomínio LIM/análise , Proteínas com Homeodomínio LIM/biossíntese , Camundongos , Camundongos Endogâmicos ICR , Proteínas do Tecido Nervoso/análise , Proteínas do Tecido Nervoso/biossíntese , Fator de Transcrição PAX6 , Fatores de Transcrição Box Pareados/análise , Fatores de Transcrição Box Pareados/biossíntese , Células Fotorreceptoras/efeitos dos fármacos , Células Fotorreceptoras/metabolismo , Proteínas Repressoras/análise , Proteínas Repressoras/biossíntese , Retina/efeitos dos fármacos , Retina/metabolismo , Degeneração Retiniana/induzido quimicamente , Degeneração Retiniana/metabolismo , Degeneração Retiniana/patologia , Células Ganglionares da Retina/efeitos dos fármacos , Células Ganglionares da Retina/metabolismo , Rodopsina/análise , Rodopsina/biossíntese , Proteína G de Ligação ao Cálcio S100/análise , Proteína G de Ligação ao Cálcio S100/biossíntese , Fatores de Transcrição/análise , Fatores de Transcrição/biossíntese
20.
Drug Deliv ; 18(7): 493-501, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-21696294

RESUMO

The efficacy of antisense oligodeoxynucleotides (AsODNs) is compromised by their poor stability in biological fluids and the inefficient cellular uptake due to their size and negative charge. Since chemical modifications of these molecules have resulted in a number of non-antisense activities, incorporation into particulate delivery systems has offered a promising alternative. The aim of this study was to evaluate various poly(D,L-lactic-co-glycolic acid) (PLGA) nanoparticles for AsODN entrapment and delivery. PLGA nanoparticles were prepared using the double emulsion solvent evaporation method. The influence of formulation parameters such as PLGA concentration and volume ratio of internal aqueous phase volume (Va1) to organic phase volume (Vo) to external aqueous phase volume (Va2) on particle size, polydispersity index (PDI) and zeta potential (ZP) was investigated using a full factorial study. The particle size increased with increasing PLGA concentrations and volume ratios, with an interaction detectable between the two factors. AsODN entrapment efficiencies ranged between 49.97% and 54.95% with no significant difference between various formulations. By fitting the in vitro release profiles to a dual first order release model it was shown that the AsODN release occurred via two processes: a diffusion controlled process in the early phase (25 to 32% within one day) and a PLGA degradation process in the latter (39 to 70% after 14 days). Cellular uptake studies using primary corneal epithelial cells suggested active transport of nanoparticles via endocytosis. PLGA nanoparticles therefore show potential to successfully entrap AsODNs, transport them into cells and release them over time due to polymer erosion.


Assuntos
Portadores de Fármacos/química , Sistemas de Liberação de Medicamentos , Epitélio Corneano/metabolismo , Oligodesoxirribonucleotídeos Antissenso/administração & dosagem , Transporte Biológico Ativo , Preparações de Ação Retardada , Emulsões , Endocitose , Humanos , Ácido Láctico/química , Modelos Teóricos , Nanopartículas , Oligodesoxirribonucleotídeos Antissenso/farmacocinética , Tamanho da Partícula , Ácido Poliglicólico/química , Copolímero de Ácido Poliláctico e Ácido Poliglicólico , Solventes/química
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