1
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Qiu G, Li F, Kowah JAH, Xie J, Long Q, Wang L, Liu X. Novel chiral matrine derivatives as potential antitumor agents: Design, synthesis and biological evaluation. Bioorg Chem 2024; 146:107276. [PMID: 38479132 DOI: 10.1016/j.bioorg.2024.107276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 03/06/2024] [Accepted: 03/07/2024] [Indexed: 04/13/2024]
Abstract
Since the thalidomide incident, research on chiral drugs has escalated immensely. Differences in drug configuration can lead to significant variations in therapeutic efficacy. Matrine, a natural product esteemed for its low toxicity and high water solubility, has garnered significant attention in research endeavors. Nonetheless, its precise target has proven elusive. In this study, we designed and synthesized a novel chiral matrine derivative. Their cytotoxicity against three types of tumor cells was assessed. Comparing the newly synthesized derivatives to the parent matrine, most compounds exhibited significantly enhanced inhibitory effects on cancer cells. Among them, Q12 exhibited the highest activity, with IC50 values of 8.31 μM against rat glioma cells C6, 6.3 μM against human liver cancer cells HepG2 and 7.14 μM against human gastric cancer cells HGC-27, meanwhile showing low toxicity. Based on IC50 values, we constructed a preliminary structure-activity relationship (SAR). Compound Q12 significantly suppressed the cloning and migration of HepG2 cells. Further mechanistic studies indicated that Q12 inhibited Topo I in HepG2 cells, leading to DNA damage, induction of G0/G1 cell cycle arrest and ultimately causing apoptosis. The molecular docking experiments provided a rational binding mode of Q12 with the Topo I-DNA complex. In vivo, experiments demonstrated that Q12 exhibited a higher tumor growth inhibition rate (TGI) compared to the positive control drug Lenvatinib, while maintaining good safety. In summary, it suggests that Topo I might be a potential target for matrine and Q12 represents a promising candidate for cancer treatment.
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Affiliation(s)
- Gan Qiu
- School of Chemistry and Chemical Engineering, Guangxi University, Nanning 530004, China
| | - Fan Li
- School of Medicine, Guangxi University, Nanning 530004, China
| | - Jamal A H Kowah
- School of Chemistry and Chemical Engineering, Guangxi University, Nanning 530004, China
| | - Junwei Xie
- School of Medicine, Guangxi University, Nanning 530004, China
| | - Qingfeng Long
- School of Medicine, Guangxi University, Nanning 530004, China
| | - Lisheng Wang
- School of Medicine, Guangxi University, Nanning 530004, China.
| | - Xu Liu
- School of Medicine, Guangxi University, Nanning 530004, China.
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2
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Xu Y, Woo SB, Treister NS. Thalidomide for management of refractory oral mucosal diseases. Oral Surg Oral Med Oral Pathol Oral Radiol 2024; 137:372-378. [PMID: 38388332 DOI: 10.1016/j.oooo.2023.12.793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 12/12/2023] [Accepted: 12/30/2023] [Indexed: 02/24/2024]
Abstract
BACKGROUND Thalidomide has anti-inflammatory properties and has been used off-label for multiple mucocutaneous disorders, but its application in managing refractory oral mucosal diseases is unclear. This study aimed to review the efficacy and safety of thalidomide in treating various oral mucosal disorders refractory to conventional therapies. METHODS The medical records of patients who were prescribed thalidomide from 2002 through 2021 for oral mucosal disorders were reviewed. Data collected included demographic characteristics, oral mucosal disease diagnosis, treatment courses, and thalidomide dose, duration, response, and side effects. RESULTS Thalidomide was prescribed for 28 patients with diagnoses of recurrent aphthous stomatitis (n = 14), inflammatory oral lichenoid lesions (n = 6), traumatic ulcerative granuloma with stroma eosinophilia (n = 5), chronic radiation-induced mucositis (n = 2), and orofacial granulomatosis (n = 1). Patients were treated for a median duration of 84 days (range 2-1,582). Clinical improvement was observed in 19 of 22 patients who completed at least 1 cycle of thalidomide (86.4%), with complete resolution in 12 patients (54.5%). Adverse events occurred in 75% of patients (n = 21), with 8 requiring thalidomide discontinuation. The most common adverse events included peripheral neuropathy (42.9%), drowsiness (28.6%), and constipation (21.4%). CONCLUSIONS Thalidomide may be considered for the management of refractory oral mucosal disorders. Drug side effects are common and need monitoring closely during use.
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Affiliation(s)
- Yuanming Xu
- Department of Oral Diagnostic Sciences, Division of Oral Medicine, Tufts University School of Dental Medicine, Boston, MA, USA.
| | - Sook Bin Woo
- Division of Oral Medicine and Dentistry, Brigham and Women's Hospital, Boston, MA USA; Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, MA, USA
| | - Nathaniel S Treister
- Division of Oral Medicine and Dentistry, Brigham and Women's Hospital, Boston, MA USA; Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, MA, USA
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3
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Meltan S, Panuganti B, Tarbox M. Evaluation and Management of Pruritus and Scabies in the Elderly Population. Clin Geriatr Med 2024; 40:91-116. [PMID: 38000864 DOI: 10.1016/j.cger.2023.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2023]
Abstract
Pruritus is the most common dermatologic complaint in the geriatric population. Its growing prevalence coincides with the rapid growth of the elderly population (>65 years of age) in the United States. According to the US Census Bureau, 16.9% of the population, or more than 56 million adults 65 years and older, lived in the United States in 2022. Pruritus is a condition that accompanies a diverse array of underlying etiologic factors. The mechanism of normal itch impulse transmission has been recently elucidated. The itch sensation originates from epidermal/dermal receptors connected to unmyelinated, afferent C-fibers that transmit the impulse from the periphery.
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Affiliation(s)
- Shakira Meltan
- School of Medicine, Texas Tech University Health Sciences Center, TX, USA
| | | | - Michelle Tarbox
- Department of Dermatology, Texas Tech Health Science Center, 3601 4th Street, Stop 9400, Lubbock, TX 79430, USA.
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4
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McSweeney SM, Mounsey S, Arujuna N, Garibaldinos T, Sarkany R, Fassihi H. A single-centre retrospective review of treatment responses and adverse events of thalidomide in patients with inflammatory skin disease. Clin Exp Dermatol 2024; 49:168-170. [PMID: 37652049 DOI: 10.1093/ced/llad294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Revised: 07/06/2023] [Accepted: 09/21/2023] [Indexed: 09/02/2023]
Abstract
This retrospective review summarizes the effectiveness and safety concerns around using thalidomide in the treatment of inflammatory dermatoses.
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Affiliation(s)
- Sheila M McSweeney
- Department of Photodermatology, St John's Institute of Dermatology, Guy's and St Thomas' Hospitals NHS Foundation Trust, London, UK
| | - Stephen Mounsey
- Department of Photodermatology, St John's Institute of Dermatology, Guy's and St Thomas' Hospitals NHS Foundation Trust, London, UK
| | - Nisha Arujuna
- Department of Photodermatology, St John's Institute of Dermatology, Guy's and St Thomas' Hospitals NHS Foundation Trust, London, UK
| | - Trish Garibaldinos
- Department of Photodermatology, St John's Institute of Dermatology, Guy's and St Thomas' Hospitals NHS Foundation Trust, London, UK
| | - Robert Sarkany
- Department of Photodermatology, St John's Institute of Dermatology, Guy's and St Thomas' Hospitals NHS Foundation Trust, London, UK
| | - Hiva Fassihi
- Department of Photodermatology, St John's Institute of Dermatology, Guy's and St Thomas' Hospitals NHS Foundation Trust, London, UK
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5
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Maronese CA, Derlino F, Moltrasio C, Cattaneo D, Iurlo A, Marzano AV. Neutrophilic and eosinophilic dermatoses associated with hematological malignancy. Front Med (Lausanne) 2024; 10:1324258. [PMID: 38249974 PMCID: PMC10796805 DOI: 10.3389/fmed.2023.1324258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 12/20/2023] [Indexed: 01/23/2024] Open
Abstract
Cutaneous manifestations of hematologic malignancy represent both a clinical challenge for the treating physician and a pathophysiological model for advancing the knowledge on individual neoplasms. Indeed, a growing body of evidence supports the concept of recurrent molecular defects associating with specific clinical features, as best exemplified by VEXAS. Herein neutrophilic and eosinophilic dermatoses of potential interest for both hematologists and dermatologists will be reviewed, including subcorneal pustular dermatosis-type IgA pemphigus, neutrophilic eccrine hidradenitis, Sweet's syndrome as well as myelodysplasia cutis and VEXAS, pyoderma gangrenosum, eosinophilic annular erythema, eosinophilic dermatosis of hematological malignancy, Wells syndrome and cutaneous involvement in hypereosinophilic syndromes. Possible management approaches are discussed for each, emphasizing scenarios that require treatment of the underlying condition to achieve remission at the skin level.
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Affiliation(s)
- Carlo Alberto Maronese
- Dermatology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Federica Derlino
- Dermatology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Chiara Moltrasio
- Dermatology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Daniele Cattaneo
- Hematology Division, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Alessandra Iurlo
- Hematology Division, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Angelo Valerio Marzano
- Dermatology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
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6
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Abdallah AE, Eissa IH, Mehany AB, Sakr H, Atwa A, El-Adl K, El-Zahabi MA. Immunomodulatory quinazoline-based thalidomide analogs: Design, synthesis, apoptosis and anticancer evaluations. J Mol Struct 2023. [DOI: 10.1016/j.molstruc.2023.135164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
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7
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Abstract
No pharmaceutical products have been demonstrated to be safe and effective to specifically treat coronavirus disease 2019 (COVID-19); therefore, the therapy administered to infected patients remains symptomatic and empiric. Alongside the development of new, often high-cost drugs, a different tactic is being applied in parallel, investigating long-established, inexpensive medications originally designed for a variety of diseases to study their potential in treating COVID-19. The skin is the largest organ of the human body. With more than 3,000 skin conditions identified, the specialty of dermatology offers a rich armamentarium of systemic therapeutic agents aimed to treat the various chronic immunologically mediated, metabolic, infectious, occupational, inherited, or paraneoplastic dermatoses. Dermatologists have extensive experience with many drugs that have demonstrated promising in vitro antiviral action (directly targeting the viral replication). Many of these drugs have been used as nonspecific immunosuppressive strategies, such as glucocorticoids, synthetic antimalarials, colchicine, or other immunomodulators, and a number of targeted therapeutics have been directed at controlling hyperinflammatory processes similar to the "cytokine storm" associated with COVID-19 infection. We discuss several dermatologic drugs that have already been used or may have a promising role in the treatment of COVID-19.
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8
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Satoh T, Yokozeki H, Murota H, Tokura Y, Kabashima K, Takamori K, Shiohara T, Morita E, Aiba S, Aoyama Y, Hashimoto T, Katayama I. 2020 guidelines for the diagnosis and treatment of prurigo. J Dermatol 2021; 48:e414-e431. [PMID: 34314056 DOI: 10.1111/1346-8138.16067] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 06/24/2021] [Accepted: 06/25/2021] [Indexed: 11/28/2022]
Abstract
Prurigo is a treatment-resistant skin disease characterized by multiple isolated papules/nodules that cause severe itch. Prurigo papules/nodules occur either as primary lesions or as secondary lesions due to persistent scratching. The fundamental concepts and classifications of prurigo have not been sufficiently established, and considerable confusion remains regarding this topic. Clinical guidelines for chronic prurigo in Japan were published in 2012 in an attempt to reduce confusion regarding the concepts of prurigo and to standardize laboratory tests and treatments. However, the diagnostic terms for prurigo and associated concepts have changed over time, and new forms of treatment are under development. We have, thus, updated and revised the guidelines to classify prurigo based on clinical forms and causes, and disease name classifications based on the clinical form have been further simplified, such as prurigo nodularis, prurigo chronica multiformis, and prurigo (not otherwise specified). Expressions for acute, subacute, and chronic forms are not used. These guidelines outline the current concepts and specify treatments for prurigo.
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Affiliation(s)
- Takahiro Satoh
- Department of Dermatology, National Defense Medical College, Tokorozawa, Japan
| | - Hiroo Yokozeki
- Department of Dermatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hiroyuki Murota
- Department of Dermatology, School of Medical Sciences, Nagasaki University, Nagasaki, Japan
| | - Yoshiki Tokura
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Kenji Kabashima
- Department of Dermatology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Kenji Takamori
- Juntendo Itch Research Center, Institute for Environmental and Gender-specific Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Tetsuo Shiohara
- Department of Dermatology, Kyorin University School of Medicine, Tokyo, Japan
| | - Eishin Morita
- Department of Dermatology, Faculty of Medicine, Shimane University, Izumo, Japan
| | - Setsuya Aiba
- Department of Dermatology, Tohoku University School of Medicine, Sendai, Japan
| | - Yumi Aoyama
- Department of Dermatology, Kawasaki Medical School, Kurashiki, Japan
| | - Takashi Hashimoto
- Department of Dermatology, National Defense Medical College, Tokorozawa, Japan
| | - Ichiro Katayama
- Department of Dermatology, Course of Integrated Medicine Graduate School of Medicine, Osaka University, Suita, Japan
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9
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Das A, Sil A, Ghosh S, Panda S. Unconventional uses of common conventional drugs: A review. Indian J Dermatol Venereol Leprol 2021; 87:592-598. [PMID: 33871199 DOI: 10.25259/ijdvl_389_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 09/01/2020] [Indexed: 11/04/2022]
Affiliation(s)
- Anupam Das
- Department of Dermatology, KPC Medical College and Hospital, Kolkata, West Bengal, India
| | - Abheek Sil
- Department of Dermatology, RG Kar Medical College and Hospital, Kolkata, West Bengal, India
| | - Shouvik Ghosh
- Department of Dermatology, KPC Medical College and Hospital, Kolkata, West Bengal, India
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10
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Obi ON, Lower EE, Baughman RP. Biologic and advanced immunomodulating therapeutic options for sarcoidosis: a clinical update. Expert Rev Clin Pharmacol 2021; 14:179-210. [PMID: 33487042 DOI: 10.1080/17512433.2021.1878024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Introduction: Sarcoidosis is a multi-organ disease with a wide range of clinical manifestations and outcomes. A quarter of sarcoidosis patients require long-term treatment for chronic disease. In this group, corticosteroids and cytotoxic agents be insufficient to control diseaseAreas covered: Several biologic agents have been studied for treatment of chronic pulmonary and extra-pulmonary disease. A review of the available literature was performed searching PubMed and an expert opinion regarding specific therapy was developed.Expert opinion: These agents have the potential of treating patients who have progressive disease. Many of these agents have different mechanisms of action, response rates, and toxicity profiles.
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Affiliation(s)
- Ogugua Ndili Obi
- Division of Pulmonary Critical Care and Sleep Medicine, Brody School of Medicine, East Carolina University, Greenville, NC, USA
| | - Elyse E Lower
- Department of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
| | - Robert P Baughman
- Department of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
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11
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Kearney N, Raichura S, Houghton J, O'Kane D. Old drug, new tricks - successful treatment of Hailey-Hailey disease with thalidomide. Australas J Dermatol 2020; 62:94-96. [PMID: 33070308 DOI: 10.1111/ajd.13474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 08/02/2020] [Accepted: 08/29/2020] [Indexed: 11/27/2022]
Affiliation(s)
- Niamh Kearney
- Department of Dermatology, Royal Victoria Hospital, Belfast, UK
| | | | - Joe Houghton
- Department of Pathology, Royal Victoria Hospital, Belfast, UK
| | - Donal O'Kane
- Department of Dermatology, Royal Victoria Hospital, Belfast, UK
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12
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Hekal MH, Ali YM, Abu El-Azm FSM. Utilization of cyanoacetohydrazide and 2-(1,3-dioxoisoindolin-2-yl) acetyl chloride in the synthesis of some novel anti-proliferative heterocyclic compounds. SYNTHETIC COMMUN 2020. [DOI: 10.1080/00397911.2020.1786125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Mohamed H. Hekal
- Chemistry Department, Faculty of Science, Ain Shams University, Cairo, Egypt
| | - Yasmeen M. Ali
- Chemistry Department, Faculty of Science, Ain Shams University, Cairo, Egypt
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13
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Hamarsheh S, Zeiser R. NLRP3 Inflammasome Activation in Cancer: A Double-Edged Sword. Front Immunol 2020; 11:1444. [PMID: 32733479 PMCID: PMC7360837 DOI: 10.3389/fimmu.2020.01444] [Citation(s) in RCA: 129] [Impact Index Per Article: 32.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 06/03/2020] [Indexed: 12/21/2022] Open
Abstract
Inflammation is involved in tumor development and progression as well as antitumor response to therapy. In the past decade, the crosstalk between inflammation, immunity, and cancer has been investigated extensively, which led to the identification of several underlying mechanisms and cells involved. The formation of inflammasome complexes leads to the activation of caspase-1, production of interleukin (IL)-1β, and IL-18 and pyroptosis. Multiple studies have shown the involvement of NLRP3 inflammasome in tumorigenesis. Conversely, other reports have indicated a protective role in certain cancers. In this review, we summarize these contradictory roles of NLRP3 inflammasome in cancer, shed the light on oncogenic signaling leading to NLRP3 activation and IL-1β production and outline the current knowledge on therapeutic approaches.
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Affiliation(s)
- Shaima'a Hamarsheh
- Department of Medicine I, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Faculty of Biology, University of Freiburg, Freiburg, Germany
| | - Robert Zeiser
- Department of Medicine I, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,German Cancer Consortium (DKTK) Partner Site Freiburg, German Cancer Research Center (DKFZ), Heidelberg, Germany.,Comprehensive Cancer Center Freiburg (CCCF), University of Freiburg, Freiburg, Germany.,Center for Biological Signalling Studies (BIOSS) and Center for Integrative Biological Signalling Studies (CIBSS), University of Freiburg, Freiburg, Germany
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14
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Cyclodextrin as a magic switch in covalent and non-covalent anticancer drug release systems. Carbohydr Polym 2020; 242:116401. [PMID: 32564836 DOI: 10.1016/j.carbpol.2020.116401] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 04/25/2020] [Accepted: 05/04/2020] [Indexed: 02/06/2023]
Abstract
Cancer has been a threat to human health, so its treatment is a huge challenge to the present medical field. One of commonly used methods is the controlled release of anticancer drug to reduce the dose for patients, increase the stability of drug treatment and minimize side effects. Cyclodextrin is a kind of cyclic oligosaccharide produced by amylase hydrolysis. Because cyclodextrin contains a cavity structure and active hydroxyl groups, it has a positive effect on the study of the controlled release of anticancer drugs. This article reviews the controlled release of current anticancer drugs based on cyclodextrins as a "flexible switch", and discusses the classification of different types of release systems, highlighting their role in cancer treatment. Moreover, the opportunities and challenges of cyclodextrin as a magic switch in the controlled release of anticancer drugs are discussed.
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15
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Mok SWF, Wong VKW, Lo HH, de Seabra Rodrigues Dias IR, Leung ELH, Law BYK, Liu L. Natural products-based polypharmacological modulation of the peripheral immune system for the treatment of neuropsychiatric disorders. Pharmacol Ther 2020; 208:107480. [DOI: 10.1016/j.pharmthera.2020.107480] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 12/31/2019] [Indexed: 02/06/2023]
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16
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Watts-Santos A, Martinez-Rico JC, Gomez-Flores M, Ocampo-Candiani J, Alba-Rojas E. Thalidomide: An option for the pediatric patient with actinic prurigo. Pediatr Dermatol 2020; 37:362-365. [PMID: 31875999 DOI: 10.1111/pde.14086] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Actinic prurigo (AP) is an immune-mediated photodermatosis that usually starts in childhood and is predominant among American indigenous and mestizo communities. In adults with AP, thalidomide is the treatment of choice; however, there is little information on its use in pediatric patients. We report the case of a 10-year-old girl with AP treated successfully with thalidomide.
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Affiliation(s)
- Anabella Watts-Santos
- Dermatology Department, Universidad Autónoma de Nuevo León, Hospital Universitario "Dr. José Eleuterio González", Monterrey, México
| | - Jessica Carolina Martinez-Rico
- Dermatology Department, Universidad Autónoma de Nuevo León, Hospital Universitario "Dr. José Eleuterio González", Monterrey, México
| | - Minerva Gomez-Flores
- Dermatology Department, Universidad Autónoma de Nuevo León, Hospital Universitario "Dr. José Eleuterio González", Monterrey, México
| | - Jorge Ocampo-Candiani
- Dermatology Department, Universidad Autónoma de Nuevo León, Hospital Universitario "Dr. José Eleuterio González", Monterrey, México
| | - Erika Alba-Rojas
- Dermatology Department, Universidad Autónoma de Nuevo León, Hospital Universitario "Dr. José Eleuterio González", Monterrey, México
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17
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Primary Langerhans Cell Histiocytosis of the Vulva in a Postmenopausal Woman: Response to Treatment With Oral Methotrexate. J Low Genit Tract Dis 2019; 22:169-170. [PMID: 29474236 DOI: 10.1097/lgt.0000000000000375] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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18
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do Socorro Silva Costa P, Woycinck Kowalski T, Rosa Fraga L, Furtado Feira M, Nazário AP, MarceloAranha Camargo L, Iop de Oliveira Caldoncelli D, Irismar da Silva Silveira M, Hutz MH, Schüler-Faccini L, Sales Luiz Vianna F. NR3C1, ABCB1, TNF and CYP2C19 polymorphisms association with the response to the treatment of erythema nodosum leprosum. Pharmacogenomics 2019; 20:503-516. [PMID: 31124417 DOI: 10.2217/pgs-2018-0192] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Aim: To evaluate the effects of gene polymorphisms in the treatment of erythema nodosum leprosum with prednisone/thalidomide. Patients & methods: A total of 152 patients from different regions of Brazil were included. Generalized estimating equation was used to evaluate the influence of polymorphisms and haplotypes on the drug dose variation throughout the treatment. Results: An association between the genotype tuberculoid of polymorphism ABCB1 3435C>T (rs1045642; p = 0.02) and prednisone dose was found in the recessive model. An association between the haplotypes 1031T/-863C/-857C/-308A/-238G (p = 0.006) and 1031T/-863C/-857T/-308A/-238G (p = 0.040) of the TNF gene and the CYP2C19*2 polymorphism were also identified, in relation to thalidomide dosage variation over the course of treatment. Conclusion: This work presents the first pharmacogenetic report of association between gene polymorphisms and erythema nodosum leprosum treatment with prednisone/thalidomide.
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Affiliation(s)
- Perpétua do Socorro Silva Costa
- Postgraduate Program in Genetics & Molecular Biology, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.,INAGEMP, Instituto Nacional de Genética Médica Populacional, Porto Alegre, RS, Brazil.,Center of Social Sciences, Health & Technology, Universidade Federal do Maranhão, Imperatriz, MA, Brazil
| | - Thayne Woycinck Kowalski
- Postgraduate Program in Genetics & Molecular Biology, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.,INAGEMP, Instituto Nacional de Genética Médica Populacional, Porto Alegre, RS, Brazil.,Department of Morphological Sciences, Institute of Health Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.,Teratogen Information Service, Medical Genetics Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Lucas Rosa Fraga
- INAGEMP, Instituto Nacional de Genética Médica Populacional, Porto Alegre, RS, Brazil.,Department of Morphological Sciences, Institute of Health Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.,Teratogen Information Service, Medical Genetics Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Mariléa Furtado Feira
- INAGEMP, Instituto Nacional de Genética Médica Populacional, Porto Alegre, RS, Brazil.,Center of Experimental Research, Genomics Medicine Laboratory & Laboratory of Research in Bioethics & Ethics in Research (LAPEBEC), Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Ana Paula Nazário
- Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil
| | - Luis MarceloAranha Camargo
- Institute of Biomedical Sciences-5, Universidade de São Paulo, Monte Negro, Rondônia, Brazil.,Center for Research in Tropical Medicine, Porto Velho, Rondônia, Brazil.,National Institute of Science and Technology-EpiAmo, Rondônia, Brazil.,Department of Medicine, Centro Universitário São Lucas, Porto Velho, Rondônia, Brazil
| | | | | | - Mara Helena Hutz
- Postgraduate Program in Genetics & Molecular Biology, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Lavínia Schüler-Faccini
- Postgraduate Program in Genetics & Molecular Biology, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.,INAGEMP, Instituto Nacional de Genética Médica Populacional, Porto Alegre, RS, Brazil.,Teratogen Information Service, Medical Genetics Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Fernanda Sales Luiz Vianna
- Postgraduate Program in Genetics & Molecular Biology, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.,INAGEMP, Instituto Nacional de Genética Médica Populacional, Porto Alegre, RS, Brazil.,Teratogen Information Service, Medical Genetics Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil.,Center of Experimental Research, Genomics Medicine Laboratory & Laboratory of Research in Bioethics & Ethics in Research (LAPEBEC), Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
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19
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Wang B, Li PK, Ma JX, Chen D. Therapeutic Effects of a Novel Phenylphthalimide Analog for Corneal Neovascularization and Retinal Vascular Leakage. Invest Ophthalmol Vis Sci 2019; 59:3630-3642. [PMID: 30029250 PMCID: PMC6054429 DOI: 10.1167/iovs.18-24015] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Purpose Neovascularization (NV) and retinal vascular leakage are major causes of impaired vision in ocular diseases. The purpose of this study was to identify novel phenylphthalimide analogs with therapeutic effects on NV and vascular leakage and to explore the mechanism of action. Methods Antiangiogenic activities of novel phenylphthalimide analogs were assessed in vitro by using VEGF ELISA and endothelial cell proliferation assay. Their efficacies on retinal vascular leakage were evaluated using rat models of oxygen-induced retinopathy (OIR) and streptozotocin (STZ)-induced diabetes. The in vivo antiangiogenic activity was evaluated using topical administration in the alkali burn-induced corneal NV model. The expression of VEGF and intercellular adhesion molecule-1 (ICAM-1) were measured using ELISA. Results Thalidomide and three novel analogs all showed inhibitory effects on endothelial cell proliferation and VEGF expression in vitro. Through intravitreal injection, all of the compounds reduced retinal vascular leakage in the OIR and STZ-induced diabetic models. Among these compounds, (2,6-diisopropylphenyl)-5-amino-1H-isoindole-1,3-dione (DAID) displayed the most potent efficacy and reduced retinal vascular leakage in a dose-dependent manner in both the OIR and STZ-diabetes models. Topical administration of DAID also inhibited alkali burn-induced corneal NV. Furthermore, DAID attenuated the overexpression of VEGF and ICAM-1 in the retina of the OIR model. Intravitreal injection of DAID did not result in any detectable side effects, as shown by electroretinogram and retinal histological analysis. Conclusions DAID is a novel phenylphthalimide analog with potent effects on NV and retinal vascular leakage through downregulation of VEGF and inflammatory factors and has therapeutic potential.
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Affiliation(s)
- Bing Wang
- Department of Physiology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States.,Department of Ophthalmology, Fujian Medical University Union Hospital, Fujian Province, China
| | - Pui-Kai Li
- Division of Medicinal Chemistry and Pharmacognosy, College of Pharmacy, Ohio State University, Columbus, Ohio, United States
| | - Jian-Xing Ma
- Department of Physiology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States
| | - Danyang Chen
- Charlesson, LLC, Oklahoma City, Oklahoma, United States
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20
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Scalp Pruritus: Review of the Pathogenesis, Diagnosis, and Management. BIOMED RESEARCH INTERNATIONAL 2019; 2019:1268430. [PMID: 30766878 PMCID: PMC6350598 DOI: 10.1155/2019/1268430] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2018] [Accepted: 01/03/2019] [Indexed: 12/19/2022]
Abstract
Scalp pruritus is a frequent problem encountered in dermatological practice. This disorder is caused by various underlying diseases and is a diagnostic and therapeutic challenge. Scalp pruritus may be localized to the scalp or extended to other body areas. It is sometimes not only associated with skin diseases or specific skin changes, but also associated with lesions secondary to rubbing or scratching. Moreover, scalp pruritus may be difficult to diagnose and manage and may have a great impact on the quality of life of patients. It can be classified as dermatologic, neuropathic, systemic, and psychogenic scalp pruritus based on the potential underlying disease. A thorough evaluation of patients presenting with scalp pruritus is important. Taking history and performing physical examination and further investigations are essential for diagnosis. Therapeutic strategy comprises removal of the aggravating factors and appropriate treatment of the underlying condition. All treatments should be performed considering an individual approach. This review article focuses on the understanding of the pathophysiology and the diagnostic and therapeutic management of scalp pruritus.
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21
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Understanding the Thalidomide Chirality in Biological Processes by the Self-disproportionation of Enantiomers. Sci Rep 2018; 8:17131. [PMID: 30459439 PMCID: PMC6244226 DOI: 10.1038/s41598-018-35457-6] [Citation(s) in RCA: 63] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Accepted: 11/06/2018] [Indexed: 01/08/2023] Open
Abstract
Twenty years after the thalidomide disaster in the late 1950s, Blaschke et al. reported that only the (S)-enantiomer of thalidomide is teratogenic. However, other work has shown that the enantiomers of thalidomide interconvert in vivo, which begs the question: why is teratogen activity not observed in animal experiments that use (R)-thalidomide given the ready in vivo racemization (“thalidomide paradox”)? Herein, we disclose a hypothesis to explain this “thalidomide paradox” through the in-vivo self-disproportionation of enantiomers. Upon stirring a 20% ee solution of thalidomide in a given solvent, significant enantiomeric enrichment of up to 98% ee was observed reproducibly in solution. We hypothesize that a fraction of thalidomide enantiomers epimerizes in vivo, followed by precipitation of racemic thalidomide in (R/S)-heterodimeric form. Thus, racemic thalidomide is most likely removed from biological processes upon racemic precipitation in (R/S)-heterodimeric form. On the other hand, enantiomerically pure thalidomide remains in solution, affording the observed biological experimental results: the (S)-enantiomer is teratogenic, while the (R)-enantiomer is not.
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22
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Hijji Y, Benjamin E, Jasinski JP, Butcher RJ. Crystal structure of the thalidomide analog (3a R*,7a S*)-2-(2,6-dioxopiperidin-3-yl)hexa-hydro-1 H-iso-indole-1,3(2 H)-dione. Acta Crystallogr E Crystallogr Commun 2018; 74:1595-1598. [PMID: 30443388 PMCID: PMC6218906 DOI: 10.1107/s2056989018014317] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Accepted: 10/10/2018] [Indexed: 11/23/2022]
Abstract
The title compound, C13H16N2O4, crystallizes in the monoclinic centrosymmetric space group, P21/c, with four mol-ecules in the asymmetric unit, thus there is no crystallographically imposed symmetry and it is a racemic mixture. The structure consists of a six-membered unsaturated ring bound to a five-membered pyrrolidine-2,5-dione ring N-bound to a six-membered piperidine-2,6-dione ring and thus has the same basic skeleton as thalidomide, except for the six-membered unsaturated ring substituted for the aromatic ring. In the crystal, the mol-ecules are linked into inversion dimers by R 2 2(8) hydrogen bonding involving the N-H group. In addition, there are bifurcated C-H⋯O inter-actions involving one of the O atoms on the pyrrolidine-2,5-dione with graph-set notation R 1 2(5). These inter-actions along with C-H⋯O inter-actions involving one of the O atoms on the piperidine-2,6-dione ring link the mol-ecules into a complex three-dimensional array. There is pseudomerohedral twinning present which results from a 180° rotation about the [100] reciprocal lattice direction and with a twin law of 1 0 0 0 0 0 0 [BASF 0.044 (1)].
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Affiliation(s)
- Yousef Hijji
- Department of Chemistry and Earth Sciences, Qatar University, Doha, Qatar
| | - Ellis Benjamin
- Department of Chemistry, Richard Stockton College of New Jersey, Galloway, NJ 08205, USA
| | - Jerry P Jasinski
- Department of Chemistry, Keene State College, 229 Main Street, Keene NH 03435, USA
| | - Ray J Butcher
- Department of Chemistry, Howard University, 525 College Street NW, Washington, DC 20059, USA
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Synthesis and Biological Evaluation of Thalidomide Derivatives as Potential Anti-Psoriasis Agents. Int J Mol Sci 2018; 19:ijms19103061. [PMID: 30301277 PMCID: PMC6212999 DOI: 10.3390/ijms19103061] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 09/27/2018] [Accepted: 10/05/2018] [Indexed: 12/11/2022] Open
Abstract
Several thalidomide derivatives were synthesized and evaluated for their anti-inflammatory activity. Introduction of the benzyl group to the parent thalidomide is unfavorable in which 2-(1-benzyl-2,6-dioxopiperidin-3-yl)isoindoline-1,3-dione (4a) was inactivated. However, the inhibitory activities on TNF-α and IL-6 expression in HaCaT cells were improved by the substitution of a chloro- or methoxy- group at the phenyl position of 4a. The IL-6 inhibitory activity decreased in an order of 5c (69.44%) > 4c (48.73%) > 6c (3.19%) indicating the 3-substituted derivative is more active than the 4-substituted counterpart, which in turn is more active than the 2-substituted counterpart. Among them, 2-[1-(3-chlorobenzyl)-2,6-dioxopiperidin-3-yl]isoindoline-1,3-dione (5c) was found to inhibit TNF-α and IL-6 expression in HaCaT cells with a higher potency than thalidomide and no significant cell cytotoxicity was detected at 10 μM. In psoriasis, Compound 5c reduced IL-6, IL-8, IL-1β and IL-24 in imiquimod-stimulated models. Our results indicated that compound 5c is a potential lead of novel anti-psoriasis agents. Structural optimization of compound 5c and its in vivo assay are ongoing.
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24
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Qureshi AA, Abate LE, Yosipovitch G, Friedman AJ. A systematic review of evidence-based treatments for prurigo nodularis. J Am Acad Dermatol 2018; 80:756-764. [PMID: 30261199 DOI: 10.1016/j.jaad.2018.09.020] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 09/04/2018] [Accepted: 09/08/2018] [Indexed: 12/20/2022]
Abstract
Prurigo nodularis is a chronic dermatologic condition involving the development of multiple cutaneous nodules in the setting of intractable pruritus. Given emerging treatment options for this difficult-to-treat condition, a current review of therapeutics is needed. A systematic review was performed for clinical studies investigating prurigo nodularis treatment published from 1990 to present including ≥5 subjects. A total of 35 articles were assigned a level of evidence according to the Oxford Center for Evidence-based Medicine. All 5 studies investigating topical agents, including corticosteroids, calcineurin inhibitors, calcipotriol, and capsaicin, conveyed some beneficial effect with level of evidence 2b or higher. Six of 8 reports investigating photo- and photochemotherapy achieved levels of evidence 2b or greater and showed good partial response rates. Thalidomide was studied by 6 reports providing evidence of good symptom response, only 2 of which were rated level 2b or greater. Cyclosporine and methotrexate have demonstrated benefit in 4 combined studies, albeit with level 4 evidence. Pregabalin, amitriptyline, paroxetine, fluvoxamine, and neurokinin-1 receptor antagonists have demonstrated promising evidence in 5 level 2b studies. Higher-powered studies and additional randomized controlled trials are needed for the evaluation of safe and efficacious systemic treatment options for prurigo nodularis.
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Affiliation(s)
- Azam A Qureshi
- Department of Dermatology, George Washington Medical Faculty Associates, Washington, DC
| | - Laura E Abate
- Himmelfarb Health Sciences Library, George Washington University, Washington, DC
| | - Gil Yosipovitch
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida
| | - Adam J Friedman
- Department of Dermatology, George Washington Medical Faculty Associates, Washington, DC; Department of Dermatology, George Washington School of Medicine and Health Sciences, George Washington University, Washington, DC.
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25
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The roles of neutrophil serine proteinases in idiopathic inflammatory myopathies. Arthritis Res Ther 2018; 20:134. [PMID: 29976235 PMCID: PMC6034343 DOI: 10.1186/s13075-018-1632-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2017] [Accepted: 05/24/2018] [Indexed: 12/13/2022] Open
Abstract
Background Dermatomyositis and polymyositis are the best known idiopathic inflammatory myopathies (IIMs). Classic histopathologic findings include the infiltration of inflammatory cells into muscle tissues. Neutrophil serine proteinases (NSPs) are granule-associated enzymes and play roles in inflammatory cell migration by increasing the permeability of vascular endothelial cells. In this study, we aimed to find the roles of NSPs in pathogenesis of IIMs. Methods RNA and DNA were isolated to measure the relative expression of NSPs and their methylation levels. The expression of NSPs in serum and muscle tissues was tested by enzyme-linked immunosorbent assay, immunohistochemistry, and immunofluorescence, respectively. Serum from patients was used to culture the human dermal microvascular endothelial cells (HDMECs), and then we observed the influence of serum on expression of VE-cadherin, endothelial cell tube formation, and transendothelial migration of peripheral blood mononuclear cells (PBMCs). Results We found that the expression of NSPs was increased in PBMCs, serum, and muscle tissues of IIM patients; these NSPs were hypomethylated in the PBMCs of patients. Serum NSPs were positively correlated with clinical indicators of IIM patients, including lactic dehydrogenase, erythrocyte sedimentation rate, C-reactive protein, immunoglobulin G, immunoglobulin M, and immunoglobulin A. Patients with anti-Jo-1, with anti-Ro-52, or without interstitial lung disease had lower levels of proteinase 3. Serum NSPs degraded the VE-cadherin of HDMECs, and serum NSP application increased the permeability of HDMECs. Conclusions Our studies indicate, for the first time, that NSPs play an important role in muscle inflammatory cell infiltration by increasing the permeability of vascular endothelial cells in IIM patients. Electronic supplementary material The online version of this article (10.1186/s13075-018-1632-x) contains supplementary material, which is available to authorized users.
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Costa PDSS, Fraga LR, Kowalski TW, Daxbacher ELR, Schuler-Faccini L, Vianna FSL. Erythema Nodosum Leprosum: Update and challenges on the treatment of a neglected condition. Acta Trop 2018; 183:134-141. [PMID: 29474830 DOI: 10.1016/j.actatropica.2018.02.026] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Revised: 02/09/2018] [Accepted: 02/11/2018] [Indexed: 01/25/2023]
Abstract
Erythema Nodosum Leprosum (ENL) occurs due to the immunological complication of multibacillary leprosy and is characterized by painful nodules and systemic compromising. It is usually recurrent and/or chronic and has both physical and economic impact on the patient, being a very important cause of disability. In addition, ENL is a major health problem in countries where leprosy is endemic. Therefore, adequate control of this condition is important. The management of ENL aims to control acute inflammation and neuritis and prevent the onset of new episodes. However, all currently available treatment modalities have one or two drawbacks and are not effective for all patients. Corticosteroid is the anti-inflammatory of choice in ENL but may cause dependence, especially for chronic patients. Thalidomide has a rapid action but its use is limited due the teratogenicity and neurotoxicity. Clofazimine and pentoxifylline have slow action and have important adverse effects. Finally, there is no pattern or guidelines for treating these patients, becoming more difficult to evaluate and to control this condition. This review aims to show the main drugs used in the treatment of ENL and the challenges in the management of the reaction.
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27
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A case of granuloma faciale successfully treated with oral prednisone, tranilast and thalidomide. Postepy Dermatol Alergol 2018; 35:109-112. [PMID: 29599681 PMCID: PMC5872251 DOI: 10.5114/ada.2018.73170] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Accepted: 01/03/2017] [Indexed: 01/16/2023] Open
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Shevchenko A, Valdes-Rodriguez R, Yosipovitch G. Causes, pathophysiology, and treatment of pruritus in the mature patient. Clin Dermatol 2017; 36:140-151. [PMID: 29566918 DOI: 10.1016/j.clindermatol.2017.10.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Chronic itch is a common and debilitating health condition in the elderly. There are several common causes of itch in the mature population, such as skin xerosis, immunosenescence, and neuropathic changes. In addition, skin diseases, such as seborrheic dermatitis and stasis dermatitis, systemic conditions (end-stage renal disease and diabetes), or psychogenic derailments, such as depression, anxiety, and dementia, can all serve as triggers of pruritus. Polypharmacy, a common occurrence among the elderly population, may also serve as a cause of itch that may or may not be accompanied by dermatitis. Such medications as μ opioids and calcium channel blockers have been found to have a connection with pruritus in the advanced aging population. Determining the exact trigger for pruritus in the elderly may be especially challenging, because itch can be idiopathic in many cases. The role of treatments should not only take into account elimination of various underlying cutaneous, systemic, or psychogenic conditions associated with itch but also focus on the skin changes that are characteristic of the aging process. Development of such treatment options can be guided by elucidation of the mechanisms underlying the pathophysiology of itch in the geriatric population.
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Affiliation(s)
- Alina Shevchenko
- Department of Dermatology, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | - Rodrigo Valdes-Rodriguez
- Department of Dermatology, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | - Gil Yosipovitch
- Department of Dermatology & Miami Itch Center at the University of Miami, Leonard M. Miller School of Medicine, Miami, FL, USA.
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29
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Vignesh R, Shankar EM. Thalidomide as a Potential HIV Latency Reversal Agent: Is It the Right Time to Forget the Ancestral Sins? EBioMedicine 2017; 24:20-21. [PMID: 28865747 PMCID: PMC5651972 DOI: 10.1016/j.ebiom.2017.08.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Accepted: 08/28/2017] [Indexed: 11/24/2022] Open
Affiliation(s)
- Ramachandran Vignesh
- YRG Centre for AIDS Research and Education (YRG CARE), VHS Hospital Campus, Taramani, Chennai 600 113, India; Lab-based Department, Royal College of Medicine Perak, Universiti Kuala Lumpur (UniKL-RCMP), Ipoh, Malaysia.
| | - Esaki M Shankar
- Center of Excellence for Research in AIDS (CERiA), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; Division of Infection Biology, Department of Life Sciences, Central University of Tamil Nadu (CUTN), Thiruvarur 610 005, India; Department of Microbiology, Central University of Tamil Nadu (CUTN), Thiruvarur 610 005, India
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30
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Design, synthesis and antiproliferative activity of thiazolo[5,4-d]pyrimidine derivatives through the atom replacement strategy. Eur J Med Chem 2017; 138:1034-1041. [PMID: 28759876 DOI: 10.1016/j.ejmech.2017.07.039] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Revised: 07/02/2017] [Accepted: 07/20/2017] [Indexed: 12/19/2022]
Abstract
A series of thiazolo[5,4-d]pyrimidine derivatives were designed through the atom replacement strategy based on biologically validated scaffolds and then evaluated for their antiproliferative activities on cancer cell lines. The structure-activity relationship studies were conducted, leading to the identification of compound 22, which exhibited good antiproliferative activity against HGC-27 with an IC50 value of 1.22 μM and low toxicity against GES-1 cells. Mechanistic studies showed that compound 22 inhibited the colony formation and migration of HGC-27 as well as induced apoptosis. The western blot experiments proved that compound 22 up-regulated expression of Bax, down-regulated expression levels of Bcl-2 and cleaved caspased-3/9. These findings indicate that compound 22 may serve as a template for designing new agents for the treatment of human gastric cancers. The atom replacement strategy could be viable strategy for designing new anticancer drugs and may find its applications in drug design.
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31
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Wu EY, Schanberg LE, Wershba EC, Rabinovich CE. Lenalidomide for refractory cutaneous manifestations of pediatric systemic lupus erythematosus. Lupus 2017; 26:646-649. [PMID: 27837194 PMCID: PMC5388573 DOI: 10.1177/0961203316676377] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Objective Cutaneous manifestations of pediatric systemic lupus erythematosus cause significant morbidity. Lenalidomide, a thalidomide analogue, has shown promise treating cutaneous lupus erythematosus in adults. Our objective was to evaluate lenalidomide's efficacy and safety in treating refractory cutaneous manifestations of pediatric systemic lupus erythematosus. Methods We performed a retrospective chart review of 10 adolescents who received lenalidomide for recalcitrant cutaneous lupus erythematosus. Information was gathered at drug initiation and 6-month follow-up. The Wilcoxon matched-pairs signed-rank test was used to assess change in quantitative parameters of disease activity. Results Nine subjects were girls and six were African-American. Indications for lenalidomide treatment included alopecia, nasal and oral ulcers, extensive malar rash, discoid lesions, bullous lesions, panniculitis, cutaneous vasculitis, and Raynaud's phenomenon with digital ulcerations. Within 6 months, all patients demonstrated complete or near resolution based on physician report. Prednisone dose decreased from a mean 23.5 mg (SD± 13.3) to 12.25 mg (SD± 9.2) ( P= 0.008). Sedimentation rate decreased from a mean 29 mm/hour (SD± 31.5) to 17 mm/hour (SD± 18.1) ( P= 0.004). Lenalidomide was well tolerated. Conclusion Lenalidomide is an effective and safe treatment for a spectrum of dermatological conditions in pediatric systemic lupus erythematosus. Its use may allow a reduction in prednisone dose and decreased disfigurement. Prospective study is needed to clarify lenalidomide's role in treating cutaneous manifestations of systemic lupus erythematosus.
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Affiliation(s)
- E Y Wu
- 1 Department of Pediatrics, The University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - L E Schanberg
- 2 Department of Pediatrics, Duke University Medical Center, Durham, USA
| | - E C Wershba
- 3 Phoenix Children's Medical Group, Phoenix, USA
| | - C E Rabinovich
- 2 Department of Pediatrics, Duke University Medical Center, Durham, USA
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32
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Li ZH, Zhang J, Liu XQ, Geng PF, Ma JL, Wang B, Zhao TQ, Zhao B, Wei HM, Wang C, Fu DJ, Yu B, Liu HM. Identification of thiazolo[5,4-d]pyrimidine derivatives as potent antiproliferative agents through the drug repurposing strategy. Eur J Med Chem 2017; 135:204-212. [PMID: 28456031 DOI: 10.1016/j.ejmech.2017.04.056] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2017] [Revised: 04/01/2017] [Accepted: 04/20/2017] [Indexed: 01/14/2023]
Abstract
A series of thiazolo[5,4-d]pyrimidine derivatives were synthesized and evaluated for their antiproliferative activities on three cancer cell lines. The structure-activity relationship studies were conducted through the variation in the three regions of the thiazolo-pyrimidine core. Substitution with morpholine led to compound 24, which exerted the most potent antiproliferative activity as well as good selectivity between cancer and normal cells (IC50 values of 1.03 μM against MGC803 and 38.95 μM against GES-1). In addition, compound 24 inhibited the colony formation and migration of MGC803 as well as induced apoptosis. Western blot experiments indicated the expression changes of apoptosis-related proteins, including up-regulation of Bax and caspase-3/9, as well as down-regulation of Bcl-2.
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Affiliation(s)
- Zhong-Hua Li
- Collaborative Innovation Center of New Drug Research and Safety Evaluation, Henan Province, Key Laboratory of Technology of Drug Preparation (Zhengzhou University), Ministry of Education of China, Key Laboratory of Henan Province for Drug Quality and Evaluation, School of Pharmaceutical Sciences, Zhengzhou University, Zhengzhou 450001, PR China
| | - Ji Zhang
- Collaborative Innovation Center of New Drug Research and Safety Evaluation, Henan Province, Key Laboratory of Technology of Drug Preparation (Zhengzhou University), Ministry of Education of China, Key Laboratory of Henan Province for Drug Quality and Evaluation, School of Pharmaceutical Sciences, Zhengzhou University, Zhengzhou 450001, PR China
| | - Xue-Qi Liu
- Collaborative Innovation Center of New Drug Research and Safety Evaluation, Henan Province, Key Laboratory of Technology of Drug Preparation (Zhengzhou University), Ministry of Education of China, Key Laboratory of Henan Province for Drug Quality and Evaluation, School of Pharmaceutical Sciences, Zhengzhou University, Zhengzhou 450001, PR China
| | - Peng-Fei Geng
- Collaborative Innovation Center of New Drug Research and Safety Evaluation, Henan Province, Key Laboratory of Technology of Drug Preparation (Zhengzhou University), Ministry of Education of China, Key Laboratory of Henan Province for Drug Quality and Evaluation, School of Pharmaceutical Sciences, Zhengzhou University, Zhengzhou 450001, PR China
| | - Jin-Lian Ma
- Collaborative Innovation Center of New Drug Research and Safety Evaluation, Henan Province, Key Laboratory of Technology of Drug Preparation (Zhengzhou University), Ministry of Education of China, Key Laboratory of Henan Province for Drug Quality and Evaluation, School of Pharmaceutical Sciences, Zhengzhou University, Zhengzhou 450001, PR China
| | - Bo Wang
- Collaborative Innovation Center of New Drug Research and Safety Evaluation, Henan Province, Key Laboratory of Technology of Drug Preparation (Zhengzhou University), Ministry of Education of China, Key Laboratory of Henan Province for Drug Quality and Evaluation, School of Pharmaceutical Sciences, Zhengzhou University, Zhengzhou 450001, PR China
| | - Tao-Qian Zhao
- Collaborative Innovation Center of New Drug Research and Safety Evaluation, Henan Province, Key Laboratory of Technology of Drug Preparation (Zhengzhou University), Ministry of Education of China, Key Laboratory of Henan Province for Drug Quality and Evaluation, School of Pharmaceutical Sciences, Zhengzhou University, Zhengzhou 450001, PR China
| | - Bing Zhao
- Collaborative Innovation Center of New Drug Research and Safety Evaluation, Henan Province, Key Laboratory of Technology of Drug Preparation (Zhengzhou University), Ministry of Education of China, Key Laboratory of Henan Province for Drug Quality and Evaluation, School of Pharmaceutical Sciences, Zhengzhou University, Zhengzhou 450001, PR China
| | - Hao-Ming Wei
- Collaborative Innovation Center of New Drug Research and Safety Evaluation, Henan Province, Key Laboratory of Technology of Drug Preparation (Zhengzhou University), Ministry of Education of China, Key Laboratory of Henan Province for Drug Quality and Evaluation, School of Pharmaceutical Sciences, Zhengzhou University, Zhengzhou 450001, PR China
| | - Chao Wang
- Collaborative Innovation Center of New Drug Research and Safety Evaluation, Henan Province, Key Laboratory of Technology of Drug Preparation (Zhengzhou University), Ministry of Education of China, Key Laboratory of Henan Province for Drug Quality and Evaluation, School of Pharmaceutical Sciences, Zhengzhou University, Zhengzhou 450001, PR China
| | - Dong-Jun Fu
- Collaborative Innovation Center of New Drug Research and Safety Evaluation, Henan Province, Key Laboratory of Technology of Drug Preparation (Zhengzhou University), Ministry of Education of China, Key Laboratory of Henan Province for Drug Quality and Evaluation, School of Pharmaceutical Sciences, Zhengzhou University, Zhengzhou 450001, PR China
| | - Bin Yu
- Collaborative Innovation Center of New Drug Research and Safety Evaluation, Henan Province, Key Laboratory of Technology of Drug Preparation (Zhengzhou University), Ministry of Education of China, Key Laboratory of Henan Province for Drug Quality and Evaluation, School of Pharmaceutical Sciences, Zhengzhou University, Zhengzhou 450001, PR China.
| | - Hong-Min Liu
- Collaborative Innovation Center of New Drug Research and Safety Evaluation, Henan Province, Key Laboratory of Technology of Drug Preparation (Zhengzhou University), Ministry of Education of China, Key Laboratory of Henan Province for Drug Quality and Evaluation, School of Pharmaceutical Sciences, Zhengzhou University, Zhengzhou 450001, PR China.
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Iacopetta D, Carocci A, Sinicropi MS, Catalano A, Lentini G, Ceramella J, Curcio R, Caroleo MC. Old Drug Scaffold, New Activity: Thalidomide-Correlated Compounds Exert Different Effects on Breast Cancer Cell Growth and Progression. ChemMedChem 2017; 12:381-389. [PMID: 28099781 DOI: 10.1002/cmdc.201600629] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Revised: 01/16/2017] [Indexed: 12/17/2022]
Abstract
Thalidomide was first used for relief of morning sickness in pregnant women and then withdrawn from the market because of its dramatic effects on normal fetal development. Over the last decades, it has been used successfully for the treatment of several pathologies, including cancer. Many analogues with improved activity have been synthesized and tested. Herein we report some effects on the growth and progression of MCF-7 and MDA-MB-231 breast cancer cells by a small series of thalidomide-correlated compounds, which are very effective at inducing cancer cell death by triggering TNFα-mediated apoptosis. The most active compounds are able to drastically reduce the migration of breast cancer cells by regulation of the two major proteins involved in epithelial-mesenchymal transition (EMT): vimentin and E-cadherin. Moreover, these compounds diminish the intracellular biosynthesis of vascular endothelial growth factor (VEGF), which is primarily involved in the promotion of angiogenesis, sustaining tumor progression. The multiple features of these compounds that act on various key points of the tumorigenesis process make them good candidates for preclinical studies.
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Affiliation(s)
- Domenico Iacopetta
- Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, 87036, Arcavacata di Rende, Italy
| | - Alessia Carocci
- Department of Pharmacy-Drug Sciences, University of Bari "Aldo Moro", 70126, Bari, Italy
| | - Maria Stefania Sinicropi
- Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, 87036, Arcavacata di Rende, Italy
| | - Alessia Catalano
- Department of Pharmacy-Drug Sciences, University of Bari "Aldo Moro", 70126, Bari, Italy
| | - Giovanni Lentini
- Department of Pharmacy-Drug Sciences, University of Bari "Aldo Moro", 70126, Bari, Italy
| | - Jessica Ceramella
- Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, 87036, Arcavacata di Rende, Italy
| | - Rosita Curcio
- Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, 87036, Arcavacata di Rende, Italy
| | - Maria Cristina Caroleo
- Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, 87036, Arcavacata di Rende, Italy
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Ni M, Yang X. Langerhans' cell histiocytosis of the temporal bone: A case report. Exp Ther Med 2017; 13:1051-1053. [PMID: 28450940 DOI: 10.3892/etm.2017.4072] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Accepted: 11/10/2016] [Indexed: 12/28/2022] Open
Abstract
Langerhansmporal histiocytosis (LCH) refers to a group of diseases that are characterized by the primary pathogenesis of an abnormal polyclonal proliferation of Langerhans cells that affect different structures of the human body, including the temporal bone. Thus far, the etiology of LCH remains unclear. Diagnosis of LCH is based on a synthetic analysis of the clinical presentations, as well as on features of imaging and histopathology. The clinical features, diagnosis, treatment and prognosis of LCH remain obscure, and temporal LCH is often confused with ear inflammatory lesions and malignant tumors. There are several therapeutic modalities for temporal bone LCH that include surgery, chemotherapy, radiotherapy and steroidal injections. The present study reports the case of an infant presenting a 1-month history of worsening left facial paralysis and a slowly enlarging post auricular mass followed by a 1-month history of postauricular swelling in the left ear. Computed tomography demonstrated a large mass of organized tissue. Moreover, the diagnosis of LCH was confirmed by histopathological and immunohistochemical examinations. The patient also suffered from multiple organ failure, including the liver, kidney, lymphatic system, skin, hematopoietic system and lungs. Following surgical intervention with mastoidotympanectomy, the parents of the patient refused further chemotherapy, and the patient succumbed to the disease ~6 months later.
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Affiliation(s)
- Maomei Ni
- Department of Otorhinolaryngology, Guizhou Provincial People's Hospital, Guiyang, Guizhou 550002, P.R. China
| | - Xiuhai Yang
- Department of Otorhinolaryngology, Guizhou Provincial People's Hospital, Guiyang, Guizhou 550002, P.R. China
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Loesche A, Wiese J, Sommerwerk S, Simon V, Brandt W, Csuk R. Repurposing N,N'-bis-(arylamidino)-1,4-piperazinedicarboxamidines: An unexpected class of potent inhibitors of cholinesterases. Eur J Med Chem 2017; 125:430-434. [DOI: 10.1016/j.ejmech.2016.09.051] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Revised: 09/15/2016] [Accepted: 09/17/2016] [Indexed: 10/21/2022]
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Anti-angiogenic effect of a Palladium(II)-Saccharinate Complex of Terpyridine in vitro and in vivo. Microvasc Res 2017; 109:26-33. [DOI: 10.1016/j.mvr.2016.09.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 09/05/2016] [Accepted: 09/05/2016] [Indexed: 12/11/2022]
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Abstract
Severe, recalcitrant dermatologic conditions often require systemic treatment. Although efficacious, these medications have been associated with wide-ranging adverse reactions. Some are reversible, predictable, and either dose-dependent or treatment length-dependent, while others are unpredictable, irreversible, and potentially fatal. This review examines the neuropsychiatric adverse effects associated with US FDA-approved medications for treatment of the following dermatologic pathologies that typically require systemic therapy: autoimmune dermatoses, acne, psoriasis, and melanoma. A search of the literature was performed, with adverse effects ranging from mild headaches and neuropathy to severe encephalopathies. The medications associated with the most serious reactions were those used to treat psoriasis, especially the older non-biologic medications such as cyclosporine A and methotrexate. Given the importance of these systemic dermatologic therapies in treating severe, recalcitrant conditions, and the wide variety of potentially serious neuropsychiatric adverse effects of these medications, neurologists, psychiatrists, dermatologists, oncologists, and primary care providers must be aware of the potential for these neuropsychiatric adverse reactions to allow for appropriate counseling, management, and medication withdrawal.
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Shibata N. Development of Shelf-Stable Reagents for Fluoro-Functionalization Reactions. BULLETIN OF THE CHEMICAL SOCIETY OF JAPAN 2016. [DOI: 10.1246/bcsj.20160223] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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39
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A new pharmacological role for thalidomide: Attenuation of morphine-induced tolerance in rats. ACTA ACUST UNITED AC 2016; 54:65-9. [PMID: 27440278 DOI: 10.1016/j.aat.2016.06.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Revised: 05/14/2016] [Accepted: 06/16/2016] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Tolerance to the analgesic effect is the main side effect of chronic administration of opioids. Several drugs have been studied to try to find agents to prevent the development of this phenomenon. In the present study we aimed to evaluate the effect of thalidomide on morphine-induced tolerance to the analgesic effect. METHODS Groups of male rats were randomly rendered and received daily morphine in combination with thalidomide vehicle or thalidomide (2.5 mg/kg, 5 mg/kg, or 10 mg/kg, intraperitoneally). Nociception was measured using the plantar test apparatus. Latency time was recorded when the animal reacted to the light stimulus; licking or raising its hind paw. Treatments and evaluations continued until completion of tolerance to the analgesic effect of morphine. RESULTS Our findings indicated that tolerance was achieved following 11 days of morphine administration, while thalidomide postponed the day of tolerance completion for 4 days (2.5 mg/kg and 5 mg/kg thalidomide) or 10 days (10 mg/kg thalidomide). Moreover, thalidomide prevented the morphine-induced shift to the right of the ED50 in the dose-response curve. CONCLUSION It was concluded that thalidomide attenuated the morphine-induced tolerance to the analgesic effect.
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A Review of the Efficacy of Thalidomide and Lenalidomide in the Treatment of Refractory Prurigo Nodularis. Dermatol Ther (Heidelb) 2016; 6:397-411. [PMID: 27289372 PMCID: PMC4972728 DOI: 10.1007/s13555-016-0122-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Indexed: 01/19/2023] Open
Abstract
Prurigo nodularis (PN) is a chronic dermatoses characterized by intensely pruritic, excoriated, or lichenified nodules. Standard therapy includes corticosteroids, antihistamines, and phototherapy; however, treatment results are often inadequate or transient. Thalidomide and its analogue lenalidomide are immunomodulatory drugs that have successfully been used to treat refractory cases of PN. A systematic review was performed evaluating the use of thalidomide and lenalidomide for PN. Eighteen articles were included in this study in which a total of 106 patients were evaluated, of whom 76 (71.7%) had moderate to significant improvement of PN with the use of thalidomide, lenalidomide, or both. Patients given thalidomide were treated with doses of 50–300 mg daily for 1–142 months, with the majority being treated for less than 1 year. Patients treated with lenalidomide were given a daily dose of 5–10 mg from 3 to 24 months. The most common side effects observed were sedation, gastrointestinal symptoms, and transient peripheral neuropathy. While thalidomide and lenalidomide are drugs that have shown promising results in these studies, caution should be taken in prescribing these medications and patients should be informed about the potential side effects. As such, large-scale randomized controlled trials with long-term follow-up are needed to determine appropriate dosing, efficacy, and toxicity profiles.
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Thalidomide treatment in cutaneous lesions of systemic lupus erythematosus: a multicenter study in China. Clin Rheumatol 2016; 35:1521-7. [PMID: 27097914 DOI: 10.1007/s10067-016-3256-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Revised: 02/05/2016] [Accepted: 04/01/2016] [Indexed: 01/19/2023]
Abstract
Thalidomide is effective for treating severe cutaneous lupus patients. The aim of this study was to observe the optimum effective and maintenance doses of thalidomide to maximize clinical benefit and minimize side effects for patients with cutaneous lupus in China. Sixty-nine patients with lupus rash from eight hospitals in China were enrolled and treated with different doses of thalidomide. We started the dose of thalidomide at 25 mg daily and gradually increased administration dose once a week until erythema was markedly improved. The effective and maintenance doses were documented. The size of skin lesions was noted once a week. Systemic lupus erythematosus disease activity index (SLEDAI) score, levels of erythrocyte sedimentation rate (ESR), and serum TNF-α were measured before and after treatment. The remission rates were evaluated weekly until 8 weeks. Sixty-eight percent of patients showed an effective dose of 50 mg daily; another 13, 10, and 9 % of patients had an effective dose of 100, 75, and 25 mg daily, respectively. The maintenance dose was 50 mg daily for 71 % of the patients, and 100, 75, and 25 mg daily for 9, 14, and 6 % of the patients. SLEDAI score and serum ESR levels significantly decreased 4 weeks after thalidomide treatment. At the end of the fourth week, the rates of complete remission, partial remission, and no response were 56 % (n = 39), 41 % (n = 28), and 3 % (n = 2). At the eighth week, the rate of total remission rose up to 100 %. The most common side effects were drowsiness and constipation. No peripheral neuropathy was observed in these patients. Thalidomide at a dose of 50 mg daily may offer a better benefit to risk ratio in the treatment of Chinese cutaneous lupus patients.
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Possible alternative therapies for oral lichen planus cases refractory to steroid therapies. Oral Surg Oral Med Oral Pathol Oral Radiol 2016; 121:496-509. [PMID: 27068310 DOI: 10.1016/j.oooo.2016.02.002] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2015] [Revised: 01/15/2016] [Accepted: 02/02/2016] [Indexed: 02/05/2023]
Abstract
Oral lichen planus (OLP) is a chronic inflammatory disorder with a multifactorial etiopathogenesis. Immune dysregulation plays a critical role in the development and progression of this disease. Patients' lives may be affected by pain caused by atrophic-erosive lesions. Given the obscure etiology, treatment is usually symptomatic. Topical steroids remain the mainstay of management. However, their therapeutic benefits are not always evident. There are substantial data on the possible therapeutic strategies that are effective in OLP cases refractory to steroids. This review provides an overview of the current approaches for the management of steroid-refractory OLP. The miscellaneous treatment regimens include tacrolimus, pimecrolimus, thalidomide, low-level laser therapy, photodynamic therapy, and surgical excision. Some results obtained from these studies were promising. However, further studies, especially randomized controlled trials with strict inclusion and exclusion criteria and larger sample sizes, are required for the evaluation of the long-term safety and efficacy of these therapies.
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43
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Kindle SA, Wetter DA, Davis MDP, Pittelkow MR, Sciallis GF. Lenalidomide treatment of cutaneous lupus erythematosus: the Mayo Clinic experience. Int J Dermatol 2016; 55:e431-9. [PMID: 26873674 DOI: 10.1111/ijd.13226] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Revised: 10/13/2015] [Accepted: 10/19/2015] [Indexed: 01/19/2023]
Abstract
BACKGROUND Published case series describe lenalidomide as an effective treatment of refractory cutaneous lupus erythematosus (CLE). OBJECTIVES The present study aimed to further characterize lenalidomide use in the treatment of CLE. METHODS A retrospective review of patients treated with lenalidomide for CLE from January 1, 2000, to December 17, 2014, was conducted. RESULTS Eight of the nine patients (89%) were women. Their median age at initiation of lenalidomide was 62 years (range: 41-86 years). Subtypes of CLE included discoid lupus erythematosus (DLE) (n = 6), lupus panniculitis (n = 2), and subacute CLE (n = 1). Before the initiation of lenalidomide, all patients had been previously treated unsuccessfully or were intolerant to at least one antimalarial and one immunosuppressive agent. With lenalidomide, five patients achieved a complete response (CR), two a partial response, and two had no response (lupus panniculitis). Time to initial response (dose range: 2.5-10.0 mg/d) varied from 2 weeks to 3 months; the median time to CR in five patients was 3 months (range: 3-6 months). The median duration of lenalidomide therapy was 12 months (range: 2-67 months). The median duration of follow-up was 48 months (range: 20-103 months). Adverse effects included mild leukopenia; one patient had deep vein thrombosis of unclear etiology during a hospitalization. No patients developed or showed progression of systemic LE while receiving lenalidomide. CONCLUSIONS Lenalidomide was effective for the treatment of CLE (particularly DLE) but not for the treatment of lupus panniculitis in this series.
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Affiliation(s)
- Scott A Kindle
- Department of Dermatology, Mayo Clinic, Rochester, MN, USA
| | - David A Wetter
- Department of Dermatology, Mayo Clinic, Rochester, MN, USA
| | - Mark D P Davis
- Department of Dermatology, Mayo Clinic, Rochester, MN, USA
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44
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Thalidomide for the treatment of chronic refractory pruritus. J Am Acad Dermatol 2016; 74:363-9. [DOI: 10.1016/j.jaad.2015.09.039] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Revised: 09/11/2015] [Accepted: 09/16/2015] [Indexed: 12/11/2022]
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45
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Anti-inflammatory effect of thalidomide dithiocarbamate and dithioate analogs. Chem Biol Interact 2015; 238:74-81. [DOI: 10.1016/j.cbi.2015.05.017] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Revised: 05/12/2015] [Accepted: 05/29/2015] [Indexed: 12/16/2022]
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46
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Hansen CB, Callen JP. Current and future treatment options for cutaneous lupus erythematosus. Expert Opin Orphan Drugs 2015. [DOI: 10.1517/21678707.2015.1048224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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47
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Yang CS, Kim C, Antaya RJ. Review of thalidomide use in the pediatric population. J Am Acad Dermatol 2015; 72:703-11. [DOI: 10.1016/j.jaad.2015.01.002] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2014] [Revised: 12/22/2014] [Accepted: 01/05/2015] [Indexed: 02/08/2023]
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48
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DeFilippis E, Feldman S, Huang W. The genetics of pyoderma gangrenosum and implications for treatment: a systematic review. Br J Dermatol 2015; 172:1487-1497. [DOI: 10.1111/bjd.13493] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/10/2014] [Indexed: 12/22/2022]
Affiliation(s)
- E.M. DeFilippis
- Center for Dermatology Research; Department of Dermatology; Wake Forest School of Medicine, Medical Center Boulevard; Winston-Salem NC 27157 U.S.A
| | - S.R. Feldman
- Center for Dermatology Research; Department of Dermatology; Wake Forest School of Medicine, Medical Center Boulevard; Winston-Salem NC 27157 U.S.A
- Department of Pathology; Wake Forest School of Medicine, Medical Center Boulevard; Winston-Salem NC 27157 U.S.A
- Department of Public Health Sciences; Wake Forest School of Medicine, Medical Center Boulevard; Winston-Salem NC 27157 U.S.A
| | - W.W. Huang
- Center for Dermatology Research; Department of Dermatology; Wake Forest School of Medicine, Medical Center Boulevard; Winston-Salem NC 27157 U.S.A
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Case report on a patient with lupus panniculitis. Postepy Dermatol Alergol 2015; 32:59-62. [PMID: 25821430 PMCID: PMC4360008 DOI: 10.5114/pdia.2014.40958] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2013] [Revised: 11/10/2013] [Accepted: 12/02/2013] [Indexed: 11/17/2022] Open
Abstract
Lupus panniculitis is a rare variant of lupus erythematosus. It may occur as a separate disease or coexist with systemic or discoid lupus erythematosus. It is characterized by persistent, tender and hard nodules localised on the face, arms, shoulders, breast and buttocks. Healing of lesions is associated with scarring, lipoatrophy and rarely ulceration. Treatment of lupus panniculitis depends on disease advancement or concomitance of additional lupus erythematosus symptoms. We report a case of a 44-year-old patient with lupus panniculitis treated with chloroquine and glucocorticosteroids, including high dose infusions. Despite intense treatment, the patient developed symptoms that suggested a diagnosis of systemic lupus erythematosus.
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50
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Maeno M, Tokunaga E, Yamamoto T, Suzuki T, Ogino Y, Ito E, Shiro M, Asahi T, Shibata N. Self-disproportionation of enantiomers of thalidomide and its fluorinated analogue via gravity-driven achiral chromatography: mechanistic rationale and implications. Chem Sci 2015; 6:1043-1048. [PMID: 29560192 PMCID: PMC5811091 DOI: 10.1039/c4sc03047h] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2014] [Accepted: 10/30/2014] [Indexed: 01/13/2023] Open
Abstract
We report on the self-disproportionation of enantiomers (SDE) of non-racemic thalidomide (1) and 3'-fluorothalidomide (2) under the conditions of gravity-driven achiral silica-gel chromatography. The presence of a fluorine atom on the chiral center dramatically alters the structure and polarity of 1 and 2, resulting in the opposite SDE profile on silica-gel.
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Affiliation(s)
- Mayaka Maeno
- Department of Nanopharmaceutical Sciences and Department of Frontier Materials , Nagoya Institute of Technology , Gokiso, Showa-ku , Nagoya 466-8555 , Japan .
| | - Etsuko Tokunaga
- Department of Nanopharmaceutical Sciences and Department of Frontier Materials , Nagoya Institute of Technology , Gokiso, Showa-ku , Nagoya 466-8555 , Japan .
| | - Takeshi Yamamoto
- Department of Nanopharmaceutical Sciences and Department of Frontier Materials , Nagoya Institute of Technology , Gokiso, Showa-ku , Nagoya 466-8555 , Japan .
| | - Toshiya Suzuki
- Department of Life Science and Medical Bioscience , Waseda University (TWIns) , Wakamatsu-cho 2-2, Shinjuku-ku , Tokyo 162-8480 , Japan .
| | - Yoshiyuki Ogino
- Department of Life Science and Medical Bioscience , Waseda University (TWIns) , Wakamatsu-cho 2-2, Shinjuku-ku , Tokyo 162-8480 , Japan .
| | - Emi Ito
- Department of Nanopharmaceutical Sciences and Department of Frontier Materials , Nagoya Institute of Technology , Gokiso, Showa-ku , Nagoya 466-8555 , Japan .
| | - Motoo Shiro
- Consolidated Research Institute for Advanced Science and Medical Care , Waseda University (ASMeW) , Waseda-tsurumaki-cho 513, Shinjuku-ku , Tokyo 162-0041 , Japan
| | - Toru Asahi
- Department of Life Science and Medical Bioscience , Waseda University (TWIns) , Wakamatsu-cho 2-2, Shinjuku-ku , Tokyo 162-8480 , Japan .
| | - Norio Shibata
- Department of Nanopharmaceutical Sciences and Department of Frontier Materials , Nagoya Institute of Technology , Gokiso, Showa-ku , Nagoya 466-8555 , Japan .
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