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The increasing incidence of infected skin wounds poses a major challenge in clinical practice, especially when conventional antibiotic therapy fails. In this context, bacteriophages emerged as promising alternatives for the treatment of antibiotic-resistant bacteria. However, clinical implementation remains hampered by the lack of efficient delivery approaches to infected wound tissue. In this study, bacteriophage-loaded electrospun fiber mats were successfully developed as next-generation wound dressings for the treatment of infected wounds. We employed a coaxial electrospinning approach, creating fibers with a protective polymer shell, enveloping bacteriophages in the core while maintaining their antimicrobial activity. The novel fibers exhibited a reproducible fiber diameter range and morphology, while the mechanical fiber properties were ideal for application onto wounds. Further, immediate release kinetics for the phages were confirmed as well as the biocompatibility of the fibers with human skin cells. Antimicrobial activity was demonstrated against Staphylococcus aureus and Pseudomonas aeruginosa and the core/shell formulation maintained the bacteriophage activity for 4 weeks when stored at − 20 °C. Based on these promising characteristics, our approach holds great potential as a platform technology for the encapsulation of bioactive bacteriophages to enable the translation of phage therapy into clinical application.
Electrospinning is an advanced method for the generation of polymer-based fibers. This fabrication technique has gained great interest in the biomedical field in recent years due to its straightforward application and significant versatility of the resulting fiber mats. The process is carried out by dissolving a (biologically or synthetically derived) polymer or a combination of several polymers in a suitable inorganic or organic solvent and transferring these solutions into a syringe with a needle tip as a spinneret. The power source is connected to the syringe tip, allowing for the application of a high voltage to the polymer solution, and a metallic collector, often a rotating drum cylinder on which the yielded polymer fibers are deposited. The usual fiber diameters range between nano- and micrometers. The yielded fiber mats have distinct characteristics, such as a large surface area, mechanical stability, and good encapsulation efficiency. Therefore, the fiber mats can be used as a topical dosage form for a multitude of diseases (e.g., conjunctivitis, keratitis), as they can be easily applied on or into the human body to release the drug for a prolonged period of time. In addition, the fibers exhibit a high degree of resemblance with the human extracellular matrix, which consists predominantly of collagen fibrils. Therefore, the obtained fiber mats can also be employed as innovative substrates for the cultivation of cells. As a result, electrospinning is suitable for a wide range of applications in the biomedical context, specifically for the targeted, topical delivery of bioactives and also as a cell culture substrate for the cultivation of cells in an enhanced in vivo relevant situation.
One objective of this work was the development and characterization of drug-loaded electrospun fibers for application to the inflamed and infected eye to complement the existing therapy of eye drops as well as systemic administration of anti-infectives. In particular, the focus of the project was the development of ocular implants to treat a herpes simplex infection affecting the human cornea. Additionally, electrospun fibers, which immediately dissolve in the tear fluid upon application and prolong the contact time of the bioactives at the eye, were developed as a topical dosage form to treat bacterial conjunctivitis. An additional objective of this work was the development of electrospun fiber mats as an innovative substrate for the cultivation of human induced pluripotent stem cells to mimic the human blood-brain barrier in vitro. The final objective of the present work was establishing an analytical concept for the comprehensive characterization of electrospun fibers to obtain a greater comparability and reproducibility of data and results from different laboratories.
Herpes simplex keratitis is a viral disease of the cornea that can potentially lead to blindness. This disease commonly occurs after corneal transplantation. As the cornea is the most transplanted tissue worldwide, the incidence of this disease varies from 4.9% to 12.6% (high- and low-income countries). The current therapy involves the application of eye drops as many as six times a day, and in severe cases, the systemic use of antiviral agents is necessary but can cause serious side effects (e.g., renal failure). To prevent the occurrence of herpes simplex keratitis after transplantation, a biodegradable electrospun nanofiber mat with a sustained release of acyclovir was established. The rational development of the fibers was facilitated by correlating the surface wettability with the release kinetics of the individual polymers, which allowed for the successful generation of fiber mats releasing the bioactive acyclovir over three weeks. The molecularly dispersed drug is present as an amorphous solid dispersion within the PLGA-based polymer matrix. Evaluating the cell viability in in vitro models proved that neither acyclovir nor the polymers or the generated fiber mats caused any cytotoxicity. The mechanical stability of the fiber mats was evaluated to ensure adequate handling of the fibers during implantation. The findings demonstrated that the fiber mats exhibit direction-independent mechanical properties, and their mechanical load-bearing capacity is greater than that of an excised human cornea. As a result, the fiber mats are suitable for surgical implantation into the anterior chamber of the eye. An in vitro model of human keratinocytes was infected with herpes simplex virus to demonstrate the antiviral efficacy of the electrospun fiber mats. Immunostaining for two specific viral proteins demonstrated the spread of infection in the model. Hereby, it was found that the placebo- and drug-loaded fibers significantly slowed the spread of infection, which was quantified by plaque assay determination. This experiment revealed that the electrospun fibers exert a synergistic antiviral effect by simultaneously releasing acyclovir, which is a virustatic agent that inhibits the replication of the virus in infected cells, and adsorbing released viral particles onto the surface of the polymer fibers. This reduces the overall burden of released viral particles, which is associated with the severity of the infection outbreak. Thus, with the aid of electrospinning, an ocular implant was successfully generated, which is biodegradable over time and significantly reduces the viral particle burden in vitro. Hence, the fibers represent a potential alternative for the prevention of herpes simplex keratitis after corneal transplantation...
Nuclear receptors (NRs) activate transcription of target genes in response to binding of ligands to their ligand-binding domains (LBDs). Typically, in vitro assays use either gene expression or the recruitment of coactivators to the isolated LBD of the NR of interest to measure NR activation. However, this approach ignores that NRs function as homo- as well as heterodimers and that the LBD harbors the main dimerization interface. Cofactor recruitment is thereby interconnected with oligomerization status as well as ligand occupation of the partnering LBD through allosteric cross talk. Here we present a modular set of homogeneous time-resolved FRET–based assays through which we investigated the activation of PPARγ in response to ligands and the formation of heterodimers with its obligatory partner RXRα. We introduced mutations into the RXRα LBD that prevent coactivator binding but do not interfere with LBD dimerization or ligand binding. This enabled us to specifically detect PPARγ coactivator recruitment to PPARγ:RXRα heterodimers. We found that the RXRα agonist SR11237 destabilized the RXRα homodimer but promoted formation of the PPARγ:RXRα heterodimer, while being inactive on PPARγ itself. Of interest, incorporation of PPARγ into the heterodimer resulted in a substantial gain in affinity for coactivator CBP-1, even in the absence of ligands. Consequently, SR11237 indirectly promoted coactivator binding to PPARγ by shifting the oligomerization preference of RXRα toward PPARγ:RXRα heterodimer formation. These results emphasize that investigation of ligand-dependent NR activation should take NR dimerization into account. We envision these assays as the necessary assay tool kit for investigating NRs that partner with RXRα.
Redox homeostasis must be kept in balance for an intact redox signaling, which is necessary to control neuronal pathways such as growth cone pathfinding, synaptic plasticity and transmission (Oswald, Garnham, Sweeney, & Landgraf, 2018).
Nucleoredoxin (NXN) is an oxidoreductase and thioredoxin-like protein holding two conserved cysteine residues in its structure (Funato & Miki, 2007), which are essential for its redox-regulating functionality. The function of NXN in neurons is still less well studied. But the expression of NXN in neurons, which was confirmed through analyzing adult NXN-LacZ reporter mice, suggested a dominant functional role in neuronal pathways. Initial experiments revealed calcium-calmodulin-dependent kinase 2 a (Camk2a) as a potential interaction partner through a Yeast-2-Hybrid screen (not shown) which is the major protein to induce synaptic plasticity during neuronal activity. Therefore, neuronal expression of NXN and the potential interaction with Camk2a prompted us to investigate deeper into the neuronal pathway. The goal of this work was to confirm the interaction of Camk2a and NXN with further experiments and to characterize behavior of mice carrying a neuronal NXN deletion. To achieve a pan-neuronal depletion of NXN expression in our mouse model, we used the Cre/loxP system with a NestinCre driver. We did not achieve the expected complete deletion of NXN due to unknown compensatory mechanisms. Nevertheless, the partial deletion of NXN in our transgenic mouse model prevented embryonic lethality as occurring in complete NXN knockout mice (Funato et al., 2010). The interaction of Camk2a and NXN was confirmed through proximity ligation assay (PLA) and immunofluorescence staining of primary cortical neurons.
Investigations of the functional interaction revealed a lower redox-sensitivity of Camk2a activity in NXN-deficient brain samples. Additionally, the respiratory activity was significantly reduced in mitochondria of NXN deficient mouse brain pointing to possible dysfunctional mitochondria which is also observed in various neurodegenerative diseases, e.g.: Alzheimer, Parkinson, and Huntington disease (Norat et al., 2020). Unexpectedly, behavioral studies revealed only a subtle effect of the pan-neuronal NXN-deficiency. Significant differences between genotypes were found at the reduction of exploratory behavior and a reduced motivation for the voluntary wheel running in NesNXN-/- mice, which is normally seen as a joyful and rewarding activity. The observed behavior of NesNXN-/- mice potentially results from interaction mechanisms of NXN with Camk2a, as well as decreased oxidation of
Camk2a and further unidentified target proteins of NXN.
Conclusively, function of NXN was revealed as a non-essential redox modulator of Camk2a in neurons. The behavioral phenotype of NesNXN-/- mice is probably compensated through unknown mechanisms. Redox signaling of Camk2a in neurons is regulated through various components such as TXN or GSH, which can backup each other (Branco et al., 2017; Ren et al., 2017). NXN is an additional but not essential regulator.
Nukleäre Rezeptoren (NRs) sind ligandenaktivierte Transkriptionsfaktoren, die an der Regulation unzähliger (patho-)physiologischer Prozesse im Körper beteiligt sind, wodurch sie interessante therapeutische Zielstrukturen darstellen. Unter ihnen zählen die PPARs (α, γ und δ) zur Hälfte der gut erforschten NRs. Sie haben als Lipidsensoren vor allem metabolische Funktionen und ihre synthetischen Liganden sind als Arzneistoffe zugelassen, sind anderen Therapieoptionen jedoch aufgrund geringerer Wirksamkeit und klassenspezifischer Nebenwirkungen unterlegen. Daher ist der Bedarf an neuen Konzepten zur selektiven Modulation der PPARs groß. Den gut studierten NRs gegenüber steht die andere Hälfte der NRs, deren Funktionen noch nicht umfassend verstanden sind. Nurr1 ist ein solcher NR, dem großes therapeutisches Potential bei neurodegenerativen Erkrankungen wie Parkinson, Alzheimer-Demenz und Multipler Sklerose zugeschrieben wird. Der konstitutiv aktive NR wird hauptsächlich im ZNS, und dort vor allem in dopaminergen Neuronen, exprimiert, wo er neuroprotektive und anti-entzündliche Effekte vermittelt. Trotz der jüngsten Erkenntnisse zu potenziellen endogenen Liganden der direkten Interaktion der Nurr1-Ligandbindedomäne (LBD) mit kleinen, wirkstoffartigen Molekülen, mangelt es an geeigneten chemischen Tools, um die Nurr1-Modulation als neues therapeutisches Konzept zu validieren. Ziel dieser Arbeit war daher die Identifikation, Entwicklung und Charakterisierung neuer tool compounds für die PPARs und Nurr1.
Das Konzept der Photopharmakologie eröffnet neue Möglichkeiten in der zeitlichen und räumlichen Kontrolle biologischer Effekte. Mit Hilfe computergestützten Designs wurden aus dem PPARγ-Agonist Rosiglitazon und dem pan-PPAR-Agonist GL479 Azobenzen-basierte photoschaltbare PPAR-Agonisten entwickelt und optimiert. Das Rosiglitazon-Azolog 36 wurde durch terminale Erweiterung als cis-präferenzieller selektiver PPARγ-Agonist erhalten, der durch Licht aktiviert werden konnte. Aus GL479 ging zum einen 38 als hochpotenter und selektiver PPARα-Agonist hervor, der in seiner trans-Konfiguration 35-mal potenter war als das entsprechende cis-Isomer. Zum anderen wurde ein dualer trans-präferenzieller PPARα- und -δ-Agonist (41) entwickelt. In einem eigens etablierten Fluoreszenz-Reportergenassay konnte durch die neuen photopharmakologischen Tools die PPAR-Aktivität in lebenden Zellen im zeitlichen Verlauf kontrolliert werden.
Auch die Identifikation und Charakterisierung endogener Liganden ist von großer Relevanz für die Modulation von NRs. Mit der Entdeckung der PPARγ-Aktivierung durch Garcinolsäure (48), einem Vitamin-E-Metaboliten, konnte ein neuer Aktivierungsmechanismus aufgedeckt werden, der ein besonderes Co-Regulator-Interaktionsprofil umfasst. Eine Co-Kristallstruktur der PPARγ-LBD im Komplex mit 48 zeigte, dass 48 sowohl die orthosterische als auch eine neue allosterische Bindestelle adressiert. Eine Genexpressionsanalyse in humanen Hepatozyten zeigte, dass sich dieser besondere Aktivierungsmechanismus von 48 auch in einer differenzierten Modulation der PPARγ-regulierten Genexpression widerspiegelte, woraus sich mögliche therapeutische Anwendungen für eine selektiv allosterische PPAR-Modulation ableiten lassen.
Der erste Ansatz zur Suche nach Nurr1-Modulatoren als tool compounds war von den Prostaglandinen A1 und A2 als potenziellen endogenen Nurr1-Liganden inspiriert. Da diese Entzündungsmediatoren durch Aktivität der Cyclooxygenasen (COX) 1 und 2 entstehen, entstand die Hypothese, dass synthetische COX-Inhibitoren, auch bekannt als nichtsteroidale Antirheumatika (NSARs), Nurr1 modulieren könnten. Dies konnte in einem Screening von 39 strukturell diversen NSARs im Gal4-Nurr1-Reportergenassay bestätigt werden. Mit Meclofenaminsäure als differenziellem Nurr1-Modulator sowie Oxaprozin und Parecoxib als den ersten inversen Nurr1-Agonisten konnte dabei außerdem gezeigt werden, dass die hohe konstitutive Nurr1-Aktivität bidirektional moduliert werden kann, und dass sowohl das Co-Regulator-Rekrutierungsprofil als auch das Dimerisierungsverhalten an der Vermittlung von Nurr1-Ligand-Effekten entscheidend beteiligt sind.
Die zweite Strategie beruhte auf den alten Antimalariawirkstoffen Amodiaquin (19) und Chloroquin (25), die zuvor als moderate Nurr1-Agonisten (EC50 Nurr1: 36 µM (19), 47 µM (25)) identifiziert wurden, aber aufgrund zahlreicher unspezifischer Effekte für den breiten Einsatz als tool compounds für Nurr1 ungeeignet sind. Eine Evaluation der einzelnen Strukturmerkmale dieses Chemotyps zeigte, dass das gemeinsame 7-Chlorochinolin-4-amin Grundgerüst ausreichend ist, um Nurr1 zu aktivieren (EC50 Nurr1: 259 µM). Basierend auf dieser Erkenntnis gingen durch gezielte Strukturmodifikationen dieses Grundgerüstes die Nurr1-Agonisten 71 und 73 hervor (EC50 Nurr1: 7,3 µM (71), 17 µM (73)), die die Leitstrukturen in ihrer Potenz übertrafen...
Functional coupling of Slack channels and P2X3 receptors contributes to neuropathic pain processing
(2021)
The sodium-activated potassium channel Slack (KNa1.1, Slo2.2, or Kcnt1) is highly expressed in populations of sensory neurons, where it mediates the sodium-activated potassium current (IKNa) and modulates neuronal activity. Previous studies suggest that Slack is involved in the processing of neuropathic pain. However, mechanisms underlying the regulation of Slack activity in this context are poorly understood. Using whole-cell patch-clamp recordings we found that Slack-mediated IKNa in sensory neurons of mice is reduced after peripheral nerve injury, thereby contributing to neuropathic pain hypersensitivity. Interestingly, Slack is closely associated with ATP-sensitive P2X3 receptors in a population of sensory neurons. In vitro experiments revealed that Slack-mediated IKNa may be bidirectionally modulated in response to P2X3 activation. Moreover, mice lacking Slack show altered nocifensive responses to P2X3 stimulation. Our study identifies P2X3/Slack signaling as a mechanism contributing to hypersensitivity after peripheral nerve injury and proposes a potential novel strategy for treatment of neuropathic pain.
Physiologically based pharmacokinetic/pharmacodynamic (PBPK/PD) models can serve as a powerful framework for predicting the influence as well as the interaction of formulation, genetic polymorphism and co-medication on the pharmacokinetics and pharmacodynamics of drug substances. In this study, flurbiprofen, a potent non-steroid anti-inflammatory drug, was chosen as a model drug. Flurbiprofen has absolute bioavailability of ~95% and linear pharmacokinetics in the dose range of 50–300 mg. Its absorption is considered variable and complex, often associated with double peak phenomena, and its pharmacokinetics are characterized by high inter-subject variability, mainly due to its metabolism by the polymorphic CYP2C9 (fmCYP2C9 ≥ 0.71). In this study, by leveraging in vitro, in silico and in vivo data, an integrated PBPK/PD model with mechanistic absorption was developed and evaluated against clinical data from PK, PD, drug-drug and gene-drug interaction studies. The PBPK model successfully predicted (within 2-fold) 36 out of 38 observed concentration-time profiles of flurbiprofen as well as the CYP2C9 genetic effects after administration of different intravenous and oral dosage forms over a dose range of 40–300 mg in both Caucasian and Chinese healthy volunteers. All model predictions for Cmax, AUCinf and CL/F were within two-fold of their respective mean or geometric mean values, while 90% of the predictions of Cmax, 81% of the predictions of AUCinf and 74% of the predictions of Cl/F were within 1.25 fold. In addition, the drug-drug and drug-gene interactions were predicted within 1.5-fold of the observed interaction ratios (AUC, Cmax ratios). The validated PBPK model was further expanded by linking it to an inhibitory Emax model describing the analgesic efficacy of flurbiprofen and applying it to explore the effect of formulation and genetic polymorphisms on the onset and duration of pain relief. This comprehensive PBPK/PD analysis, along with a detailed translational biopharmaceutic framework including appropriately designed biorelevant in vitro experiments and in vitro-in vivo extrapolation, provided mechanistic insight on the impact of formulation and genetic variations, two major determinants of the population variability, on the PK/PD of flurbiprofen. Clinically relevant specifications and potential dose adjustments were also proposed. Overall, the present work highlights the value of a translational PBPK/PD approach, tailored to target populations and genotypes, as an approach towards achieving personalized medicine.
Alzheimer’s disease (AD) is the major cause of dementia. It is characterized by the accumulation of abnormal proteins (amyloid-β plaque and neurofibrillary tangles) leading to loss of synapses, dendrites, neurons, memory and cognition. Sporadic late-onset AD is the major type of AD characterized by unclear etiology and a lack of disease-modifying therapy. To understand this disease, an alternative AD hypothesis has been proposed: AD may resemble diabetes in the brain or “diabetes type 3”. This hypothesis is supported by the fact that (1) brain glucose hypometabolism precedes AD clinical symptoms and (2) diabetes increases the risk of AD. To test this hypothesis, wild-type rats receiving intracerebroventricular administration of streptozotocin (icv-STZ) were used as a model. Streptozotocin (STZ) is a glucosamine-nitrosourea compound commonly used to induce experimental diabetes by peripheral administration. A similar pathological mechanism to peripheral STZ is then proposed to explain icv-STZ toxicity: insulin receptor signaling impairment results in glucose hypometabolism leading to cognitive deficits.
Objective: Icv-STZ model seems promising as a toxin-induced, non-transgenic AD model with the possibility to connect AD and diabetes mellitus (DM), one of the risk factors for AD. However, the mechanisms of how icv-STZ induced AD-like symptoms are unclear. Therefore, using microdialysis as the main technique, we tested 2 AD hypotheses in this model: (1) the glucose hypometabolism as an alternative AD hypothesis and (2) the cholinergic deficit as an important characteristic of AD pathology. Hippocampus was chosen because cholinergic function in this region is severely affected in AD. In comparison, the striatum was chosen because it contains cholinergic interneurons and is less affected in AD.
Methods: In this study, we used male Wistar rats of 190-220 g body weight (5 weeks of age). The rats were injected intracerebrally with STZ at a dose of 3 mg/kg (2x1.5 mg/kg; „high dose“) and 0.6 mg/kg („low dose“) with saline as control. After 21 days, samples were collected to investigate cholinergic and metabolic changes using histology, biochemistry, and neurochemistry. Brain injury was confirmed using GFAP staining and Fluoro jade staining in the hippocampus. Mitochondrial toxicity was investigated by measurement of mitochondrial
respiratory function in both hippocampus and striatum. Cholinergic markers such as acetylcholinesterase (AChE) activity, choline acetyltransferase (ChAT) activity, and choline transporter (CHT-1) activity, commonly known as high-affinity choline uptake (HACU), were measured in both hippocampus and striatum using a spectrophotometer and a scintillator.
Microdialysis is the main technique in our study. It was done in awake animals under behavioral or pharmacological stimulation. We used a self-built probe with a semi-permeable membrane (pore size of 30 kDa) that was implanted in either hippocampus or striatum. The probes were then perfused with artificial cerebrospinal fluid (aCSF) supplemented with 0.1 μM neostigmine for extracellular acetylcholine level measurement. During the perfusion, small hydrophilic compounds from brain extracellular space diffuse into the dialysates. Dialysates of 15 minutes intervals were collected for 90 minutes and used for analysis. After collection of dialysates for the first 90 minutes (basal data), rats were moved to an open field box (35x32x20 cm) for behavioral stimulation. After collection of the second 90 minute dialysates, the rats were transferred back to the microdialysis cage and dialysates were collected for another 90 minutes. On day 2, after collection of dialysates under basal conditions, 1 μM scopolamine was added to the perfusion solution for stimulation of acetylcholine release. The dialysates were also collected for 90 min followed by another 90 min of dialysis without scopolamine. The microdialysate samples were then analyzed as follows. ACh level was measured by HPLC-ECD. Glucose metabolites (glucose, lactate, pyruvate) were measured by a CMA-600 microanalyzer. An alternative energy metabolite (beta-hydroxybutyrate/BHB) was measured by GC-MS. Choline and glycerol as membrane breakdown markers were also measured by HPLC-ECD and CMA-600 microanalyzer, respectively. Markers of oxidative stress (isoprostanes) were measured using a commercially available ELISA kit.
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Die Superfamilie der nukleären Rezeptoren umfasst 48 ligandenabhänige Transkriptionsfaktoren, die durch Veränderungen in der Genexpression unterschiedlichste (patho-)physiologische Vorgänge wie Metabolismus, Entzündungen und Zelldifferenzierung beeinflussen.
Für die Vertreter der Retinoid X Rezeptoren (RXRs) und Peroxisomen Proliferator-aktivierten Rezeptoren (PPARs) wurden in den letzten Jahren vielversprechende Effekte auf neurodegenerative Erkrankungen berichtet. Beide Rezeptorklassen beeinflussen u.a. Bildung, Transport und Abbau des neurotoxischen Amyloid-β, das als eine der Ursachen für die Entstehung einer Alzheimer Demenz (AD) vermutet wird. Außerdem gibt es Hinweise darauf, dass durch gezielte Modulation der RXRs (besonders RXRγ) eine Remyelinisierung auto-immun demyelinisierter Neurone und damit eine regenerative Therapie für die Multiple Sklerose (MS) möglich sein könnte. Die aktuell zur Verfügung stehenden Liganden der RXRs besitzen unzureichende Subtypenselektivität und meist unvorteilhafte physikochemische Eigenschaften, die der weiteren Erforschung im Wege stehen. Um diese Hindernisse zu überwinden, sollten im Rahmen dieser Arbeit neuartige RXR-Agonisten synthetisiert und umfassend charakterisiert werden.
Ein kürzlich publizierter RXR-Agonist besitzt eine ungewöhnlich lineare Biphenylgrundstruktur und offenbart ein attraktives Aktivitätsprofil: Während alle drei RXR-Subtypen mit einem ähnlichen EC50-Wert (RXRα/β/γ = 12/12/14 µM) adressiert werden, führt die Bindung an RXRα nur zu einer minimalen Aktivierung (max. 5-fache Aktivierung im Vergleich zur Grundaktivität), während RXRβ und γ deutlich stärker aktiviert werden (60-70-fache Aktivierung). Da für diesen Chemotyp bislang noch keine systematischen Studien vorlagen, wurden seine Struktur-Wirkungs-Beziehungen (SAR) erforscht. Durch Synthese und in vitro Charakterisierung von 24 Derivaten konnten sowohl selektivitäts- als auch potenzfördernde Strukturmerkmale identifiziert werden, die sich auch kombinieren ließen. Es wurden ein RXRβ-selektives Derivat, mehrere RXRα/β-präferierende Analoga und ein potentes Derivat mit annähernd 100-fach gesteigerter Potenz ((EC50(RXRα/β/γ) = 0,08/0,15/0,22 µM) erhalten. Im Zuge der Charakterisierung wurden außerdem strukturelle Variationen identifiziert, die eine Umgehung des LXR/RXR-Heterodimers ermöglichen könnten. Zusätzlich gelang die Kristallisation der Ligandbindedomäne (LBD) von RXRα im Komplex mit dem potentesten Vertreter der Serie und offenbarte Potential für weitere Optimierungen, u.a. der Möglichkeit eine kovalente Bindung mit Cys432 zu etablieren und damit eine weitere Potenzsteigerung zu erreichen.
Neben der mangelnden Subtypenpräferenz behindern auch die ungünstigen physikochemischen Eigenschaften von RXR-Liganden die weitere Entwicklung von RXR-basierten Therapieoptionen. Deshalb sollte eine neue Leitstruktur mit überlegenen physikochemischen Eigenschaften identifiziert und durch systematische SAR-Untersuchungen weiterentwickelt werden. Für den experimentellen Wirkstoff Wy14,643, einem dualen Agonisten an PPARα und γ, wurden im Laufe der letzten vier Jahrzehnte wiederholt Effekte patentiert, die sich mit dem bislang bekannten Aktivitätsprofil nicht erklären ließen. Er zeigte u.a. in einem Tiermodell der MS einen immunmodulierenden Effekt und reduzierte in vitro die Bildung von Amyloid-β.Im Rahmen dieser Arbeit konnte Wy14,643 als potenter RXR-Agonist (EC50 (PPARα/γ/δ) = 36/54/- µM¸ EC50(RXRα/β/γ) = 9,1/13/31 µM) mit überlegenen physikochemischen Eigenschaften (z.B. Löslichkeit in Wasser = 48,6 mg/L) identifiziert und dadurch dessen Wirkungen erklärt werden.
Wy14,643 wurde als Startpunkt einer systematischen Untersuchung der Ligand-Rezeptor-Interaktionen sowohl an den PPARs und den RXRs ausgewählt. Dabei wurden ein potenter selektiver PPAR-Agonist und ein potenter und ausgeglichener panRXR/panPPAR-Agonist erhalten. Der panRXR/panPPAR-Agonist konnte im Komplex mit der LBD von PPARγ kristallisiert werden, wo der Ligand gleich doppelt gebunden vorliegt. Eines der Moleküle bindet in einer alternativen Bindungstasche. Diese Erkenntnis könnte die Grundlage für die Entwicklung einer neuen Klasse von PPARγ-Modulatoren legen.
Durch Kombination des erlangten SAR-Wissens wurde ein selektiver RXR-Agonist (EC50 (PPARα/γ/δ) = -/-/- µM¸ EC50(RXRα/β/γ) = 0,09/0,14/0,36 µM) mit annähernd 100-fach gesteigerter Potenz synthetisiert, der die günstigen physikochemischen Eigenschaften der Leitstruktur erhalten konnte (Löslichkeit in Wasser = 14,3 mg/L). Mit diesem Profil ist es gelungen einen RXR-Agonisten zu kreieren, der dem bisherigen Goldstandard Bexaroten bei vergleichbarer Potenz in physikochemischen Eigenschaften überlegen ist.
Die Kristallstruktur des RXR-selektiven Derivats im Komplex mit der LBD von RXRα zeigte einen orthosterischen Bindemodus und legte weitere Optimierungen nahe: So gibt es sowohl ungenutzten Raum, der zukünftig durch strukturbasierte Substitutionen adressiert werden könnte, als auch die Möglichkeit eine kovalente Bindung zum Rezeptor (Cys432) zu initiieren. Durch diese Arbeit konnten nicht nur eine Reihe von potenten RXR-Liganden identifiziert werden, durch die Entwicklung eines Sets aus PPAR-selektiven, dual PPAR/RXR-aktiven und RXR-selektiven Derivaten gleichen Chemotyps, entstand auch ein nützliches pharmakologisches Werkzeug zur weiteren Entschlüsselung des Zusammenspiels dieser Rezeptoren.
Die systematische Entwicklung einer Leitstruktur, wie sie in den vorangegangenen Projekten praktiziert wurde, kann je nach deren Komplexität eine kostenintensive und synthetisch anspruchsvolle Aufgabe darstellen. Im Rahmen dieser Arbeit wurde eine computergestützte Optimierung einer Leitstruktur als Teil einer selektiven Optimierung von Nebenaktivitäten (SOSA) etabliert, um den präparativen Aufwand der Strukturoptimierung zu reduzieren. Als Modellsubstanz wurde das Fettsäuremimetikum Cinalukast ausgewählt, das einen potenten Cysteinylleukotrienrezeptor 1 (CysLT1R)-Antagonisten darstellt, für den eine schwache Aktivität an PPARα entdeckt wurde. Ein automatisierter Arbeitsablauf testete eine virtuelle Bibliothek von annähernd 8000 Cinalukastanaloga auf ihre PPARα-Aktivität und die Derivate mit der besten vorhergesagten PPARα-Aktivität wurden durch maschinelles Lernen nach ihrem CysLT1R-Antagonismus klassifiziert. Die Synthese und Charakterisierung eines virtuell bevorzugten Derivats zeigte selektiven PPARα-Agonismus und konnte so den computergestützten Arbeitsablauf als wertvolles Instrument zur Optimierung von Fettsäuremimetika bestätigten.
Die vorliegende Arbeit hat bedeutende Fortschritte bei der Entwicklung von zwei neuen Chemotypen als RXR-Liganden erreicht. Die Klasse der Biphenyl-Analoga kann als Ausgangspunkt für eine weitere Entwicklung von subtypenselektiven RXR-Agonisten dienen und könnte gleichzeitig die gezielte Umgehung einzelner Heterodimere ermöglichen. Das Set aus drei Derivaten von Wy14,643 mit identischem Chemotyp, aber drastisch unterschiedlichen Aktivitätsprofilen an den PPARs und RXRs ermöglicht eine intensive pharmakologische Untersuchung der beiden Rezeptorfamilien und deren Zusammenspiel. Außerdem entstand aus dieser Klasse einer der zurzeit fortschrittlichsten RXR-Agonisten. Zukünftig kann außerdem der im Zuge der Arbeit etablierte computergestützte Arbeitsablauf die Optimierung von Fettsäuremimetika deutlich beschleunigen.
Purpose. Status epilepticus (SE) is characterized by recurrent seizure activity and can be drug-resistant. Knowledge of neuronal and metabolic activity of the brain during SE may be helpful to improve medical care. We here report the effects of three anti-seizure drugs on changes of acetylcholine energy metabolites and oxidative stress during SE. Methods. We used the lithium-pilocarpine model in rats to induce SE and in vivo-microdialysis to monitor cholinergic and metabolic activity in the hippocampus. We measured extracellular concentrations of acetylcholine, glucose, lactate, pyruvate, glycerol and isoprostanes before and during SE, and after acute treatment with pregabalin, valproic acid, and levetiracteam. Results. Upon onset of SE, acetylcholine (ACh) release increased six- to eightfold. Glucose was increased only transiently by 30% but lactate levels rose four-fold, and extracellular concentrations of glycerol ten-fold. Isoprostanes are markers of oxidative stress and increased more than 20-fold. Two hours after pilocarpine adminstration, rats were treated with pregabalin (100 mg/kg), levetiracetam (200 mg/kg) or valproic acid (400 mg/kg) by i.p. injection. All three drugs stopped seizure activity in a delayed fashion, but at the doses indicated, only animals that received levetiracetam reached consciousness. All drugs reduced ACh release within 60-120 minutes. Lactate/pyruvate ratios, glycerol and isoprostanne levels were also reduced significantly after drug administration. Conclusions. Hippocampal ACh release closely follows seizure activity in SE and is attenuated when SE subsides. Pregabalin, valproic acid and levetiracetam all terminate seizures in the rat SE model and attenuate cholinergic and metabolic changes within two hours.
Цель: Оценить влияние локализации точки разрыва в геномной ДНК гена MLL на прогноз острых лейкозов (ОЛ) у детей первого года жизни.
Методы: В исследование было включено 68 детей первого года жизни (29 мальчиков и 39 девочек с медианой возраста 4,8 мес.) с MLL-позитивными острым лимфобластным лейкозом (ОЛЛ) (n = 46), острым миелоидным лейкозом (ОМЛ) (n = 20) и ОЛ смешанной линейности (n = 2).
Результаты: 5-летняя бессобытийная выживаемость (БСВ) детей первого года жизни с ОЛЛ, включенных в исследование MLL-Baby, с точкой разрыва в интроне 11 ДНК гена MLL (n = 29) была статистически значимо ниже, чем у пациентов c локализацией точек разрыва, начиная с интрона 7 по экзон 11 (n = 17; 0,16 ± 0,07 и 0,38 ± 0,14; p = 0,039), а кумулятивная вероятность развития рецидива была значительно выше в группе с точкой разрыва в интроне 11 (0,74 ± 0,09 и 0,52 ± 0,17; p = 0,045). В то же время многофакторный анализ показал, что единственным значимым фактором, связанным с неблагоприятным прогнозом, остается сохранение минимальной остаточной болезни (МОБ) в точке наблюдения 4 протокола MLL-Baby (отношение опасности 5,994; 95%-й доверительный интервал 2,209–16,263; p < 0,001). У 22 пациентов с ОМЛ связи между прогнозом и локализацией точки разрыва в ДНК гена MLL не выявлено.
Заключение: Наличие точки разрыва в интроне 11 гена MLL у детей первого года жизни с ОЛЛ, получавших лечение по протоколу MLL-Baby, вело к статистически значимо более низким показателям БСВ и более высокой кумулятивной вероятности развития рецидива. Однако в многофакторной модели риска это нивелировалось сохранением МОБ в точке наблюдения 4. У детей первого года жизни с ОМЛ взаимосвязи между локализацией точки разрыва в ДНК гена MLL и прогнозом не выявлено.
The ability to permeate accross the blood brain barrier (BBB) is essential for drugs acting on the central nervous system (CNS). Thus, systems that allow rapid and inexpensive screening of the BBB-permeability properties of novel lead compounds are of great importance for speeding up the drug discovery process in the CNS-area. We used immortalized porcine brain microvessel endothelial cells (PBMECICl-2) to develop a model for measurement of blood-brain barrier permeation of CNS active drugs. Investigation of different cell culture conditions showed, that a system using C6 astrocyte glioma conditioned medium and addition of a cyclic AMP analog in combination with a type IV phosphodiesterase inhibitor (R020-1724) leads to cell layers with transendothelial electrical resistance values up to 300 Ω.cm2. Permeability studies with U-[14C]sucroseg ave a permeability coefficient Pe of 3.24 + 0.14 × 10−4 cm/min, which is in good agreement to published values and thus indicates the formation of tight junctions in vitro.
Patient therapy is based mainly on a combination of diagnosis, suitable monitoring or support devices and drug treatment and is usually employed for a pre-existing disease condition. Therapy remains predominantly symptom-based, although it is increasingly clear that individual treatment is possible and beneficial. However, reasonable precision medicine can only be realized with the coordinated use of diagnostics, devices and drugs in combination with extensive databases (4Ds), an approach that has not yet found sufficient implementation. The practical combination of 4Ds in health care is progressing, but several obstacles still hamper their extended use in precision medicine.
Chimeric antigen receptor (CAR) T cells are in prime focus of current research in cancer immunotherapy. Facilitating CAR T cell generation is among the top goals. We have recently demonstrated direct in vivo generation of human CD19-CAR T cells by targeting CD8+ cells using lentiviral vectors (LVs). The anti-tumor potency of in vivo generated CAR T cells was assessed in human PBMC-transplanted NSG mice carrying i.v. injected CD19+ Nalm-6 tumor cells. A single injection of CD8-targeted LV delivering CD19-CAR was sufficient to completely eliminate the tumor cells from bone marrow and spleen, whereas control animals contained high levels of CD19+ cells. Tumor elimination was due to in vivo generated CAR+ cells. Notably, these were not only composed of T lymphocytes but also included CAR+ natural killer cells (NK and NKT). This is the first demonstration of tumor elimination by in vivo generated human CAR T cells.
This open access book presents a unique collection of practical examples from the field of pharma business management and research. It covers a wide range of topics such as: "Brexit and its Impact on pharmaceutical Law - Implications for Global Pharma Companies", "Implementation of Measures and Sustainable Actions to Improve Employee's Engagement", "Global Medical Clinical and Regulatory Affairs (GMCRA)", and "A Quality Management System for R&D Project and Portfolio Management in a Pharmaceutical Company".
The chapters are summaries of master’s theses by "high potential" Pharma MBA students from the Goethe Business School, Frankfurt/Main, Germany, with 8-10 years of work experience and are based on scientific know-how and real-world experience. The authors applied their interdisciplinary knowledge gained in 22 months of studies in the MBA program to selected practical themes drawn from their daily business.
Phytochemical analysis of Ficus carica L. active compounds possessing anticonvulsant activity
(2018)
The anticonvulsant potential of Ficus carica methanol-extract (Fc) has been studied. It was found that Fc most active fraction is rich in oligosaccharides (OFG). 1H, 13C NMR and Nano-ESI, MALDI MS, and LC-MS techniques proved that OFG contains alpha-glucopyranoside oligomer in high amounts. Both Fc and OFG reduced strychnine (STR) convulsion-action. Fc and OFG fully protected the experimental-animals from STR-lethality. The intracerebroventricular-administration (ICV) of Fc or OFG in combination with glycine in ethanol-treated mice caused a dose-dependent returning to a 2nd-loss of righting-reflex (LORR), and was antagonized by STR. FC and OFG ICV injection counteracted STR-inhibition, confirming that Fc/OFG anticonvulsant mechanism of action was mediated by potentiation of glycine receptor. These results support Fc and OFG potential anticonvulsant-activity with good safety-profile. Keywords: Ficus carica, Moraceae, Nano-ESI MS, MALDI MS, Intracerebroventricular, Anticonvulsant activity.
Hepatitis Delta virus (HDV) is a satellite of Hepatitis B virus with a single-stranded circular RNA genome. HDV RNA genome synthesis is carried out in infected cells by cellular RNA polymerases with the assistance of the small hepatitis delta antigen (S-HDAg). Here we show that S-HDAg binds the bromodomain (BRD) adjacent to zinc finger domain 2B (BAZ2B) protein, a regulatory subunit of BAZ2B-associated remodeling factor (BRF) ISWI chromatin remodeling complexes. shRNA-mediated silencing of BAZ2B or its inactivation with the BAZ2B BRD inhibitor GSK2801 impairs HDV replication in HDV-infected human hepatocytes. S-HDAg contains a short linear interacting motif (SLiM) KacXXR, similar to the one recognized by BAZ2B BRD in histone H3. We found that the integrity of the S-HDAg SLiM sequence is required for S-HDAg interaction with BAZ2B BRD and for HDV RNA replication. Our results suggest that S-HDAg uses a histone mimicry strategy to co-activate the RNA polymerase II-dependent synthesis of HDV RNA and sustain HDV replication.
Amorphous formulation technologies to improve oral absorption of poorly soluble active pharmaceutical ingredients (APIs) have become increasingly prevalent. Currently, polymer-based amorphous formulations manufactured by spray drying, hot melt extrusion (HME), or co-precipitation are most common. However, these technologies have challenges in terms of the successful stabilization of poor glass former compounds in the amorphous form. An alternative approach is mesoporous silica, which stabilizes APIs in non-crystalline form via molecular adsorption inside nano-scale pores. In line with these considerations, two poor glass formers, haloperidol and carbamazepine, were formulated as polymer-based solid dispersion via HME and with mesoporous silica, and their stability was compared under accelerated conditions. Changes were monitored over three months with respect to solid-state form and dissolution. The results were supported by solid-state nuclear magnetic resonance spectroscopy (SS-NMR) and scanning electron microscopy (SEM). It was demonstrated that mesoporous silica was more successful than HME in the stabilization of the selected poor glass formers. While both drugs remained non-crystalline during the study using mesoporous silica, polymer-based HME formulations showed recrystallization after one week. Thus, mesoporous silica represents an attractive technology to extend the formulation toolbox to poorly soluble poor glass formers.
Background. TLR ligands can promote Th1-biased immune responses, mimicking potent stimuli of viruses and bacteria. Aim. To investigate the adjuvant properties of dual TLR2/7 ligands compared to those of the mixture of both single ligands.
Methods. Dual TLR2/7 ligands: CL401, CL413, and CL531, including CL264 (TLR7-ligand) and Pam2CysK4 (TLR2-ligand), were used. Immune-modulatory capacity of the dual ligands with the individual ligands alone or as a mixture in mouse BMmDCs, BMmDC:TC cocultures, or BMCMCs was compared and assessed in naïve mice and in a mouse model of OVA-induced intestinal allergy.
Results. CL413 and CL531 induced BMmDC-derived IL-10 secretion, suppressed rOVA-induced IL-5 secretion from OVA-specific DO11.10 CD4+ TCs, and induced proinflammatory cytokine secretion in vivo. In contrast, CL401 induced considerably less IL-10 secretion and led to IL-17A production in BMmDC:TC cocultures, but not BMCMC IL-6 secretion, or IL-6 or TNF-α production in vivo. No immune-modulating effects were observed with single ligands. All dual TLR2/7 ligands suppressed DNP-induced IgE-and-Ag-specific mast cell degranulation. Compared to vaccination with OVA, vaccination with the mixture CL531 and OVA, significantly suppressed OVA-specific IgE production in the intestinal allergy model.
Conclusions. Based on beneficial immune-modulating properties, CL413 and CL531 may have utility as potential adjuvants for allergy treatment.
Purpose: The design of biorelevant conditions for in vitro evaluation of orally administered drug products is contingent on obtaining accurate values for physiologically relevant parameters such as pH, buffer capacity and bile salt concentrations in upper gastrointestinal fluids.
Methods: The impact of sample handling on the measurement of pH and buffer capacity of aspirates from the upper gastrointestinal tract was evaluated, with a focus on centrifugation and freeze-thaw cycling as factors that can influence results. Since bicarbonate is a key buffer system in the fasted state and is used to represent conditions in the upper intestine in vitro, variations on sample handling were also investigated for bicarbonate-based buffers prepared in the laboratory.
Results: Centrifugation and freezing significantly increase pH and decrease buffer capacity in samples obtained by aspiration from the upper gastrointestinal tract in the fasted state and in bicarbonate buffers prepared in vitro. Comparison of data suggested that the buffer system in the small intestine does not derive exclusively from bicarbonates.
Conclusions: Measurement of both pH and buffer capacity immediately after aspiration are strongly recommended as “best practice” and should be adopted as the standard procedure for measuring pH and buffer capacity in aspirates from the gastrointestinal tract. Only data obtained in this way provide a valid basis for setting the physiological parameters in physiologically based pharmacokinetic models.
Changes in vitamin D serum levels have been associated with inflammatory diseases, such as inflammatory bowel disease (IBD), rheumatoid arthritis, systemic lupus erythematosus, multiple sclerosis (MS), atherosclerosis, or asthma. Genome- and transcriptome-wide studies indicate that vitamin D signaling modulates many inflammatory responses on several levels. This includes (i) the regulation of the expression of genes which generate pro-inflammatory mediators, such as cyclooxygenases or 5-lipoxygenase, (ii) the interference with transcription factors, such as NF-κB, which regulate the expression of inflammatory genes and (iii) the activation of signaling cascades, such as MAP kinases which mediate inflammatory responses. Vitamin D targets various tissues and cell types, a number of which belong to the immune system, such as monocytes/macrophages, dendritic cells (DCs) as well as B- and T cells, leading to individual responses of each cell type. One hallmark of these specific vitamin D effects is the cell-type specific regulation of genes involved in the regulation of inflammatory processes and the interplay between vitamin D signaling and other signaling cascades involved in inflammation. An important task in the near future will be the elucidation of the regulatory mechanisms that are involved in the regulation of inflammatory responses by vitamin D on the molecular level by the use of techniques such as chromatin immunoprecipitation (ChIP), ChIP-seq, and FAIRE-seq.
Therapy of acute myeloid leukemia (AML) is unsatisfactory. Histone deacetylase inhibitors (HDACi) are active against leukemic cells in vitro and in vivo. Clinical data suggest further testing of such epigenetic drugs and to identify mechanisms and markers for their efficacy. Primary and permanent AML cells were screened for viability, replication stress/DNA damage, and regrowth capacities after single exposures to the clinically used pan-HDACi panobinostat (LBH589), the class I HDACi entinostat/romidepsin (MS-275/FK228), the HDAC3 inhibitor RGFP966, the HDAC6 inhibitor marbostat-100, the non-steroidal anti-inflammatory drug (NSAID) indomethacin, and the replication stress inducer hydroxyurea (HU). Immunoblotting was used to test if HDACi modulate the leukemia-associated transcription factors β-catenin, Wilms tumor (WT1), and myelocytomatosis oncogene (MYC). RNAi was used to delineate how these factors interact. We show that LBH589, MS-275, FK228, RGFP966, and HU induce apoptosis, replication stress/DNA damage, and apoptotic fragmentation of β-catenin. Indomethacin destabilizes β-catenin and potentiates anti-proliferative effects of HDACi. HDACi attenuate WT1 and MYC caspase-dependently and -independently. Genetic experiments reveal a cross-regulation between MYC and WT1 and a regulation of β-catenin by WT1. In conclusion, reduced levels of β-catenin, MYC, and WT1 are molecular markers for the efficacy of HDACi. HDAC3 inhibition induces apoptosis and disrupts tumor-associated protein expression.
Comprehensive landscape of active deubiquitinating enzymes profiled by advanced chemoproteomics
(2019)
Enzymes that bind and process ubiquitin, a small 76-amino-acid protein, have been recognized as pharmacological targets in oncology, immunological disorders, and neurodegeneration. Mass spectrometry technology has now reached the capacity to cover the proteome with enough depth to interrogate entire biochemical pathways including those that contain DUBs and E3 ligase substrates. We have recently characterized the breast cancer cell (MCF7) deep proteome by detecting and quantifying ~10,000 proteins, and within this data set, we can detect endogenous expression of 65 deubiquitylating enzymes (DUBs), whereas matching transcriptomics detected 78 DUB mRNAs. Since enzyme activity provides another meaningful layer of information in addition to the expression levels, we have combined advanced mass spectrometry technology, pre-fractionation, and more potent/selective ubiquitin active-site probes with propargylic-based electrophiles to profile 74 DUBs including distinguishable isoforms for 5 DUBs in MCF7 crude extract material. Competition experiments with cysteine alkylating agents and pan-DUB inhibitors combined with probe labeling revealed the proportion of active cellular DUBs directly engaged with probes by label-free quantitative (LFQ) mass spectrometry. This demonstrated that USP13, 39, and 40 are non-reactive to probe, indicating restricted enzymatic activity under these cellular conditions. Our extended chemoproteomics workflow increases depth of covering the active DUBome, including isoform-specific resolution, and provides the framework for more comprehensive cell-based small-molecule DUB selectivity profiling.
The interaction of fibroblast growth factors (FGFs) with their fibroblast growth factor receptors (FGFRs) are important in the signaling network of cell growth and development. SSR128129E (SSR),[1, 2] a ligand of small molecular weight with potential anti-cancer properties, acts allosterically on the extracellular domains of FGFRs. Up to now, the structural basis of SSR binding to the D3 domain of FGFR remained elusive. This work reports the structural characterization of the interaction of SSR with one specific receptor, FGFR3, by NMR spectroscopy. This information provides a basis for rational drug design for allosteric FGFR inhibitors.
Neuropathic pain is a debilitating and commonly treatment-refractory condition requiring novel therapeutic options. Accumulating preclinical studies indicate that the potassium channel Slack (KNa1.1) contributes to the processing of neuropathic pain, and that Slack activators, when injected into mice, ameliorate pain-related hypersensitivity. However, whether Slack activation might reduce neuropathic pain in humans remains elusive. Here, we evaluated the tolerability and analgesic efficacy of loxapine, a first-generation antipsychotic drug and Slack activator, in neuropathic pain patients. We aimed to treat 12 patients with chronic chemotherapy-induced, treatment-refractory neuropathic pain (pain severity ≥ 4 units on an 11-point numerical rating scale) in a monocentric, open label, proof-of-principle study. Patients received loxapine orally as add-on analgesic in a dose-escalating manner (four treatment episodes for 14 days, daily dose: 20, 30, 40, or 60 mg loxapine) depending on tolerability and analgesic efficacy. Patient-reported outcomes of pain intensity and/or relief were recorded daily. After enrolling four patients, this study was prematurely terminated due to adverse events typically occurring with first-generation antipsychotic drugs that were reported by all patients. In two patients receiving loxapine for at least two treatment episodes, a clinically relevant analgesic effect was found at a daily dose of 20–30 mg of loxapine. Another two patients tolerated loxapine only for a few days. Together, our data further support the hypothesis that Slack activation might be a novel strategy for neuropathic pain therapy. However, loxapine is no valid treatment option for painful polyneuropathy due to profound dopamine and histamine receptor-related side effects.
Clinical Trial Registration: www.ClinicalTrials.gov, identifier NCT02820519.
Introduction: When developing bio-enabling formulations, innovative tools are required to understand and predict in vivo performance and may facilitate approval by regulatory authorities. EMEND® is an example of such a formulation, in which the active pharmaceutical ingredient, aprepitant, is nano-sized. The aims of this study were 1) to characterize the 80 mg and 125 mg EMEND® capsules in vitro using biorelevant tools, 2) to develop and parameterize a physiologically based pharmacokinetic (PBPK) model to simulate and better understand the in vivo performance of EMEND® capsules and 3) to assess which parameters primarily influence the in vivo performance of this formulation across the therapeutic dose range.
Methods: Solubility, dissolution and transfer experiments were performed in various biorelevant media simulating the fasted and fed state environment in the gastrointestinal tract. An in silico PBPK model for healthy volunteers was developed in the Simcyp Simulator, informed by the in vitro results and data available from the literature.
Results: In vitro experiments indicated a large effect of native surfactants on the solubility of aprepitant. Coupling the in vitro results with the PBPK model led to an appropriate simulation of aprepitant plasma concentrations after administration of 80 mg and 125 mg EMEND® capsules in both the fasted and fed states. Parameter Sensitivity Analysis (PSA) was conducted to investigate the effect of several parameters on the in vivo performance of EMEND®. While nano-sizing aprepitant improves its in vivo performance, intestinal solubility remains a barrier to its bioavailability and thus aprepitant should be classified as DCS IIb.
Conclusions: The present study underlines the importance of combining in vitro and in silico biopharmaceutical tools to understand and predict the absorption of this poorly soluble compound from an enabling formulation. The approach can be applied to other poorly soluble compounds to support rational formulation design and to facilitate regulatory assessment of the bio-performance of enabling formulations.
Pharmacology: the pharmacodynamics of nutrients and nutrient interactions in biological functions
(2015)
Epidemiological studies and randomized controlled trials (RCTs) have shown that nutrition and nutritional habits may play a critical role in the optimal functioning of biological systems from conception to old age. Epidemiological studies, due to their methodology, can only provide correlations between consumption of nutrient(s) and biological outcomes, whereas RCTs normally study just one dose of a certain nutrient. Both study types are therefore ill-suited to study the mechanisms by which nutrients exert their benefits. Moreover, the nutrients’ functions may depend on each other. For example, B-vitamins’ functions are known to be interdependent. While the exact mechanisms are unclear, the course and severity of conditions such as obesity, cellular aging, cancer, and neurological disorders can be affected by nutritional approaches. Thus, food and nutrition play an intimate and inextricable role in human health. Despite growing interest in adequate nutrition, the effects of nutrient interaction, the possible varying effects on different organs, and the dependency of such effects on age or health status are complicated topics that deserve careful examination. ...
Mitochondria are involved in the aging processes that ultimately lead to neurodegeneration and the development of Alzheimer’s disease (AD). A healthy lifestyle, including a diet rich in antioxidants and polyphenols, represents one strategy to protect the brain and to prevent neurodegeneration. We recently reported that a stabilized hexanic rice bran extract (RBE) rich in vitamin E and polyphenols (but unsuitable for human consumption) has beneficial effects on mitochondrial function in vitro and in vivo (doi:10.1016/j.phrs.2013.06.008, 10.3233/JAD-132084). To enable the use of RBE as food additive, a stabilized ethanolic extract has been produced. Here, we compare the vitamin E profiles of both extracts and their effects on mitochondrial function (ATP concentrations, mitochondrial membrane potential, mitochondrial respiration and mitochondrial biogenesis) in PC12 cells. We found that vitamin E contents and the effects of both RBE on mitochondrial function were similar. Furthermore, we aimed to identify components responsible for the mitochondria-protective effects of RBE, but could not achieve a conclusive result. α-Tocotrienol and possibly also γ-tocotrienol, α-tocopherol and δ-tocopherol might be involved, but hitherto unknown components of RBE or a synergistic effect of various components might also play a role in mediating RBE’s beneficial effects on mitochondrial function.
Bromodomains (BRDs) are conserved protein interaction modules which recognize (read) acetyl-lysine modifications, however their role(s) in regulating cellular states and their potential as targets for the development of targeted treatment strategies is poorly understood. Here we present a set of 25 chemical probes, selective small molecule inhibitors, covering 29 human bromodomain targets. We comprehensively evaluate the selectivity of this probe-set using BROMOscan and demonstrate the utility of the set identifying roles of BRDs in cellular processes and potential translational applications. For instance, we discovered crosstalk between histone acetylation and the glycolytic pathway resulting in a vulnerability of breast cancer cell lines under conditions of glucose deprivation or GLUT1 inhibition to inhibition of BRPF2/3 BRDs. This chemical probe-set will serve as a resource for future applications in the discovery of new physiological roles of bromodomain proteins in normal and disease states, and as a toolset for bromodomain target validation.
Cysteinyl leukotriene receptor 1 antagonists (CysLT1RA) are frequently used as add-on medication for the treatment of asthma. Recently, these compounds have shown protective effects in cardiovascular diseases. This prompted us to investigate their influence on soluble epoxide hydrolase (sEH) and peroxisome proliferator activated receptor (PPAR) activities, two targets known to play an important role in CVD and the metabolic syndrome. Montelukast, pranlukast and zafirlukast inhibited human sEH with IC50 values of 1.9, 14.1, and 0.8 μM, respectively. In contrast, only montelukast and zafirlukast activated PPARγ in the reporter gene assay with EC50 values of 1.17 μM (21.9% max. activation) and 2.49 μM (148% max. activation), respectively. PPARα and δ were not affected by any of the compounds. The activation of PPARγ was further investigated in 3T3-L1 adipocytes. Analysis of lipid accumulation, mRNA and protein expression of target genes as well as PPARγ phosphorylation revealed that montelukast was not able to induce adipocyte differentiation. In contrast, zafirlukast triggered moderate lipid accumulation compared to rosiglitazone and upregulated PPARγ target genes. In addition, we found that montelukast and zafirlukast display antagonistic activities concerning recruitment of the PPARγ cofactor CBP upon ligand binding suggesting that both compounds act as PPARγ modulators. In addition, zafirlukast impaired the TNFα triggered phosphorylation of PPARγ2 on serine 273. Thus, zafirlukast is a novel dual sEH/PPARγ modulator representing an excellent starting point for the further development of this compound class.
5-lipoxygenase (5-LO) is the key enzyme in the biosynthesis of leukotrienes and specialized proresolving lipid mediators (SPM). It is mainly expressed in leukocytes and is part of the innate immune system. 5-LO can shuttle between the cytosol and the nucleus. Upon cell activation the protein translocates from soluble cellular compartments to the nuclear membrane. Besides FLAP which is required for cellular leukotriene and SPM formation, 5-LO interacts with other proteins like coactosin-like protein (CLP), Dicer, β-catenin and p53. In this review, the factors involved in the regulation of 5-LO expression, the role of 5-LO in the regulation of stem cell proliferation and differentiation and its biological functions apart from leukotriene and SPM formation are summarized.
Background: Human genetic research has implicated functional variants of more than one hundred genes in the modulation of persisting pain. Artificial intelligence and machine‐learning techniques may combine this knowledge with results of genetic research gathered in any context, which permits the identification of the key biological processes involved in chronic sensitization to pain.
Methods: Based on published evidence, a set of 110 genes carrying variants reported to be associated with modulation of the clinical phenotype of persisting pain in eight different clinical settings was submitted to unsupervised machine‐learning aimed at functional clustering. Subsequently, a mathematically supported subset of genes, comprising those most consistently involved in persisting pain, was analysed by means of computational functional genomics in the Gene Ontology knowledgebase.
Results: Clustering of genes with evidence for a modulation of persisting pain elucidated a functionally heterogeneous set. The situation cleared when the focus was narrowed to a genetic modulation consistently observed throughout several clinical settings. On this basis, two groups of biological processes, the immune system and nitric oxide signalling, emerged as major players in sensitization to persisting pain, which is biologically highly plausible and in agreement with other lines of pain research.
Conclusions: The present computational functional genomics‐based approach provided a computational systems‐biology perspective on chronic sensitization to pain. Human genetic control of persisting pain points to the immune system as a source of potential future targets for drugs directed against persisting pain. Contemporary machine‐learned methods provide innovative approaches to knowledge discovery from previous evidence.
Significance: We show that knowledge discovery in genetic databases and contemporary machine‐learned techniques can identify relevant biological processes involved in Persitent pain.
IKZF1 deletion (ΔIKZF1) is an important predictor of relapse in both childhood and adult B-cell precursor acute lymphoblastic leukemia (B-ALL). Previously, we revealed that COBL is a hotspot for breakpoints in leukemia and could promote IKZF1 deletions. Through an international collaboration, we provide a detailed genetic and clinical picture of B-ALL with COBL rearrangements (COBL-r). Patients with B-ALL and IKZF1 deletion (n = 133) were included. IKZF1 ∆1-8 were associated with large alterations within chromosome 7: monosomy 7 (18%), isochromosome 7q (10%), 7p loss (19%), and interstitial deletions (53%). The latter included COBL-r, which were found in 12% of the IKZF1 ∆1-8 cohort. Patients with COBL-r are mostly classified as intermediate cytogenetic risk and frequently harbor ETV6, PAX5, CDKN2A/B deletions. Overall, 56% of breakpoints were located within COBL intron 5. Cryptic recombination signal sequence motifs were broadly distributed within the sequence of COBL, and no enrichment for the breakpoint cluster region was found. In summary, a diverse spectrum of alterations characterizes ΔIKZF1 and they also include deletion breakpoints within COBL. We confirmed that COBL is a hotspot associated with ΔIKZF1, but these rearrangements are not driven by RAG-mediated recombination.
A series of derivatives of the potent dual soluble epoxide hydrolase (sEH)/5-lipoxygenase-activating protein (FLAP) inhibitor diflapolin was designed, synthesized, and characterized by 1H NMR, 13C NMR, and elemental analysis. These novel compounds were biologically evaluated for their inhibitory activity against sEH and FLAP. Molecular modeling tools were applied to analyze structure–activity relationships (SAR) on both targets. Results show that even small modifications on the lead compound diflapolin markedly influence the inhibitory potential, especially on FLAP, suggesting very narrow SAR.
During erythropoiesis, haematopoietic stem cells (HSCs) differentiate in successive steps of commitment and specification to mature erythrocytes. This differentiation process is controlled by transcription factors that establish stage- and cell type-specific gene expression. In this study, we demonstrate that FUSE binding protein 1 (FUBP1), a transcriptional regulator important for HSC self-renewal and survival, is regulated by T-cell acute lymphocytic leukaemia 1 (TAL1) in erythroid progenitor cells. TAL1 directly activates the FUBP1 promoter, leading to increased FUBP1 expression during erythroid differentiation. The binding of TAL1 to the FUBP1 promoter is highly dependent on an intact GATA sequence in a combined E-box/GATA motif. We found that FUBP1 expression is required for efficient erythropoiesis, as FUBP1-deficient progenitor cells were limited in their potential of erythroid differentiation. Thus, the finding of an interconnection between GATA1/TAL1 and FUBP1 reveals a molecular mechanism that is part of the switch from progenitor- to erythrocyte-specific gene expression. In summary, we identified a TAL1/FUBP1 transcriptional relationship, whose physiological function in haematopoiesis is connected to proper erythropoiesis.
Impaired NO-cGMP signaling has been linked to several neurological disorders. NO-sensitive guanylyl cyclase (NO-GC), of which two isoforms—NO-GC1 and NO-GC2—are known, represents a promising drug target to increase cGMP in the brain. Drug-like small molecules have been discovered that work synergistically with NO to stimulate NO-GC activity. However, the effects of NO-GC stimulators in the brain are not well understood. In the present study, we used Förster/fluorescence resonance energy transfer (FRET)-based real-time imaging of cGMP in acute brain slices and primary neurons of cGMP sensor mice to comparatively assess the activity of two structurally different NO-GC stimulators, IWP-051 and BAY 41-2272, in the cerebellum, striatum and hippocampus. BAY 41-2272 potentiated an elevation of cGMP induced by the NO donor DEA/NO in all tested brain regions. Interestingly, IWP-051 potentiated DEA/NO-induced cGMP increases in the cerebellum and striatum, but not in the hippocampal CA1 area or primary hippocampal neurons. The brain-region-selective activity of IWP-051 suggested that it might act in a NO-GC isoform-selective manner. Results of mRNA in situ hybridization indicated that the cerebellum and striatum express NO-GC1 and NO-GC2, while the hippocampal CA1 area expresses mainly NO-GC2. IWP-051-potentiated DEA/NO-induced cGMP signals in the striatum of NO-GC2 knockout mice but was ineffective in the striatum of NO-GC1 knockout mice. These results indicate that IWP-051 preferentially stimulates NO-GC1 signaling in brain slices. Interestingly, no evidence for an isoform-specific effect of IWP-051 was observed when the cGMP-forming activity of whole brain homogenates was measured. This apparent discrepancy suggests that the method and conditions of cGMP measurement can influence results with NO-GC stimulators. Nevertheless, it is clear that NO-GC stimulators enhance cGMP signaling in the brain and should be further developed for the treatment of neurological diseases.
Gegenstand dieser Dissertation war das Ermitteln der Verbesserung der peroralen Bioverfügbarkeit Fenofibrat (FFB) durch lipid-basierte Formulierung (LBF). Eine weitere Aufgabe bestand darin, verschiedene analytische Methoden zur Bewertung der Verbesserung der oralen Bioverfügbarkeit von Fenofibrat einzusetzen. Diese schlossen in vitro biorelevante Löslichkeits-, Dispersions-, Auflösungs- und Präzipitationstests ein. Auf Basis der analytischen Ergebnisse wurden dann PBPK-Modelle verwendet, um menschliche Plasmaprofile nach der Verabreichung der FFB-Formulierungen zu simulieren. Die daraus resultierenden in silico-Vorhersagen stimmten mit den in vivo-Beobachtungen überein. Durch Anwendung der Parametersensitivitätsanalyse war es weiterhin möglich, ein mechanistisches Verständnis der beteiligten geschwindigkeitsbegrenzenden Schritte zu erreichen.
Formulierungen auf Lipidbasis können nach dem Pouton-Klassifizierungssytem eingeteilt werden. Typ I Formulierungen bestehen ausschließlich aus Ölen, während am anderen Ende der Skala die Typ IV Formulierung weitestgehend aus Tensiden ist. In dieser Arbeit wurden in erster Linie Lipidformulierungen Typ IIIA und Typ IIIB untersucht.
Es wurde gezeigt, dass Dispersionstests an FFB-Lipidformulierungen am besten unter Verwendung der USP 3-Apparatur durchgeführt werden, da in diesem Apparat die GI-Motilität in vivo am besten reflektiert wird. Um die Hydrodynamik in verschiedenen Auflösungsapparaten zu vergleichen, wurde der Auflösungsversuch von LBF Nr. 1 – Nr. 4 von FFB auch unter Verwendung von USP 2 durchgeführt. Ungeachtet von kompendialen oder biorelevanten Medien führten die meisten dieser Lipidformulierungen zur Auflösung eines Großteils des beladenen Medikaments, im Gegensatz zum unformulierten Fenofibrat, das sich in nüchternem Zustand kaum auflöst. Weiter zeigten die Transfermodellexperimente an den Lipidformulierungen von FFB, dass eine intestinale Präzipitation nach einer Magenauflösung unwahrscheinlich ist.
Durch mathematische Transformation der Noyes-Whitney-Gleichung kann ein Excel-Toolkit zur Berechnung des z-Werts aus in-vitro-Auflösungsprofilen verwendet werden. Die z-Werte werden dann in physiologisch-basierte pharmakokinetische in silico Modelle, STELLA® und Simcyp®, eingesetzt. Anhand der erforderlichen post-absorptiven Parameter kann mithilfe dieser Modelle die Plasma-Arzneistoff-Konzentration nach oraler Verabreichung von verschiedenen Formulierungen vorhergesagt werden. Darüber hinaus ermöglicht der Simcyp®-Simulator eine Reihe von virtuellen Versuchen, die PK-Variabilität vom Wirkstoff in verschiedenen Bevölkerungsgruppen zu bestimmen. Um diese Möglichkeiten für LBF von Fenofibrat zu testen, wurde LBF Nr. 4 modelliert. Das Simulationsergebnis von Simcyp® entsprach dem aus der STELLA®-Software. Weiterhin wurden die Plasmafenofibrinsäure-Konzentrationsprofile von den Modellen genau vorhergesagt. Die Punktschätzwerte für Cmax und AUC, berechnet aus den In-silico und in vivo Plasmaprofilen, lagen sogar im Bereich von 0,8-1,25 für die SMEDDS Lösung und Kapselformulierungen. Diese Übereinstimmung von in vitro-in silico mit in vivo wurde weiterhin durch Berechnung der jeweiligen f2 Faktoren unterstützt.
Basierend auf diesen Ergebnissen scheint es, dass der In-vitro-In-Silico-In-vivo-Ansatz ein nützliches Werkzeug zum Identifizieren und Vergleichen von Beschränkungen der oralen Absorption für Formulierungen auf Lipidbasis und zum Optimieren der Lipidformulierungsentwicklung von schlecht löslichen Arzneimitteln darstellt.
Full reconstruction of large lobula plate tangential cells in Drosophila from a 3D EM dataset
(2018)
With the advent of neurogenetic methods, the neural basis of behavior is presently being analyzed in more and more detail. This is particularly true for visually driven behavior of Drosophila melanogaster where cell-specific driver lines exist that, depending on the combination with appropriate effector genes, allow for targeted recording, silencing and optogenetic stimulation of individual cell-types. Together with detailed connectomic data of large parts of the fly optic lobe, this has recently led to much progress in our understanding of the neural circuits underlying local motion detection. However, how such local information is combined by optic flow sensitive large-field neurons is still incompletely understood. Here, we aim to fill this gap by a dense reconstruction of lobula plate tangential cells of the fly lobula plate. These neurons collect input from many hundreds of local motion-sensing T4/T5 neurons and connect them to descending neurons or central brain areas. We confirm all basic features of HS and VS cells as published previously from light microscopy. In addition, we identified the dorsal and the ventral centrifugal horizontal, dCH and vCH cell, as well as three VSlike cells, including their distinct dendritic and axonal projection area.
The adaptor molecule stimulator of IFN genes (STING) is central to production of type I IFNs in response to infection with DNA viruses and to presence of host DNA in the cytosol. Excessive release of type I IFNs through STING-dependent mechanisms has emerged as a central driver of several interferonopathies, including systemic lupus erythematosus (SLE), Aicardi–Goutières syndrome (AGS), and stimulator of IFN genes-associated vasculopathy with onset in infancy (SAVI). The involvement of STING in these diseases points to an unmet need for the development of agents that inhibit STING signaling. Here, we report that endogenously formed nitro-fatty acids can covalently modify STING by nitro-alkylation. These nitro-alkylations inhibit STING palmitoylation, STING signaling, and subsequently, the release of type I IFN in both human and murine cells. Furthermore, treatment with nitro-fatty acids was sufficient to inhibit production of type I IFN in fibroblasts derived from SAVI patients with a gain-of-function mutation in STING. In conclusion, we have identified nitro-fatty acids as endogenously formed inhibitors of STING signaling and propose for these lipids to be considered in the treatment of STING-dependent inflammatory diseases.
Age-related diseases, such as osteoarthritis, Alzheimer’s disease, diabetes, and cardiovascular disease, are often associated with chronic unresolved inflammation. Neutrophils play central roles in this process by releasing tissue-degenerative proteases, such as cathepsin G, as well as pro-inflammatory leukotrienes produced by the 5-lipoxygenase (5-LO) pathway. Boswellic acids (BAs) are pentacyclic triterpene acids contained in the gum resin of the anti-inflammatory remedy frankincense that target cathepsin G and 5-LO in neutrophils, and might thus represent suitable leads for intervention with age-associated diseases that have a chronic inflammatory component. Here, we investigated whether, in addition to BAs, other triterpene acids from frankincense interfere with 5-LO and cathepsin G. We provide a comprehensive analysis of 17 natural tetra- or pentacyclic triterpene acids for suppression of 5-LO product synthesis in human neutrophils. These triterpene acids were also investigated for their direct interference with 5-LO and cathepsin G in cell-free assays. Furthermore, our studies were expanded to 10 semi-synthetic BA derivatives. Our data reveal that besides BAs, several tetra- and pentacyclic triterpene acids are effective or even superior inhibitors of 5-LO product formation in human neutrophils, and in parallel, inhibit cathepsin G. Their beneficial target profile may qualify triterpene acids as anti-inflammatory natural products and pharmacological leads for intervention with diseases related to aging.
Adult neurogenesis is regulated by stem cell niche-derived extrinsic factors and cell-intrinsic regulators, yet the mechanisms by which niche signals impinge on the activity of intrinsic neurogenic transcription factors remain poorly defined. Here, we report that MEIS2, an essential regulator of adult SVZ neurogenesis, is subject to posttranslational regulation in the SVZ olfactory bulb neurogenic system. Nuclear accumulation of MEIS2 in adult SVZ-derived progenitor cells follows downregulation of EGFR signaling and is modulated by methylation of MEIS2 on a conserved arginine, which lies in close proximity to nested binding sites for the nuclear export receptor CRM1 and the MEIS dimerization partner PBX1. Methylation impairs interaction with CRM1 without affecting PBX1 dimerization and thereby allows MEIS2 nuclear accumulation, a prerequisite for neuronal differentiation. Our results describe a form of posttranscriptional modulation of adult SVZ neurogenesis whereby an extrinsic signal fine-tunes neurogenesis through posttranslational modification of a transcriptional regulator of cell fate.
Background: Treatment complexity rises in line with the number of drugs, single doses, and administration methods, thereby threatening patient adherence. Patients with multimorbidity often need flexible, individualised treatment regimens, but alterations during the course of treatment may further increase complexity. The objective of our study was to explore medication changes in older patients with multimorbidity and polypharmacy in general practice.
Methods: We retrospectively analysed data from the cluster-randomised PRIMUM trial (PRIoritisation of MUltimedication in Multimorbidity) conducted in 72 general practices. We developed an algorithm for active pharmaceutical ingredients (API), strength, dosage, and administration method to assess changes in physician-reported medication data during two intervals (baseline to six-months: ∆1; six- to nine-months: ∆2), analysed them descriptively at prescription and patient levels, and checked for intervention effects.
Results: Of 502 patients (median age 72 years, 52% female), 464 completed the study. Changes occurred in 98.6% of patients (changes were 19% more likely in the intervention group): API changes during ∆1 and ∆2 occurred in 414 (82.5%) and 338 (67.3%) of patients, dosage alterations in 372 (74.1%) and 296 (59.2%), and changes in API strength in 158 (31.5%) and 138 (27.5%) respectively. Administration method changed in 79 (16%) of patients in both ∆1 and ∆2. Simvastatin, metformin and aspirin were most frequently subject to alterations.
Conclusion: Medication regimens in older patients with multimorbidity and polypharmacy changed frequently. These are mostly due to discontinuations and dosage alterations, followed by additions and restarts. These findings cast doubt on the effectiveness of cross-sectional assessments of medication and support longitudinal assessments where possible.
Trial registration: 1. Prospective registration: Trial registration number: NCT01171339; Name of registry: ClinicalTrials.gov; Date of registration: July 27, 2010; Date of enrolment of the first participant to the trial: August 12, 2010.
2. Peer reviewed trial registration: Trial registration number: ISRCTN99526053; Name of registry: Controlled Trials; Date of registration: August 31, 2010; Date of enrolment of the first participant to the trial: August 12, 2010.
Objective: To evaluate the efficacy and tolerability of brivaracetam (BRV) in a severely drug refractory cohort of patients with epileptic encephalopathies (EE).
Method: A multicenter, retrospective cohort study recruiting all patients treated with EE who began treatment with BRV in an enrolling epilepsy center between 2016 and 2017.
Results: Forty-four patients (27 male [61%], mean age 29 years, range 6 to 62) were treated with BRV. The retention rate was 65% at 3 months, 52% at 6 months and 41% at 12 months. A mean retention time of 5 months resulted in a cumulative exposure to BRV of 310 months. Three patients were seizure free during the baseline. At 3 months, 20 (45%, 20/44 as per intention-to-treat analysis considering all patients that started BRV including three who were seizure free during baseline) were either seizure free (n = 4; 9%, three of them already seizure-free at baseline) or reported at least 25% (n = 4; 9%) or 50% (n = 12; 27%) reduction in seizures. An increase in seizure frequency was reported in two (5%) patients, while there was no change in the seizure frequency of the other patients. A 50% long-term responder rate was apparent in 19 patients (43%), with two (5%) free from seizures for more than six months and in nine patients (20%, with one [2 %] free from seizures) for more than 12 months. Treatment-emergent adverse events were predominantly of psychobehavioural nature and were observed in 16%.
Significance: In this retrospective analysis the rate of patients with a 50% seizure reduction under BRV proofed to be similar to those seen in regulatory trials for focal epilepsies. BRV appears to be safe and relatively well tolerated in EE and might be considered in patients with psychobehavioral adverse events while on levetiracetam.
The p300/CBP‐associated factor (PCAF) and related GCN5 bromodomain‐containing lysine acetyl transferases are members of subfamily I of the bromodomain phylogenetic tree. Iterative cycles of rational inhibitor design and biophysical characterization led to the discovery of the triazolopthalazine‐based L‐45 (dubbed L‐Moses) as the first potent, selective, and cell‐active PCAF bromodomain (Brd) inhibitor. Synthesis from readily available (1R,2S)‐(−)‐norephedrine furnished L‐45 in enantiopure form. L‐45 was shown to disrupt PCAF‐Brd histone H3.3 interaction in cells using a nanoBRET assay, and a co‐crystal structure of L‐45 with the homologous Brd PfGCN5 from Plasmodium falciparum rationalizes the high selectivity for PCAF and GCN5 bromodomains. Compound L‐45 shows no observable cytotoxicity in peripheral blood mononuclear cells (PBMC), good cell‐permeability, and metabolic stability in human and mouse liver microsomes, supporting its potential for in vivo use.