Physicochemical, pharmacokinetic, and pharmacodynamic characterization of isradipine tablets for controlled release

Isradipine is a dihydropyridine calcium channel blocker (CCB) commonly used as vasodilator with antihypertensive properties. A remote-controlled release formulation for isradipine would substantially improve the clinical outcomes of the patients requiring chronic long-term treatment. In this work, sustained release (SR) tablets of isradipine, composed of hydroxypropylmethyl cellulose (HPMC), have been produced by wet granulation and their in vitro and in vivo characterization was compared to a conventional tablet dosage form of immediate release (IR) as preliminary assessment. Tablets composed of 15.0% (wt/wt) HPMC exhibited a SR profile over a period of 24 hours. The release of isradipine followed a Fickian diffusion pattern obeying to the first order kinetics and the extent of absorption was even higher in comparison to the developed conventional tablets, which showed immediate drug release. In vivo studies were carried out in rabbits, showing that the extent of isradipine absorption from the developed tablets was higher in comparison to IR tablets due to the modified release profile obtained for the former (p < 0.05). Our results suggest that SR tablets of isradipine are an efficient solid dosage form to overcome the limitations encountered in conventional IR tablets.

Ocular Cell Lines and Genotoxicity Assessment

Genotoxicity screening tests aim to evaluate if and to what extent a compound in contact with the human body (e.g., a drug molecule, a compound from the environment) interacts with DNA. The comet assay is a sensitive method used to predict the risk of DNA damage in individual cells, as it quantifies the tape breaks, being the alkaline version (pH > 13) the most commonly used in the laboratory. Epithelial cells serve as biomatrices in genotoxicity assessments. As ca. 80% of solid cancers are of epithelial origin, the quantification of the DNA damage upon exposure of epithelial cells to a drug or drug formulation becomes relevant. Comet assays run in epithelial cells also have clinical applications in human biomonitoring, which assesses whether and to what extent is the human body exposed to environmental genotoxic compounds and how such exposure changes over time. Ocular mucosa is particularly exposed to environmental assaults. This review summarizes the published data on the genotoxicity assessment in estimating DNA damage in epithelial cells with a special focus on ocular cell lines. General comet assay procedures for ex vivo and in vivo epithelium samples are also described.

Multiple Cell Signalling Pathways of Human Proinsulin C-Peptide in Vasculopathy Protection

A major hallmark of diabetes is a constant high blood glucose level (hyperglycaemia), resulting in endothelial dysfunction. Transient or prolonged hyperglycemia can cause diabetic vasculopathy, a secondary systemic damage. C-Peptide is a product of cleavage of proinsulin by a serine protease that occurs within the pancreatic β-cells, being secreted in similar amounts as insulin. The biological activity of human C-peptide is instrumental in the prevention of diabetic neuropathy, nephropathy and other vascular complications. The main feature of type 1 diabetes mellitus is the lack of insulin and of C-peptide, but the progressive β-cell loss is also observed in later stage of type 2 diabetes mellitus. C-peptide has multifaceted effects in animals and diabetic patients due to the activation of multiple cell signalling pathways, highlighting p38 mitogen-activated protein kinase and extracellular signal-regulated kinase ½, Akt, as well as endothelial nitric oxide production. Recent works highlight the role of C-peptide in the prevention and amelioration of diabetes and also in organ-specific complications. Benefits of C-peptide in microangiopathy and vasculopathy have been shown through conservation of vascular function, and also in the prevention of endothelial cell death, microvascular permeability, neointima formation, and in vascular inflammation. Improvement of microvascular blood flow by replacing a physiological amount of C-peptide, in several tissues of diabetic animals and humans, mainly in nerve tissue, myocardium, skeletal muscle, and kidney has been described. A review of the multiple cell signalling pathways of human proinsulin C-peptide in vasculopathy protection is proposed, where the approaches to move beyond the state of the art in the development of innovative and effective therapeutic options of diabetic neuropathy and nephropathy are discussed.

Nanoparticle Delivery Systems in the Treatment of Diabetes Complications

Diabetes mellitus, an incurable metabolic disease, is characterized by changes in the homeostasis of blood sugar levels, being the subcutaneous injection of insulin the first line treatment. This administration route is however associated with limited patient's compliance, due to the risk of pain, discomfort and local infection. Nanoparticles have been proposed as insulin carriers to make possible the administration of the peptide via friendlier pathways without the need of injection, i.e., via oral or nasal routes. Nanoparticles stand for particles in the nanometer range that can be obtained from different materials (e.g., polysaccharides, synthetic polymers, lipid) and are commonly used with the aim to improve the physicochemical stability of the loaded drug and thereby its bioavailability. This review discusses the use of different types of nanoparticles (e.g., polymeric and lipid nanoparticles, liposomes, dendrimers, niosomes, micelles, nanoemulsions and also drug nanosuspensions) for improved delivery of different oral hypoglycemic agents in comparison to conventional therapies.

Linseed Essential Oil - Source of Lipids as Active Ingredients for Pharmaceuticals and Nutraceuticals

Linseed - also known as flaxseed - is known for its beneficial effects on animal health attributed to its composition. Linseed comprises linoleic and α-linolenic fatty acids, various dietary fibers and lignans, which are beneficial to health because they reduce the risk of cardiovascular diseases, as well as cancer, decreasing the levels of cholesterol and relaxing the smooth muscle cells in arteries increasing the blood flow. Essential fatty acids from flax participate in several metabolic processes of the cell, not only as structuring components of the cell membrane but also as storage lipids. Flax, being considered a functional food, can be consumed in a variety of ways, including seeds, oil or flour, contributing to basic nutrition. Several formulations containing flax are available on the market in the form of e.g. capsules and microencapsulated powders having potential as nutraceuticals. This paper revises the different lipid classes found in flaxseeds and their genomics. It also discusses the beneficial effects of flax and flaxseed oil and their biological advantages as ingredients in pharmaceuticals and in nutraceuticals products.

Myasthenia gravis: State of the art and new therapeutic strategies

Myasthenia Gravis (MG) - an autoimmune neuromuscular disease - is known by the production of autoantibodies against components of the neuromuscular junction mainly to the acetylcholine receptor, which cause the destruction and compromises the synaptic transmission. This disease is characterized by fluctuating and fatigable muscle weakness, becoming more intensive with activity, but with an improvement under resting. There are many therapeutic strategies used to alleviate MG symptoms, either by improving the transmission of the nerve impulse or by ameliorating autoimmune reactions with e.g. steroids, immunosuppressant drugs, or monoclonal antibodies (rituximab and eculizumab). Many breakthroughs in the discovery of new therapeutic targets have been reported, but MG remains to be a chronic disease where the symptoms are kept in the majority of patients. In this review, we discuss the different therapeutic strategies that have been used over the years to alleviate MG symptoms, as well as innovative therapeutic approaches currently under study.

Optimization of nimesulide-loaded solid lipid nanoparticles (SLN) by factorial design, release profile and cytotoxicity in human Colon adenocarcinoma cell line

The aim of this work is development of a nontoxic, long-term stable solid lipid nanoparticles (SLN) formulation for the loading of Nimesulide (NiM) by a 2² factorial design. The optimized formulation was composed of 10 wt% of glyceryl behenate and 2.5 wt% of poloxamer 188. Immediately after production, Z-Ave of NiM-SLN was 166.1 ± 0.114 nm, with a polydispersity index (PI) of 0.171 ± 0051 and zeta potential nearly neutral (-3.10 ± 0.166 mV). A slight increase of Z-Ave was recorded for NiM-SLN stored at 25 °C for a period of 15 days, whereas at 4 °C particles kept size within similar range. Long-term stability was monitored using TurbiscanLab^®, showing a high stability of the nanoparticles with variations in the backscattering profiles below 10%. The release profile of NiM-SLN followed a sustained pattern with ca. 30% of drug released up to 24 h. Empty-SLN and NiM-SLN were nontoxic after exposing Caco-2 cells to the highest concentration (100 μg/mL) up to 48 hours (cell viability higher than 80%). NiM-SLN were lyophilized using different cryoprotectants, producing particles of 463.1 ± 36.63 nm (PI 0.491 ± 0.027) with 5% trehalose. Solid character of NiM-SLN was confirmed by DSC, recording a recrystallization index of 83% for NiM-SLN and of 74% for lyophilized SLN.

Phase Behavior of Polymorphic Fats in Drug Delivery Systems - A Review of the State of Art

Fats are essential nutrients that have a significant role in the human diet and are essential to provide energy. Fatty acids are present in several types of lipids, such as triglycerides and phospholipids. Fatty acids differ among them, depending on the number of double bonds and on the length of the hydrocarbon chains. If there are no double bonds, the fatty acids are considered saturated and show a linear structure. Compounds with double bonds are unsaturated and have bent structure. The saturated fatty acids are usually solid at room temperature and the unsaturated fatty acids are liquid at that very same temperature. These compounds are of recognized value as raw materials for drug delivery systems, such as lipid nanoparticles. The behaviour of the macroscopic aspects of fat polymorphisms is directly influenced by the melting point, the crystallization and their polymorphic transformations. In this work, we revise the most critical factors contributing for the long-term stability of lipid nanoparticles, as well as the influence of the polymorphism on the loading capacity for drug molecules.

Morphological and functional preservation of pre-antral follicles after vitrification of macaque ovarian tissue in a closed system

STUDY QUESTION

What are the appropriate conditions to vitrify the macaque ovarian cortex in a large-volume, closed system that will preserve functional pre-antral follicles?

SUMMARY ANSWER

The combination of glycerol, ethylene glycol (EG) and polymers with cooling in liquid nitrogen (LN2) vapor and a two-step warming procedure was able to preserve tissue and follicle morphology as well as function of a small population of secondary follicles in the macaque ovarian cortex following vitrification in a closed system.

WHAT IS KNOWN ALREADY

For prepubertal cancer patients or those who require immediate cancer therapy, ovarian tissue cryopreservation offers the only hope for future fertility. However, the efficacy of live birth from the transplantation of cryopreserved ovarian tissue is still unclear. In addition, live birth from cryopreserved ovarian tissue has only been demonstrated after tissue autotransplantation, which poses the risk of transmitting metastatic cancer cells back to the cancer survivor in certain cancers.

STUDY DESIGN, SIZE, DURATION

Non-human primate model, n = 4, randomized, control versus treatment. End-points were collected from tissue histology, tissue culture (48 h) and isolated secondary follicle culture (6 weeks).

PARTICIPANTS/MATERIALS, SETTING, METHODS

Two vitrification solutions (VSs) containing EG + glycerol (VEG) and EG + dimethylsulfoxide (VED) were examined for vitrification, devitrification and thermodynamic properties. Once the optimal VS was determined, macaque ovarian cortical pieces (3 × 3 × 0.5 mm(3)) were divided into fresh and two vitrified groups (VEG and VED). For the vitrification groups, tissues were exposed to 1/4, 1/2 and 1× VS for 5 min/step as well as 1× VS + polymers for 1 min at 37°C, loaded into high-security straws with 1 ml of VS + polymers, heat sealed and cooled in LN2 vapor. Samples were warmed in a 40°C water bath and cryoprotective agents were diluted with 1, 0.5, 0.25 and 0 M sucrose. Tissues were fixed for histological analysis and cultured with bromodeoxyuridine (BrdU). Secondary follicles from VEG tissues were encapsulated and cultured (n = 24/treatment/animal). Follicle health, diameter and steroid [progesterone, androstenedione (A4), estradiol (E2)] production were analyzed weekly.

MAIN RESULTS AND THE ROLE OF CHANCE

Dense stroma and intact pre-antral follicles were observed using VS containing 27% glycerol, 27% EG and 0.8% polymers with cooling in LN2 vapor and a two-step warming. Higher cooling and warming rates led to fracturing. BrdU uptake was evident in granulosa cells of growing follicles in fresh and vitrified tissues. Secondary follicles from fresh tissues (70 ± 12%) and tissues vitrified with VEG (52 ± 2%) showed similar survival rates (all data: mean ± SEM; P > 0.05). For both groups, the initial follicle diameter was similar and increased (P < 0.05) by Week 3, but diameters in vitrified follicles were smaller (P < 0.05) by Week 6 (566 ± 27 µm) than those of the fresh follicles (757 ± 26 µm). Antrum formation rates were lower (P < 0.05) for vitrified (37 ± 6%) relative to fresh (64 ± 8%) follicles. There was no significant change in levels in culture media of E2, P4 and A4 between fresh and VEG groups at any time point during culture.

LIMITATIONS, REASONS FOR CAUTION

Only in vitro studies are reported. Future in vivo tissue transplantation studies will be needed to confirm long-term function and fertility potential of vitrified ovarian tissues.

WIDER IMPLICATIONS OF THE FINDINGS

This is the first demonstration of antral follicle development during 3D culture following ovarian tissue vitrification in a closed system using primate ovarian tissue. While diminished antrum formation and slower growth in vitro reflect residual cryodamage, continued development of ovarian tissue vitrification based on cryobiology principles using a non-human primate model will identify safe, practical and efficient protocols for eventual clinical use. Tissue function following heterotopic transplantation is currently being examined.

STUDY FUNDING/COMPETING INTEREST(S)

National Institutes of Health (NIH) Oncofertility Consortium UL1 RR024926 (1RL1-HD058293, HD058295, PL1 EB008542), the Eunice Kennedy Shriver NICHD/NIH (U54 HD018185) and ONPRC 8P51OD011092-53. G.M.F. works for the company that makes the polymers used in the current study.

Preventing Microbial Contamination during Long-Term In Vitro Culture of Human Granulosa-Lutein Cells: An Ultrastructural Analysis

Purpose. To investigate whether the addition of antibiotic/antimycotic during human granulosa-lutein cells (GLCs) isolation and cell-plating procedures prevents microbial contamination after 144 h of culture and also evaluate the effects of contamination on GLCs ultrastructure and steroid secretion. Methods. GLCs obtained from five women submitted to assisted reproductive techniques (ARTs) were isolated with PBS supplemented with antibiotic/antimycotic or PBS nonsupplemented and cultured for 144 h. GLCs were evaluated by transmission electron microscopy (TEM), and estradiol (E2) and progesterone (P4) secretion was assayed by chemiluminescence. Results. Although no contaminating microorganisms were identified by light microscopy, TEM analyses revealed several bacterial colonies in culture dishes of GLCs isolated with only PBS. Bacterial contamination disrupted the adherence of the GLCs to the culture plate interfering with monolayer formation affecting the growth pattern of GLCs. Various cellular debris and bacteria were observed, and no organelles were found in the cytoplasm of infected cells. While bacterial contamination decreased estradiol media levels, it increased progesterone, as compared with noncontaminated group. Conclusion. Taken together, our data showed that the addition of a high dose of antibiotic/antimycotic during the isolation and cell-plating procedures prevents microbial contamination of long-term GLCs culture as its effects on cells growth and function in vitro.

The use of microsensors to study the role of the loading rate and surface velocity on the growth and the composition of nitrifying biofilms

The good composition and activity of biofilms are very important for successful operation and control of fixed-film biological reactors employed in liquid effluents treatment. During the last decade, microsensors have been applied to study microbial ecology. These sensors could provide information regarding the microbial activity concerning nitrification and denitrification that occur inside biofilms. Other techniques of molecular biology, such as fluorescence in situ hybridization (FISH), have also contributed to this matter because their application aids in the identification of the bacterial populations that compose the biofilms. The focus of this paper was to study the loading rate and surface velocity to promote the development of nitrifying biofilms in three distinct flow cells that were employed in the post treatment of a synthetic wastewater simulating the effluent from a UASB (Upflow Anaerobic Sludge Blanket) reactor. Using the FISH technique, it was found that the population of ammonia-oxidizing-bacteria was greater than that of nitrite-oxidizing-bacteria; this was also supported by the lower production of nitrate determined by physicochemical and microsensor analyses. It was verified that the loading rate and surface velocity that promoted the greatest nitrogen removal were 0.25 g N-amon m(-2)biofilm day(-1) and 1 m h(-1), respectively.

Behaviour of a full-scale expanded bed reactor with overlaid anaerobic and aerobic zones for domestic wastewater treatment

This paper presents the behaviour of a full-scale expanded bed reactor (160 m3) with overlaid anaerobic and aerobic zones used for municipal wastewater treatment. The research was carried out in two experimental steps: anaerobic and anaerobic-aerobic conditions, and the experimental results presented in this paper refer to four months of reactor operation. In the anaerobic condition, after inoculation and 60 days of operation, the reactor treating 3.40 kg CODm(-3)d(-1) for thetaH of 2.69 h, reached mean removal efficiencies of 76% for BOD, 72% for COD, and 80% for TSS, when the effluent presented mean values of 225 mg.L(-1) of COD, 98 mg.L(-1) of BOD and 35 mg.L(-1) of TSS. Under these conditions, for nitrogen loading of 0.27 kgN.m(-3)d(-1), the reactor generated an effluent with mean N-org. of 8 mg.L(-1) and N-ammon. of 37 mg.L(-1), demonstrating high potential of ammonification. For the anaerobic-aerobic condition (118th day) the system was operated with thetaH of 5.38 h presented mean removal efficiencies of 84% for BOD, 79% for COD, 76% for TSS, and 30% for TKN. The reactor's operation time was less than two months, which was not long enough to reach nitrification. Regarding the obtained results, this research confirmed that this reactor is configured as a flexible and adequate alternative for the treatment of sewage, requiring relatively small area and only thetaH of 10 h that can be adjusted to the local circumstances.

Development and analysis of anaerobic biofilms onto hydrophobic and hydrophilic surfaces

Fluorescent in situ hybridization (FISH) with domain and group specific probes that target intracellular 16S rRNA were used to investigate microbial composition of anaerobic biofilms developed on polypropylene (hydrophobic) and glass (hydrophilic) surfaces fitted inside a Modified Robbins Device (MRD). Crushed anaerobic granular sludge was used as inoculum for biofilm development in the MRD. The inoculum and biofilms formed showed nearly the same microbial composition, both were dominated by hydrogenotrophic methanogenic Archaea related to the Methanobacteriaceae as detected by the specific probe (MB1174). This group accounted for 44 to 90% of the DAPI-stained cells. Cells which hybridized to the Bacteria specific probe (EUB338) accounted for 3-18% of the DAPI-stained cells. After the first day of the biofilm formation experiment, a larger number of cells, 4.6 x 10(4) cells mm-2, could be seen colonizing the polypropylene coupon compared to the glass, 8.2 x 10(3) cells mm-2. However, after 9 days these numbers were very similar, i.e. 6.3 x 10(5) cells mm-2 and 7.2 x 10(5) cells mm-2, for the glass and polypropylene coupons, respectively. Our data suggest that the hydrophobicity of the support material did not influence the initial development and the microbial composition of anaerobic biofilms developed in the MRD.

Full scale fluidized bed anaerobic reactor for domestic wastewater treatment: performance, sludge production and biofilm

This paper describes the performance, sludge production and biofilm characteristics of a full scale fluidized bed anaerobic reactor (32 m3) for domestic wastewater treatment. The reactor was operated with 10.5 m x h(-1) upflow velocity, 3.2 h hydraulic retention time, and recirculation ratio of 0.85 and it presented removal efficiencies of 71+/-8% of COD and 77+/-14% of TSS. During the apparent steady-state period, specific sludge production and sludge age in the reactor were (0.116+/-0.033) kgVSS. kgCOD(-1) and (12+/-5)d, respectively. Biofilm formed in the reactor presented two different patterns: one of them at the beginning of the colonization and the other of mature biofilm. These different colonization patterns are due to bed stratification in the reactor, caused by the difference in local-energy dissipation rates along the reactor's height, and density, shape, etc. of the bioparticles. The biofilm population is formed mainly of syntrophic consortia among sulfate reducing bacteria, methanogenic archaea such as Methanobacterium and Methanosaeta-like cells.

Influence of flocculation conditions in the performance of an experimental domestic sewage treatment plant consisting of an anaerobic expanded bed reactor followed by dissolved air flotation

This paper presents the results of a study performed with an experimental domestic sewage treatment plant (240 m3 x d(-1) flow) consisting of expanded bed anaerobic reactor (EBAR) followed by dissolved air flotation (DAF) unit. For the flotation step, the anaerobic reactor effluent was previously coagulated with 50 mgFeCl3 x l(-1) and flocculated under different conditions (mean velocity gradient, Gf, and flocculation time, Tf). The Gf values were from 60 to 100 s(-1) associated with 13 and 20 min Tf values. During the tests, the following operational conditions of the flotation unit were maintained: chemical addition (50 mgFeCl3 x l(-1)), 18% recirculation rate associated with a pressure of 450 +/- 10 kPa in the saturation chamber and overflow rate of 180 m3 x m(-2) x d(-1). Temperature ranged from 23.8 degrees C to 30.0 degrees C. Best results were achieved for Gf = 80 s(-1) and Tf = 20 min. For these conditions, the DAF unit removal efficiencies were: 94.4% for chemical oxygen demand (with 53 mg x l(-1) COD residual), 87% for phosphorus (with 0.80 mgP x l(-1) residual), 96.7% for total suspended solids (with 9 mg x l(-1) TSS residual) and 96.4% for turbidity (with 12.9 NTU residual), when the anaerobic reactor effluents have worst quality during the whole day.

Sewage treatment by anaerobic biological process associated with dissolved air flotation

This paper presents the results of a study performed with a lab-scale batch DAF unit fed with previously coagulated (with FeCl3 or cationic polymer) effluent from a pilot scale up-flow anaerobic sludge blanket (UASB) reactor treating domestic sewage. The adequate coagulation/flocculation conditions--chemical dosage, time (Tf) and mean velocity gradient (Gf) in the flocculation step--and air requirements for flotation process were investigated. Best results were achieved for 65 mg.l-1 of FeCl3 at Tf around 15 min and Gf of 80 s-1. In the assays where only polymer was applied, 7 mg.l-1 of cationic polymer dosage gave optimum removals with Tf around 15 min and Gf of 30 s-1. Air requirements ranged from 9.5 to 19.0 g of air.m-3 wastewater. Best TSS (95% and residual of 2 mg.l-1), COD (85% and residual of 20 mg.l-1) and total phosphate (95% and residual of 0.6 mg.l-1) removals were obtained when applying FeCl3, although the use of cationic polymer also produced good level of TSS (74% and residual of 14 mg.l-1) and COD (75% and residual of 45 mg.l-1) removals. For the UASB-DAF (batch) system and FeCl3, global efficiencies would be 97.2% for COD, 97.9% for phosphate and 98.9% for TSS.

[Esophagectomy using videosurgery]

This is a report of 10 cases of esophagetomy by videosurgery. Five patients had esophageal carcinoma and five had achalasia. The patients who had neoplasia were submitted to thoracoscopic, laparoscopic and cervicotomy and the others who had benign pathology were submitted to laparoscopic with transdiafragmatic approach and cervicotomy. The evolution was very satisfactory but there were complications that had no relation with the method. The follow up is being made and we have no sure about real results.

Identification of a novel glucocorticoid response unit (GRU) in the 5'-flanking region of the mouse IL-2 receptor alpha gene

Glucocorticoid hormones inhibit the production of IL-2 and upregulate mouse interleukin 2 receptor alpha (IL-2Ralpha) gene expression in T cell lines by increasing its transcription rate. Now, the authors have used functional approaches to search for regulatory elements present in the 5'-flanking region of the IL-2Ralpha gene responsible for this effect. An important regulatory region was detected between -1382 and -1100 bp from the transcription initiation site. Within this region the authors characterized two 20 bp long cis-acting regulatory elements, named G1 and G2, which are involved in the modulation of the expression of the IL-2Ralpha gene by glucocorticoids. G1 contains a relatively well-conserved GRE half palindrome site, able to bind a partially purified glucocorticoid receptor but giving rise to an unstable complex. The G2 regulatory element contains no consensus sequences of binding sites for GR nor for any other described transcriptional factors but is able to form complexes with factors present in liver or T cells. Whereas G1 or G2 alone were unable to induce a glucocorticoid-response, the contiguous presence of G1 and G2 gave rise to an efficient response. Therefore, it is postulated that the glucocorticoid-induction of IL-2Ralpha gene is mediated, at least partly, through G1 and G2 elements which constitute a novel multicomponent glucocorticoid response unit (GRU).

[Mediastinoscopy: technical aspects and current indications]

Mediastinoscopy is an useful tool for mediastinal exploration with minimal surgical trauma. The anatomical and Technical basis of this procedure are simple and safe, and can be adapted to specific purposes. Surgical intervention is performed under general anesthesia and is carried out direct visual inspection. Mediastinoscopy is a diagnostic routine procedure in lung cancer staging and mediastinal adenopathy investigation. Since Carlens described the method of cervical mediastinoscopy, other authors developed new techniques, in order to improve and extend the range of mediatinal exploration. The mediastinoscope and the other tools used to perform the classic mediastinoscopy can also be used to perform pleuroscopy and even the transmediastinal esophagectomy.