Magnetic Resonance Imaging Diagnosis in Normal Pressure Hydrocephalus

BACKGROUND

Idiopatic normal pressure hydrocephalus (iNPH) is a progressive neurologic syndrome featured by the triad of gait disturbance, mental deterioration and urinary incontinence, associated with ventriculomegaly and normal cerebrospinal fluid (CSF) pressure. The clinical presentation may be atypical or incomplete, or mimicked by other diseases, so conventional neuroradiologic imaging plays an important role in defining this pathology. iNPH pathophysiologic mechanisms have not yet been fully elucidated, although several studies have demonstrated the involvement of the glymphatic system, a highly organized fluid transport system, the malfunction of which is involved in the pathogenesis of several disorders including normotensive hydrocephalus.

METHODS

Recent studies have shown how crucial in the diagnosis of this pathology is the definition of morphologic biomarkers, such as ventricular enlargement disproportionate to cerebral atrophy and associated ballooning of frontal horns; periventricular hyperintensities; and corpus callosum thinning and elevation, with callosal angle <90 degrees.

RESULTS

Another interesting feature that is becoming a well-recognized factor to look for and useful for the diagnosis of iNPH is disproportionately enlarged subarachnoid space hydrocephalus, which includes enlarged ventricles, tight high-convexity and medial surface subarachnoid spaces, and expanded Sylvian fissures. A correct choice of MRI sequences is important for a proper characterization identification of others diseases that may underlie this pathology. Magnetic resonance imaging allows us to evaluate CSF flow, enabling us to define qualitative and quantitative parameters necessary for the purpose of accurate iNPH diagnosis.

CONCLUSIONS

iNPH can represent a real diagnostic challenge; a proper correlation among clinical features, traditional MRI, and CSF dynamics analysis can lead to a correct diagnosis.

Genotypic and phenotypic diversity of Lactobacillus delbrueckii subsp. lactis strains of dairy origin

Eighty-nine strains of Lactobacillus delbrueckii subsp. lactis isolated from Italian hard and semi-hard cheeses and artisan starter cultures were characterised by phenotypic and genotypic methods. Phenotypic diversity was evaluated by studying biochemical characteristics (i.e. acidifying and peptidase activities) of technological interest. Genotypic diversity was evidenced by RAPD-PCR and pulsed field gel electrophoresis (PFGE). Phenotypic characterisation indicated a wide variability of the acidifying activity within Lact. delbrueckii subsp. lactis. Although the data was variable, it allowed us to evidence groups of strains with different acidifying properties, especially in terms of acidification intensity. Concerning peptidase activity, Lact. delbrueckii subsp. lactis showed a homogeneously high x-prolil-dipeptidil-aminopeptidase activity and a considerable but more heterogeneous lysil-aminopeptidase activity. The increased resolution obtained by the use of two molecular typing techniques, i.e. RAPD-PCR and PFGE, allowed to widen the level of strain heterogeneity. Technological and ecological pressures are determinant in selecting Lact. delbrueckii subsp. lactis sub-populations which are more functional to the different cheese technologies.

Some new methyl-8-methoxypsoralens: synthesis, photobinding to DNA, photobiological properties and molecular modelling

The tricyclic structure of known natural photochemotherapeutic drugs such as 8-methoxypsoralen and 5-methoxypsoralen is often taken as a model in the search of new photosensitizer agents with less phototoxic and mutagenic effects. This paper describes the synthesis, characterization, photobinding to DNA, photobiological properties and computational chemistry of some 8-methoxypsoralen derivatives bearing two or three methyl groups at the key positions of the two photoactive double bonds. Results showed that photoreactivity and photobiological behaviour depend on the pattern of methyl substitutions. Antiproliferative activity in cell lines shows good correlation with DNA interaction data.

[Immune responses of IgG, IgA and anti-CagA IgG to Helicobacter pylori in dyspeptic and peptic ulcer patients]

The anti-H. pylori IgG, IgA, and anti CagA responses in dyspeptic patients have been evaluated. Of 481 patients 76% tested positive for IgG anti-H. pylori, 57% for anti-CagA, and 52% IgA for anti H. pylori. There was a significant age-related increase in IgG anti-H. pylori and IgA anti-H. Pylori prevalence, whereas anti-CagA positives were unreliable in this respect. The IgG seropositivity was the highest (93%) in duodenal ulcers (DU), 82% in antral gastritis and/or bulbitis (AG +/- /B), and 71% in gastric ulcer (GU). GU patients compared with DU and AG +/- /B ones tended to have the highest IgA anti-H. pylori prevalence (78% vs. 66% and 61%). The anti-CagA seropositivity was the most pronounced (80%) in DU followed by GU (72%) and AG +/- /B (68%). It is suggested that the serodiagnosis including IgG, IgA anti-H. pylori and anti-CagA determinations can not replace endoscopy in revealing the exact nature of gastroduodenal lesions. IgA anti-H. pylori determination in female patients with GU can be a valuable diagnostic tool. It is stated that in Hungary the prevalence of CagA positive H. pylori strains in anti-H. pylori IgG positive dyspeptic patients is 85%.

4'-Methyl derivatives of 5-MOP and 5-MOA: synthesis, photoreactivity, and photobiological activity

The synthesis and photobiological activity of four new 4'-methyl derivatives of 5-MOP (5-methoxypsoralen) and 5-MOA (5-methoxyangelicin), i.e., 4,4'-dimethyl-5-methoxypsoralen, 3,4'-dimethyl-5-methoxypsoralen, 4,4'-dimethyl-5-methoxyangelicin, and 3,4'-dimethyl-5-methoxyangelicin, are described. All these compounds photobind efficiently to DNA. The DNA-photobinding process was investigated using various nucleic acid structures such as double-helix DNA, bacterial DNA, and synthetic polydeoxyribonucleotides. Photoreaction experiments showed that, unlike 8-MOP (8-methoxypsoralen) and 5-MOP, both angular derivatives bind thymine and cytosine with the same efficiency. The principal nucleoside-psoralen monoadducts were isolated and characterized after enzymatic digestion or acid hydrolysis. Biological activity studies revealed a good correlation with the extent of covalent photoaddition. Moreover, the two angular derivatives and the 4,4'-dimethyl-5-methoxypsoralen were unable to induce skin erythema, in striking contrast with the reference drugs, 8-MOP and 5-MOP; only the 3,4'-dimethyl-5-methoxypsoralen caused erythema, although to a substantially lower extent than that induced by the two parent compounds.

Synthesis and characterization of new methylpsoralens as potential photochemotherapeutic agents

Three new psoralens with methyl groups on carbons involved in their reactive double bonds (compounds 9-11 in Scheme 1) were synthesized from the corresponding 7-hydroxycoumarins by cyclization of acetonyl derivatives of the latter in an alkaline medium. In preliminary tests, the new methyl-substituted psoralens exhibited considerable interaction in the dark with DNA, good photoreactivity against the macromolecule, and also interesting antiproliferative activity.

Synthesis and photobiological activity of new methylpsoralen derivatives

The synthesis and the photobiological activity of two new derivatives of psoralen (3,4'-dimethylpsoralen and 3,4',8-trimethylpsoralen) has been described. They are congeners of the monofunctional linear furocoumarin 3,4'-dimethyl-8-methoxypsoralen. Both compounds bind very efficiently to DNA, the extent of this process being modulated by the nature of substituents at position 8. The number of photolesions is linearly related to adenine-thymine content of the nucleic acid which indicates lack of specificity for particular sequences of the nucleic acid. The structural arrangement of DNA (single stranded, double stranded, nucleosomes and chromatin) plays an additional role in affecting the photobinding process. Unlike their 8-methoxy congener the new derivatives cross-link DNA to a substantial extent. Their photobiological properties, including erythema formation, reflect very closely those of 8-methoxypsoralen (8-MOP). The conclusion can be drawn that 3,4'-dimethyl-8-MOP represents a unique derivative in its family.

Photobiological activity of 3,4'-dimethyl-8-methoxypsoralen, a linear furocoumarin with unusual DNA-binding properties

The furocoumarin derivative 3,4'-dimethyl-8-methoxypsoralen (DMe-8-MOP) exhibits remarkable antiproliferative activity, but is devoid of skin phototoxicity. To gain insight into this peculiar behaviour we investigated non-covalent and covalent binding of DMe-8-MOP to calf thymus DNA, along with DNA-synthesis inhibition and mutagenic activity. The non-covalent interaction of DMe-8-MOP with the nucleic acid is quite poor as shown by equilibrium dialysis, spectroscopic, chiroptical and hydrodynamic techniques. However, it exhibits relevant photobinding ability to DNA using both isolated nucleic acid samples and cellular systems. Unlike the large majority of congeners, DMe-8-MOP undergoes predominantly photochemical monoaddition to the double helical polynucleotide. Upon examination of the products obtained by enzymatic hydrolysis of DMe-8-MOP photomodified DNA, the formation of an unusual furan side adduct is proposed, which could account for the peculiar photochemical and photobiological properties of the 3,4'-dimethyl furocoumarin derivative.

Diethylaminopropionamido-hydroxy-anthraquinones as potential anticancer agents: synthesis and characterization

A number of new 9,10-anthracenediones were obtained, bearing one or two hydroxyl groups and one positively charged side chain at different positions of the aromatic ring system (compounds 1-5 in Chart 1). These derivatives resemble the anticancer agents mitoxantrone and ametantrone. The synthesis started from dihydroxy- or amino-hydroxy-9,10-anthracenediones, which were converted into the nitro-derivatives. After reduction to the corresponding amines and acylation with 3-chloropropionyl chloride, substitution with diethylamine led to the final diethylaminopropionamido derivatives. The new anthracenediones cause a quite relevant inhibition of cell growth in vitro and will be tested as possible anticancer agents.

Bis-substituted hydroxy-anthracenediones: DNA binding and biological activity

Three new hydroxy-9,10-anthracenedione derivatives (compounds 1-3 in Figure 1), bearing two charged or polar side chains at positions 2 and 4/5 of the tricyclic system, have been investigated for their DNA binding, cytotoxic and genotoxic activity. The interaction mode with nucleic acids is intercalative for compounds 1 and 2, while external and intercalative binding probably coexist for compound 3. Complexation of the nucleic acid occurs in all cases in a cooperative manner, so that drug binding favours further binding to double helical DNA. The scale of the intrinsic binding constant is discussed in terms of the nature and position of the side chain. Cell growth and DNA synthesis inhibition data match quite well with DNA affinity. Alkaline elution experiments show a correlation between drug cytotoxicity and DNA damage. Our results indicate that the position and number of OH groups, as well as of charged side chains, play an important role in modulating drug affinity for DNA and the consequent biological effects.

Antitumor activity of new anthraquinone derivatives

Seven new 9,10-anthracenedione derivatives bearing positively-charged side chains at different positions of the condensed ring system have been investigated in their interaction with DNA and their biological effects, including antitumor activity in the P 388 mouse miniscreen. The drug's affinity for DNA was found to be related to the efficacy of inhibition of cell growth and nucleic acid synthesis for a number of cell lines. Moreover, alkaline elution experiments showed a close relationship between mutagenic potential and cytotoxicity. With the exception of one, all compounds behaved like intercalating agents, as shown by the unwinding of supercoiled plasmid DNA. DNA appeared, therefore, to be the more important target for drug action. The marginal in vivo activity shown by two substances in this series suggests a number of possible structural modifications which may increase their therapeutic efficacy.

A search for potential antitumor agents: biological effects and DNA binding of a series of anthraquinone derivatives

In an effort to establish a relationship between mechanism of binding and affinity to DNA, cytotoxic activity, and genotoxic activity, we have studied four new anthracenedione derivatives bearing charged side chain groups at various positions of the polycyclic aromatic system. Cytotoxicity, genotoxicity, and thermodynamic DNA binding parameters were shown to be directly related, indicating the polynucleotide as an important target for drug action, rather than a minor, subterminal interacting site. This finding was further supported by the observation of extensive anthraquinone accumulation occurring in the nuclear compartment. The relative binding affinities of the drugs are discussed in terms of nature and position of side-chain substituents. Different binding modes were found: three compounds intercalate into the nucleic acid double helix, and one interacts with the exterior of the macromolecule. The biological results suggest that the mode of complex formation plays a less relevant role than DNA binding efficiency.

Photobiological properties of some water-soluble 5-MOP and 8-MOP derivatives

The photobiological properties of a number of water-soluble psoralen derivatives have been investigated. The compounds are characterized by the presence of protonated diethylaminoalkyloxy side-chains at position 5 or 8. Thus they are strictly related to the photochemotherapeutic agents 5-MOP and 8-MOP. Inhibition of DNA synthesis by the above compounds has been evaluated in mouse skin in vivo and in Ehrlich ascites tumor cells. In the latter experiments, inhibition of tumor transmitting capacity has been demonstrated by injection of irradiated cells into healthy animals. Finally, skin erythema formation has been studied in albino guinea pigs. The photobiological responses were quite remarkable in all cases. In general, derivatives at position 5 exhibit stronger antiproliferative effects, while the 8 isomers display higher skin phototoxicity.

New anthracenedione derivatives: interaction with DNA and biological effects

Two anthracenedione derivatives [1 - (omega - diethylaminopropylamido) - 4 - hydroxy - 9,10 - anthracenedione hydrochloride (I) and 1 - (omega - diethylaminopropylamido) - 2 - methoxy - 4 - hydroxy - 9, 10 - anthracenedione hydrochloride (II)], having an electron-rich planar chromophore and an amino-substituted side chain, have been synthesized. Their binding ability to DNA was investigated by means of spectroscopic, equilibrium dialysis and fluorescence measurements. Their inhibition efficiency on nucleic acid synthesis was also evaluated both in mouse and human cells. Our results indicate that, in comparison with adriamycin, compound I shows a slightly weaker complexation ability to DNA, while compound II interacts with DNA at a substantially lower level. These data match quite well with the biological response on the inhibition of DNA and RNA synthesis exhibited by the above mentioned compounds; in fact compound I is slightly less efficient than adriamycin and about ten times more efficient than compound II. The close relationship between the results of physicochemical and biological studies is discussed.

3-Amino- and 3-oxy-derivatives of psoralen: preparation and interactions with DNA

3-Amino- and 3-oxy-derivatives of psoralen, thus having electron-donating groups at the 3-position of the alpha-pyronic ring, were prepared and studied as regards their capacities of interaction and photoreaction with native DNA in vitro. Very interesting properties were shown especially by the 3-amino-derivatives, namely 3-amino-4'-methylpsoralen and 3-diethylaminoacetylamido-4'-methylpsoralen, having a very high photobinding capacity with DNA and behaving as pure, or fairly pure, monofunctional reagents. These properties appear to be quite suitable for the therapeutic treatment of psoriasis and other skin diseases characterized by an increased reproducing activity of epidermal cells.

Photoreactive water-soluble derivatives of psoralen

Photobinding to DNA and cross-linking formation in vitro, as well as the skin photosensitizing activity on guinea pigs of two water-soluble derivatives of psoralen (5 and 8-diethylaminopropyloxypsoralen hydrochloride) have been studied. For purposes of comparison, the results have been correlated with those obtained, in the same experimental conditions, with 5- and 8-methoxypsoralen. The water-soluble 8-derivative showed an increased photoaddition to DNA and cross-linking formation, when compared with 8-methoxy-derivative; on the contrary, the water-soluble 5-derivative was less photoreactive than the corresponding 5-methoxy-derivative. The skin photosensitizing potency of 8-diethylaminopropyloxypsoralen (the more interesting of the two compounds) appears weaker than that of 8-methoxypsoralen after topical application, but higher after oral ingestion or subcutaneous injection.

Diethylaminoalkyloxycoumarin and -furocoumarin derivatives

Four series of diethylaminoalkoxyderivatives of coumarin (at the positions 4 and 7) and furocoumarin (at the positions 5 and 8) have been prepared, in order to study their complexing capacity with DNA, these compounds having a double possibility of interaction, that is intercalation of the aromatic moiety between two base pairs and formation of an electrostatic bond between their terminal amino group and a phosphoric group of DNA. Some biological effects connected with the interaction with DNA have also been studied. The results obtained showed that coumarin derivatives have a low complexing capacity and lack any biological activity. The furocoumarin derivatives showed a markedly increased complexing capacity both in respect to the coumarin derivatives and to the parent furocoumarin (psoralen, as well as its 5- and 8-methoxy derivatives) and proved able to inhibit DNA and RNA synthesis in Ehrlich ascites tumor cells, as well as the growth of Staphylococcus aureus and of various strains of Escherichia coli. This activity was generally low but was constantly higher in 5-than in 8-derivatives, the same behavior being found with regard to the complexing capacity with DNA. A good correlation between the ability to form complexes with DNA and the capacity to inhibit cells growth was clearly evidenced.

On the binding of benz(a)pyrene to DNA "in vivo"

The Possibility that “in vivo” a binding takes place between DNA and benz [a] pyrene was examined. After oral administration of 3H-benz [a] pyrene, radioactive DNA was isolated from the skin, spleen and liver of NCLmice, and especially from the liver. This suggest that covalent binding between DNA and benz [a] pyrene takes place.

Isolation of a benz(a)pyrene-thymine photoadduct from DNA hydrolized after irradiation at 365 nm in the presence of benz(a)pyrene

The photoreaction which takes place between benz [a] pyrene and DNA by irradiation at 365 nm leads to a covalent combination. To ascertain the reactive sites of DNA, a sample of the macromolecule has been precipitated after irradiation in the presence of benz [a] pyrene and hydrolized; among the products of hydrolysis four different fluorescent substances have been isolated, one of which was identical with the photoadduct benz [a] pyrene-thymine, already prepared by irradiation of the two substances at 365 nm. This photoadduct has been obtained in an amount corresponding to a molecular ratio 1 : 7000 in respect to the nucleotides (P atoms) present in the sample of DNA.