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Ramos AL, Goedken ER, Frank KE, Argiriadi MA, Bazzaz S, Bian Z, Brown JTC, Centrella PA, Chen HJ, Disch JS, Donner PL, Duignan DB, Gikunju D, Greszler SN, Guié MA, Habeshian S, Hartl HE, Hein CD, Hutchins CW, Jetson R, Keefe AD, Khan H, Li HQ, Olszewski A, Ortiz Cardona BJ, Osuma A, Panchal SC, Phelan R, Qiu W, Shotwell JB, Shrestha A, Srikumaran M, Su Z, Sun C, Upadhyay AK, Wood MD, Wu H, Zhang R, Zhang Y, Zhao G, Zhu H, Webster MP. Discovery of Small Molecule Interleukin 17A Inhibitors with Novel Binding Mode and Stoichiometry: Optimization of DNA-Encoded Chemical Library Hits to In Vivo Active Compounds. J Med Chem 2024; 67:6456-6494. [PMID: 38574366 DOI: 10.1021/acs.jmedchem.3c02397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2024]
Abstract
Dysregulation of IL17A drives numerous inflammatory and autoimmune disorders with inhibition of IL17A using antibodies proven as an effective treatment. Oral anti-IL17 therapies are an attractive alternative option, and several preclinical small molecule IL17 inhibitors have previously been described. Herein, we report the discovery of a novel class of small molecule IL17A inhibitors, identified via a DNA-encoded chemical library screen, and their subsequent optimization to provide in vivo efficacious inhibitors. These new protein-protein interaction (PPI) inhibitors bind in a previously undescribed mode in the IL17A protein with two copies binding symmetrically to the central cavities of the IL17A homodimer.
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Affiliation(s)
- Ashley L Ramos
- AbbVie Incorporated, North Chicago, Illinois 60064, United States
| | - Eric R Goedken
- AbbVie Bioresearch Center, Worcester, Massachusetts 01605, United States
| | - Kristine E Frank
- AbbVie Incorporated, North Chicago, Illinois 60064, United States
| | - Maria A Argiriadi
- AbbVie Bioresearch Center, Worcester, Massachusetts 01605, United States
| | - Sana Bazzaz
- X-Chem, Waltham, Massachusetts 02453, United States
| | - Zhiguo Bian
- AbbVie Incorporated, North Chicago, Illinois 60064, United States
| | - Jesse T C Brown
- AbbVie Incorporated, North Chicago, Illinois 60064, United States
| | | | - Hui-Ju Chen
- AbbVie Incorporated, North Chicago, Illinois 60064, United States
| | | | - Pamela L Donner
- AbbVie Incorporated, North Chicago, Illinois 60064, United States
| | - David B Duignan
- AbbVie Bioresearch Center, Worcester, Massachusetts 01605, United States
| | | | | | | | | | | | | | | | | | | | - Hasan Khan
- AbbVie Incorporated, North Chicago, Illinois 60064, United States
| | - Huan-Qiu Li
- AbbVie Incorporated, North Chicago, Illinois 60064, United States
| | | | | | - Augustine Osuma
- AbbVie Incorporated, North Chicago, Illinois 60064, United States
| | - Sanjay C Panchal
- AbbVie Incorporated, North Chicago, Illinois 60064, United States
| | - Ryan Phelan
- AbbVie Incorporated, North Chicago, Illinois 60064, United States
| | - Wei Qiu
- AbbVie Incorporated, North Chicago, Illinois 60064, United States
| | - J Brad Shotwell
- AbbVie Incorporated, North Chicago, Illinois 60064, United States
| | - Anurupa Shrestha
- AbbVie Incorporated, North Chicago, Illinois 60064, United States
| | - Myron Srikumaran
- AbbVie Incorporated, North Chicago, Illinois 60064, United States
| | - Zhi Su
- AbbVie Incorporated, North Chicago, Illinois 60064, United States
| | - Chaohong Sun
- AbbVie Incorporated, North Chicago, Illinois 60064, United States
| | - Anup K Upadhyay
- AbbVie Incorporated, North Chicago, Illinois 60064, United States
| | - Michael D Wood
- AbbVie Incorporated, North Chicago, Illinois 60064, United States
| | - Haihong Wu
- AbbVie Incorporated, North Chicago, Illinois 60064, United States
| | - Ruijie Zhang
- AbbVie Incorporated, North Chicago, Illinois 60064, United States
| | - Ying Zhang
- X-Chem, Waltham, Massachusetts 02453, United States
| | - Gang Zhao
- AbbVie Incorporated, North Chicago, Illinois 60064, United States
| | - Haizhong Zhu
- AbbVie Incorporated, North Chicago, Illinois 60064, United States
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Goedken ER, Argiriadi MA, Banach DL, Fiamengo BA, Foley SE, Frank KE, George JS, Harris CM, Hobson AD, Ihle DC, Marcotte D, Merta PJ, Michalak ME, Murdock SE, Tomlinson MJ, Voss JW. Tricyclic covalent inhibitors selectively target Jak3 through an active site thiol. J Biol Chem 2014; 290:4573-4589. [PMID: 25552479 DOI: 10.1074/jbc.m114.595181] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
The action of Janus kinases (JAKs) is required for multiple cytokine signaling pathways, and as such, JAK inhibitors hold promise for treatment of autoimmune disorders, including rheumatoid arthritis, inflammatory bowel disease, and psoriasis. However, due to high similarity in the active sites of the four members (Jak1, Jak2, Jak3, and Tyk2), developing selective inhibitors within this family is challenging. We have designed and characterized substituted, tricyclic Jak3 inhibitors that selectively avoid inhibition of the other JAKs. This is accomplished through a covalent interaction between an inhibitor containing a terminal electrophile and an active site cysteine (Cys-909). We found that these ATP competitive compounds are irreversible inhibitors of Jak3 enzyme activity in vitro. They possess high selectivity against other kinases and can potently (IC50 < 100 nm) inhibit Jak3 activity in cell-based assays. These results suggest irreversible inhibitors of this class may be useful selective agents, both as tools to probe Jak3 biology and potentially as therapies for autoimmune diseases.
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Affiliation(s)
- Eric R Goedken
- From the AbbVie Bioresearch Center, Worcester, Massachusetts 01605.
| | | | - David L Banach
- From the AbbVie Bioresearch Center, Worcester, Massachusetts 01605
| | - Bryan A Fiamengo
- From the AbbVie Bioresearch Center, Worcester, Massachusetts 01605
| | - Sage E Foley
- From the AbbVie Bioresearch Center, Worcester, Massachusetts 01605
| | - Kristine E Frank
- From the AbbVie Bioresearch Center, Worcester, Massachusetts 01605
| | | | | | - Adrian D Hobson
- From the AbbVie Bioresearch Center, Worcester, Massachusetts 01605
| | - David C Ihle
- From the AbbVie Bioresearch Center, Worcester, Massachusetts 01605
| | - Douglas Marcotte
- From the AbbVie Bioresearch Center, Worcester, Massachusetts 01605
| | - Philip J Merta
- From the AbbVie Bioresearch Center, Worcester, Massachusetts 01605
| | - Mark E Michalak
- From the AbbVie Bioresearch Center, Worcester, Massachusetts 01605
| | - Sara E Murdock
- From the AbbVie Bioresearch Center, Worcester, Massachusetts 01605
| | | | - Jeffrey W Voss
- From the AbbVie Bioresearch Center, Worcester, Massachusetts 01605
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Abstract
The martinellines (1 and 2) are natural products that possess both interesting biological activity and chemical structure. During the investigation of a hetero Diels-Alder route to these molecules, alternate Lewis acid-dependent cyclizations of (2'-amino-N'-tert-butoxycarbonyl-5'-chlorobenzylidene)-3-butenylamine (10) were observed. The reaction of a variety of imines with TMSOTf or TiCl(4) led to the formation of different heterocycles including iminodibenzo[b,f][1,5]diazocines, hexahydropyrido[1, 2-c]quinazolin-6-ones, tetrahydropyrrolo[1,2-c]quinazolin-5-ones, 2-arylpiperidines, and 2-arylpyrrolidines. Tetrahydropyrrolo[1, 2-c]quinazolin-5-one 54, obtained via this new methodology, was used as an intermediate in the synthesis of the tricyclic ring system (65) of the martinellines.
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Affiliation(s)
- K E Frank
- Department of Medicinal Chemistry, University of Kansas, Lawrence, Kansas 66045-2506, USA
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Frank KE, Jung M, Mitscher LA. A simple, inexpensive apparatus for performance of preparative scale solution phase multiple parallel synthesis of drug analogs. I. Preparation of a retrospective library of quinolone antiinfective agents. Comb Chem High Throughput Screen 1998; 1:73-87. [PMID: 10500767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
A simple inexpensive apparatus is described consisting of conveniently commercially available components which is suitable for the solution phase multiple parallel synthesis of 24-72 analogs of drug-like molecules. The use of the apparatus is illustrated by preparation of a retrospective library of over 100 analogs of antimicrobial fluoroquinolones prepared in 0% to quantitative yields. Each analog was prepared in up to 150 mg quantity and each was analyzed by NMR and mass spectrometric techniques to verify its purity and identity.
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Affiliation(s)
- K E Frank
- Department of Medicinal Chemistry, Kansas University, Lawrence 66045-2506, USA
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Frank KE, Devasthale PV, Gentry EJ, Ravikumar VT, Keschavarz-Shokri A, Mitscher LA, Nilius A, Shen LL, Shawar R, Baker WR. A simple, inexpensive apparatus for performance of preparative scale solution phase multiple parallel synthesis of drug analogs. II. Biological evaluation of a retrospective library of quinolone antiinfective agents. Comb Chem High Throughput Screen 1998; 1:89-99. [PMID: 10500768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
A series of pure fluoroquinolone antiinfective agents was prepared by multiple parallel synthesis using a simple new apparatus. These compounds were evaluated biologically against Gram-positive and Gram-negative microorganisms and against a BCG strain transfected with luciferase in a fluorescence-based antitubercular assay. Activity against relatively fast growing, acid-fast Mycobacterium smegmatis was determined in part by agar-dilution streak assays. Data obtained against Escherichia coli-derived DNA gyrase does not correlate well with whole cell assays against E. coli. These compounds were assayed by a convenient glass-fiber filter binding method modified for high throughput screening. In these analogs, the results with a N-1 cyclopropyl substituent were often inferior to those obtained with a N-1 2',4'-difluorophenyl substituent. None of the new compounds prepared was superior in its antimycobacterial potency to ciprofloxacin or temafloxacin.
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Affiliation(s)
- K E Frank
- Department of Medicinal Chemistry, Kansas University, Lawrence 66045-2506, USA
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Abstract
The literature of combinatorial chemistry is reviewed with particular attention paid to considerations of absorption, distribution, metabolism and excretion in the design and evaluation of libraries containing drug-like molecules. Published libraries are evaluated in particular for the likelihood that the products would possess oral bioavailability.
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Affiliation(s)
- R A Fecik
- Department of Medicinal Chemistry, Kansas University, Lawrence 66045-2506, USA
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Abstract
Bilateral serous retinal detachments are rare complications of thrombotic thrombocytopenic purpura (TTP). We report the case of a 28-year-old woman with chronic relapsing TTP with bilateral serous retinal detachments, which resolved after prompt aggressive medical therapy. Unlike several previous reports, the retinal detachments in our patient were unrelated to systemic hypertension.
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Affiliation(s)
- R E Wyszynski
- Division of Ophthalmology, University Hospitals of Cleveland, Case Western Reserve University, OH 44106
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Abstract
A 50-year-old woman was evaluated for a subretinal hemorrhage that extended into the vitreous of the right eye. Examination showed multiple refractile brown spherules in the vitreous. A vitrectomy was performed, and pathologic examination of the spherules showed them to be composed of free hemoglobin. Free-hemoglobin spherulosis in the vitreous, like cholesterosis bulbi, is a manifestation of vitreous hemorrhage.
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Affiliation(s)
- H E Grossniklaus
- Department of Pathology, University Hospital of Cleveland, Case Western Reserve University, OH
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Abstract
The authors examined an eye obtained post-mortem from a patient with chronic granulomatous disease of childhood and clinically apparent chorioretinal scars. Histologic examination disclosed numerous chorioretinal scars with associated retinal pigment epithelial changes and glial proliferation. Special stains for bacteria and fungi were negative. Additional findings were scattered pigment-containing macrophages found in the patient's spleen, liver, lymph nodes, bone marrow, lungs, kidney, thymus, choroid, and retina. The significance of the pigmented macrophages is unknown, however they may represent an abortive macrophage response to infectious agents.
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Affiliation(s)
- H E Grossniklaus
- Division of Ophthalmology, University Hospitals of Cleveland, Case Western Reserve University, Ohio
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Grossniklaus HE, Frank KE, Green WR. Subretinal neovascularization in a pseudophakic eye treated with krypton laser photocoagulation. A clinicopathologic case report. Arch Ophthalmol 1988; 106:78-81. [PMID: 2447858 DOI: 10.1001/archopht.1988.01060130084034] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
A 76-year-old myopic woman who had undergone bilateral extracapsular cataract extractions and received posterior intraocular lens implants underwent two sessions of krypton laser photocoagulation for subretinal neovascularization secondary to age-related macular degeneration in her right eye. The patient expired and histopathologic examination of her treated eye showed a posterior chamber intraocular lens with both haptics in the ciliary sulcus, areas of macular degeneration, evidence of krypton laser photocoagulation including a full-thickness retinal scar, and an area of clinically unsuspected subretinal neovascularization.
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Affiliation(s)
- H E Grossniklaus
- Division of Ophthalmology, University Hospitals of Cleveland, Case Western Reserve University, OH
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Abstract
We retrospectively studied eight eyes of seven patients sustaining indirect choroidal rupture secondary to blunt trauma. Clinical and fluorescein angiographic findings were reviewed. The ruptures were single in five eyes and multiple in three eyes. Four eyes contained macular ruptures, and three eyes contained extramacular ruptures. Peripapillary ruptures were noted in three eyes. Three eyes developed subretinal neovascularization as a complication. Location of the rupture but not visual acuity at presentation was predictive of visual outcome. All ruptures were concentric with the optic nerve and vertically oriented, consistent with a break in Bruch's membrane and an associated tethering effect by the optic nerve.
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Affiliation(s)
- R E Wyszynski
- Division of Ophthalmology, University Hospitals of Cleveland, Case Western Reserve University, Ohio
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Abstract
A 33-year-old man with acquired immune deficiency syndrome (AIDS) was found to have bilateral cytomegalovirus (CMV) retinitis with concomitant unilateral optic neuritis. The patient died and postmortem examination of both eyes disclosed CMV inclusions in all layers of the involved retinas including the retinal pigment epithelium (RPE). Also found were CMV inclusions in the optic nerve of his left eye. Immunohistochemical stains for glial fibrillary acid protein demonstrated that glial cells were infected in the optic nerve.
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Affiliation(s)
- H E Grossniklaus
- Division of Ophtalmology, University Hospitals of Cleveland, Case Western Reserve University, OH 44106
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Monnier VM, Elmets CA, Frank KE, Vishwanath V, Yamashita T. Age-related normalization of the browning rate of collagen in diabetic subjects without retinopathy. J Clin Invest 1986; 78:832-5. [PMID: 3745442 PMCID: PMC423683 DOI: 10.1172/jci112648] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
The age-related changes in collagen-linked fluorescence (browning) were investigated in skin from subjects with long-standing type I diabetes. Overall browning rates were 2.4 times higher in diabetics than in controls (P less than 0.02) and slope intercept accurately reflected the mean age of onset of diabetes (11.6 vs. 11.2 yr), suggesting that the browning process has the attributes of a biological clock. Browning rates were not different in controls and diabetics without retinopathy (P greater than 0.05) but were 2.4 (P less than 0.05) and 2.7 (P less than 0.01) times increased in the presence of background and proliferative retinopathy, respectively. Compared with subjects with retinopathy, individual browning rates since onset of diabetes decreased with advancing age in subjects free of retinopathy (P less than 0.001). Extrapolation revealed that they would become identical to that of nondiabetic subjects by the age of 66.4 yr. These results suggest the presence of a mechanism that controls the browning rate of collagen in diabetics who do not develop retinopathy.
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Vishwanath V, Frank KE, Elmets CA, Dauchot PJ, Monnier VM. Glycation of skin collagen in type I diabetes mellitus. Correlation with long-term complications. Diabetes 1986; 35:916-21. [PMID: 3732633 DOI: 10.2337/diab.35.8.916] [Citation(s) in RCA: 71] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Nonenzymatic glycosylation (glycation) of collagen was measured by boronate affinity chromatography in skin biopsies from 41 type I diabetics with mean duration of diabetes of 25 yr (range 20-40 yr) and from 25 age-matched controls. Mean level of Amadori products was significantly increased in diabetic [7.85 +/- 1.78 (SD) nmol/mg collagen] versus control subjects [3.34 +/- 1.06 (SD) nmol/mg collagen, P less than .001] but did not correlate with age, diabetes duration, or severity of retinopathy, nephropathy, arterial stiffness, and joint stiffness. Similarly, mean collagen content per biopsies was 42% increased in diabetic versus control subjects (P less than .001) but did not correlate with age, diabetes duration, or severity of complications. A weak but positive correlation between glycohemoglobin level and glycation of skin collagen was observed. These results indicate that Amadori products cannot explain by themselves the pathogenesis of diabetic complications unless individual tissue response to glycation is different in subjects with and without complication. They do not exclude a role for the late stages of the Maillard reaction, nonenzymatic browning, in the formation of some of these complications.
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Abstract
Nonenzymatically glycosylated proteins gradually form fluorescent cross-linked protein adducts--a process termed "browning." The rate of this reaction increases with the glucose concentration. Assaying for the presence of browning products in long-lived proteins should therefore provide information on long-term metabolic control. We measured collagen-linked fluorescence typical for nonenzymatic browning in skin-biopsy specimens from 41 subjects with longstanding Type I diabetes and from 25 controls. Fluorescence correlated with age and (weakly) with the duration of diabetes. Mean age-adjusted fluorescence values were twice as high in diabetic subjects as in control subjects (P less than 0.0001) and increased with the severity of retinopathy, nephropathy, and arterial and joint stiffness. The correlation was significant for retinopathy (r = 0.42; P less than 0.01), arterial stiffness (r = 0.41; P less than 0.01), joint stiffness (r = 0.34; P less than 0.05), and the sum of all complications (r = 0.47; P less than 0.01). Fluorescence also correlated with systolic (r = 0.42; P less than 0.01) and diastolic (r = 0.36; P less than 0.05) blood pressures. If one can assume that the fluorescence results from a browning product of glucose, our data suggest that there is an overall correlation between the severity of diabetic complications and cumulative glycemia over many years.
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Lass JH, Varley MP, Frank KE, Speck WT. Actinobacillus actinomycetemcomitans endophthalmitis with subacute endocarditis. Ann Ophthalmol 1984; 16:54-61. [PMID: 6608307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Endocarditis and unilateral endophthalmitis due to Actinobacillus actinomycetemcomitans heart disease. The ocular infection was notable for its localized presentation and slow evolution. Treatment with systemic, subconjunctival, and topical gentamicin sulfate and ampicillin sodium achieved 20/20 acuity with a residual chorioretinal scar in the nasal periphery. Intravitreal injection of the organism into a rabbit confirmed its minimal pathogenicity within the eye. This organism must now be considered in patients with differential diagnosis of endogenous endophthalmitis complicating endocarditis and septicemia.
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Abstract
A series of 22 patients with cystic fibrosis (CF) of similar clinical severity (9 with normal carbohydrate tolerance and 13 with insulin-treated fasting hyperglycemia) was examined with quantitative vitreous fluorophotometry. All of the CF patients studied had normal fundi on ophthalmoscopy, fundus photographs, and fluorescein angiography. Mean vitreous fluorescein concentration in the CF patients whose hyperglycemia was treated with insulin (11.79 ng/ml) was significantly higher than in CF patients with normal carbohydrate tolerance (6.98 ng/ml, P less than 0.005). Thus, CF patients with fasting hyperglycemia demonstrate a breakdown of the blood-retinal barrier. When CF patients with fasting hyperglycemia were compared with age- and sex-matched type I diabetics, there was no significant difference in mean vitreous fluorescein accumulation. Thus, breakdown of the blood-retinal barrier, one of the earliest detectable functional abnormalities that may be associated with the microangiopathy of diabetes mellitus, also occurs with equal frequency and severity in the diabetes secondary to pancreatic fibrosis associated with CF.
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Abstract
Mice were trained in step-down passive avoidance behavior. Bitemporal injections of puromycin (PM) were given either immediately or delayed until 24 hrs after training. PM produced a marked amnesia in both cases during retention testing 3 days later. The amnesia persisted during a second retention test 6 days after training. Of all the antibiotics, only PM is effective as an amnestic agent when injections are delayed 24 or more hours after training. cycloheximide (CXM) was also injected bitemporally immediately after training. However, CXM produced a weaker amnestic effect even though it produced a much greater inhibition of cerebral protein synthesis, more rapidly, and of longer duration. In an effort to attenuate the amnesia produced by PM, in separate experiments, the mice were injected with combined injections of PM and and CXM (bitemporally): mice were also given combined injections of PM (bitemporally) and amphetamine (subcutaneously). The amnesia produced by immediate injections of PM wa not attenuated by either CXM or amphetamine. However, the amnesia produced by delayed injections of PM was attenuated by both CXM and amphetamine. These results suggest that delayed injections of PM (25 hours after training) block the expression or retrieval of memory. This study also supports the contention that puromycin has two separate effects on memory with different temporal parameters depending on when the drug is injected relative to initial training.
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Abstract
Eleven patients with unilateral exophthalmos had sector B-scan ultrasonography. The ultrasonograms were all similar and demonstrated a "hemangiomalike" pattern consisting in a rounded, well-outlined orbital mass with a sharp anterior border, moderate to strong tissue reflectivity, and fair to good sound transmission. Although the postoperative pathologic findings in six cases confirmed the presence of cavernous hemangioma of the orbit, other lesions, such as hemangiopericytoma, lymphangioma, orbital varix, meningioma, and mixed cell tumor, were found to show a similar ultrasonographic pattern.
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Sholiton DB, Reinhart WJ, Frank KE. Indomethacin as a means of preventing cystoid macular edema following intracapsular cataract extraction. J Am Intraocul Implant Soc 1979; 5:137-40. [PMID: 479006 DOI: 10.1016/s0146-2776(79)80053-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
It has been theorized that prostaglandins E1 and E2 may be responsible for the vascular leakage leading to cystoid macular edema following cataract extraction. Indomethacin is a known inhibitor of prostaglandin synthesis. A prospective, double-blind study to evaluate the effect of oral indomethacin on four and eight week cases of postoperative CME following intracapsular cataract extraction as determined by fluorescein angiography was carried out on 42 patients. Twenty patients received 25 mg of indomethacin three times a day for three days preoperatively and three weeks postoperatively. Twenty-two patients received a placebo on an identical schedule. Four (20%) patients in the indomethacin group and five (22.7%) patients in the placebo group had positive angiograms for CME. No contributory factor resulting in CME was found.
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Abstract
An ultrasound diagnostic coding system was developed that permitted entry of diagnoses into a programmable calculator, thus permitting rapid information retrieval of patients with a specific diagnosis or diagnoses as well as the number of patients with a specific diagnosis. Cataract, vitreous opacity, trauma, choroidal disease, and retinal detachment were the most common diagnoses made. Only 7.2% of the patients had a normal ultrasound, indicating that ultrasound examination is a test probably underutilized by ophthalmologists.
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Abstract
A 17-year-old girl and an 11-year-old girl with rubella retinopathy had decreased vision in one eye secondary to subretinal neovascularization and hemorrhage. In both cases a disciform scar with permanent decrease in central vision resulted.
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