Phenotypic and functional characterization of first-trimester human placental macrophages, Hofbauer cells

Hofbauer cells (HBCs) are a population of macrophages found in high abundance within the stroma of the first-trimester human placenta. HBCs are the only fetal immune cell population within the stroma of healthy placenta. However, the functional properties of these cells are poorly described. Aligning with their predicted origin via primitive hematopoiesis, we find that HBCs are transcriptionally similar to yolk sac macrophages. Phenotypically, HBCs can be identified as HLA-DR-FOLR2+ macrophages. We identify a number of factors that HBCs secrete (including OPN and MMP-9) that could affect placental angiogenesis and remodeling. We determine that HBCs have the capacity to play a defensive role, where they are responsive to Toll-like receptor stimulation and are microbicidal. Finally, we also identify a population of placenta-associated maternal macrophages (PAMM1a) that adhere to the placental surface and express factors, such as fibronectin, that may aid in repair.

Acupuncture and the Treatment of Irritative Bladder Symptoms

The conventional management of irritative bladder symptoms, namely urgency, urge incontinence, frequency and nocturia, with anticholinergic medication is limited by the side effects of treatment. Acupuncture is shown to be as effective in the management of irritative bladder symptoms as conventional anticholinergic therapy, with few side effects and a high degree of patient acceptability and compliance.

IFPA meeting 2017 workshop report: Clinical placentology, 3D structure-based modeling of placental function, placental bed, and treating placental dysfunction

Workshops are an important part of the IFPA annual meeting as they allow for discussion of specialized topics. At IFPA meeting 2017 there were four themed workshops, all of which are summarized in this report. These workshops discussed new knowledge and technological innovations in the following areas of research: 1) placental bed; 2) 3D structural modeling; 3) clinical placentology; 4) treatment of placental dysfunction.

Hybrid inhalable microparticles for dual controlled release of levofloxacin and DNase: physicochemical characterization and in vivo targeted delivery to the lungs

Current medical treatments against recurrent pulmonary infections caused by Pseudomonas aeruginosa, such as cystic fibrosis (CF) disorder, involve the administration of inhalable antibiotics.

5β,6β-Epoxidation of 3β-Cholesteryl Acetate and its Analogues

The treatment of acetylated Δ5-steroids with chromyl diacetate at low temperature afforded the 5β,6β-epoxy derivatives with stereoselectivity greater than 90 per cent.

Demonstration of a high-field short-period superconducting helical undulator suitable for future TeV-scale linear collider positron sources

The first demonstration of a full-scale working undulator module suitable for future TeV-scale positron-electron linear collider positron sources is presented. Generating sufficient positrons is an important challenge for these colliders, and using polarized e(+) would enhance the machine's capabilities. In an undulator-based source polarized positrons are generated in a metallic target via pair production initiated by circularly polarized photons produced in a helical undulator. We show how the undulator design is developed by considering impedance effects on the electron beam, modeling and constructing short prototypes before the successful fabrication, and testing of a final module.

Abstract PD09-08: Obesity in Long-Term Disease Free Survivors of Invasive Breast Cancer

Background: As the number of breast cancer survivors increases due to improvements in screening and treatment for breast cancer, there is a particular interest in identifying lifestyle factors associated with long-term survival. Obesity may be one of the modifiable risk factors that can play a role in the outcome of breast cancer patients however studies shown controversial results. Besides, little is known about the role of obesity in long-term survivors. The objective of this study is to examine the role of obesity in breast cancer patients who remained disease free at least 5 years after diagnosis.

Methods: We reviewed the medical records of all women with invasive breast cancer diagnosed at LSUHSC between 1980 and 2005. The patients with stage IV breast cancer at diagnosis were excluded from the analysis. For this study we selected patients whom were disease free at least five years after the breast cancer diagnosis. We classified our patients by body mass index (BMI) at the time of breast cancer diagnosis into: normal weight (BMI <25 kg/m2), overweight (BMI 25-29 kg/m2), and obese (BMI >30 kg/m2). Data on demographics clinical characteristics, tumor characteristic, breast cancer therapy, and relapse were analyzed within BMI classes. Results: A total of 967 patients were diagnosed with invasive breast cancer between 1980 and 2005. Out of those 49% were African American, 29% were overweight, and 49% were obese. From this population 597 (62%) patients were disease free more than 5y: 217 (49%) obese, 113 (26%) overweight, 112 (25%) normal weight. Obese breast cancer survivors in comparison to overweight and normal weight survivors were more likely to: be African American (61%, P<0.01), received Medicaid coverage (14.2%, p=0.05) and to have lower rates of mastectomy (p=0.017). There was not difference in tumor characteristics (ER status, Nodal status, Tumor size) and adjuvant treatment (chemotherapy, radiotherapy and hormonal therapy) between obese and non-obese patients. One hundred and ten patients (19%) developed a recurrence 5 years after diagnosis (48 obese and 33 overweight): 65 local (48 obese and 33 overweight) and 45 systemic (21 obese and 10 overweight).

Discussion: Our study has some limitations typical of retrospective studies and the generalization of the results may be limited. Our analysis suggests that in long-term disease free survivors obesity and race might be associated. To further clarify the role of obesity in long-term breast cancer survivors prospective studies with long term follow up are warranted.

Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr PD09-08.

Abstract P6-09-07: Obesity; Not Associated with Risk of Second Malignancy in Early Stage Breast Cancer

Introduction: Early diagnosis and effective local and systemic therapy has reduced the risk of relapse and death from breast cancer; thus, patients are living longer but experience an increased risk for the development of a second malignancy (SM). Risk factors for SM may be genetic, related to environmental or behavioral factors or to breast cancer treatments such as radiotherapy, chemotherapy or hormone therapy. Controversy exists over the role of obesity and breast cancer outcomes, and there is little information on long term survivors. LSUHSC Shreveport provides care for a predominantly indigent population with high rates of obesity. This allows us to study the role of obesity and risk of SM after breast cancer diagnosis. In this study, we sought to determine the incidence and risk factors for SM in women after treatment for early stage breast cancer. Methods: We performed a retrospective analysis of all patients treated for invasive breast cancer from 1980 through 2006 at LSUHSC Shreveport. Patients with stage IV at diagnosis were excluded. Second malignancy was defined as a new diagnosis of primary malignancy at least three months after initial breast cancer diagnosis. We reviewed the demographics, smoking status, BMI at diagnosis of breast cancer, tumor characteristics, breast cancer treatments (surgery, radiotherapy, chemotherapy and hormonal therapy) and site and date of second malignancies. Descriptive statisticswere performed to characterize the group of patients who developed a SM and Cox proportional hazard regression model was used to estimate the relative risk of development of SM.

Results: Of the 1214 patients analyzed, 118 (9.72%) patients developed a SM: 54% (n=64) breast cancer, 12.7% (n=15) gynecologic cancer, 8.5% (n=10) GI malignancy, 6.8% (n= 8) lung cancer, 6.8% (n=8) hematologic malignancy and 11% (n=13) various miscellaneous cancers. The median time for the development of SM was 7.6 years. The risk for development of SM increased with longer follow up: the risk at 5 years after breast cancer diagnosis was 2.3%, at 10 years was 10% and at 20 years was 30%. Patients with SM in comparison with patients without it were more likely to be obese (57%, p=0.05) and to have received radiotherapy (60%, p=0.01). No differences were observed with age at diagnosis, race, smoking status, use of chemotherapy, ER status, or use of hormone therapy. In a multivariate analysis using the Cox regression model, after adjusting for race, age, smoking status, use of chemotherapy and ER status, radiotherapy was a significant predictor of SM (HR=2.8, p=0.01). Obesity was not associated with an increased risk of SM (HR=0.91, p=0.82). Conclusions: Our study has some limitations typical of retrospective studies and the generalization of the results may be limited. We found that obesity at diagnosis of breast cancer did not adversely affect the rate of SM while radiotherapy represents a significant risk factor. Further studies are needed to define the role of lifestyle and cancer treatments on develop of SM in patients with early stage breast cancer.

Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P6-09-07.

Crossing without Vision of Path Gaps

Two experiments considered the behavior of subjects who cross gaps in a pathway without benefit of vision. The first experiment contrasted visually and nonvisually guided locomotion, finding a significantly greater number of refusals under nonvisual guidance but no loss of appropriate modulation of step components to the salient dimensions of the actor and layout. Different components of crossing were modified under guidance of different sensory systems; the lengths of the crossing and support spans were primarily altered under nonvisual guidance, and the distance of the support foot to the near edge of the gap was the component of preference under visual guidance. In the second experiment, subjects crossed nonvisually, using probes that varied in length and moment of inertia. The adaptability of the step components to actor and layout dimensions was unchanged, but there was no effect of these mechanical manipulations on the components of crossing identified in Experiment 1.

Microanatomy and bacterial flora of the perineal glands of the North American porcupine

The perineal glands of the porcupine, Erethizon dorsatum (L., 1758), are sexually dimorphic, paired pockets sprouting osmetrichial hairs. They lie between the anus and urethra, lateral to the midline, amid a sebaceous glandular expanse. In their active state, the glandular pockets secrete an amber substance with a terpenoid odor. When inactive, the glands produce no stain or odor. In males, activation of the glands is associated with fully descended testes. The glandular pockets yield a microbiota (“microflora”) in both their active and inactive states. We hypothesize that the active-state microflora transforms a sebaceous secretion into a pheromonally active product that is disseminated by anal dragging. The glandular microflora was characterized by gas chromatography of bacterial fatty acid methyl esters (GC-FAME) and polymerase chain reaction – denaturing gradient gel electrophoresis (PCR-DGGE) of 16S ribosomal RNA gene fragments of bacteria. PCR-DGGE results showed the resulting bacteria profiles were the same in both sexes, but differed between the active and inactive states. Active-state microfloras were dominated by members of the Actinobacteria and showed greater coefficients of similarity than inactive-state microfloras. The microflora of individual animals changed with time and with secretory state. We argue for a reproductive role for the activated perineal glands.

Regulation of Placental Efficiency for Nutrient Transport by Imprinted Genes

Intrauterine growth and development can impact upon the long-term health of an individual. The fetus is dependent upon the placenta for its supply of nutrients and oxygen from the mother. In turn, the functional capacity of the placenta to supply that demand is under the control of the fetal and maternal genomes. Recent evidence suggests that imprinted genes, a class of genes found in placental mammals whose expression depends on their parental origin, have multiple roles in the placenta. The imprinted genes regulate the growth and transport capacity of the placenta, thereby controlling the supply of nutrients. They may also regulate the growth rate of fetal tissues directly, thereby controlling nutrient demand by the fetus. Recent studies using mice with deletions or disruption of imprinted genes with an altered balance between placental and fetal growth and changes in placental efficiency are indicative of feto-placental signalling of fetal nutrient demand. We propose that signalling mechanisms involving growth demand signals and nutrient transporters are likely to occur and are important for fine tuning normal fetal growth.

Placental morphology: from molecule to mother -- a dedication to Peter Kaufmann -- a review

Theories on the development of placental pathologies and insufficiencies are based on the assumption that the development of the placental villous trees, the invasion of extravillous trophoblast or the differentiation of the villous trophoblast is somehow dysregulated. One of the pioneers trying to answer these questions is Peter Kaufmann, who started research on the placenta nearly 40 years ago. In this review, we try to shed light on various aspects of placental development, and on how important morphology is in combination with other disciplines to elucidate the differences between a normal and a pathological placenta.

Efficacy of cyclosporin in the treatment of atopic dermatitis in dogs--combined results from two veterinary dermatology referral centres

OBJECTIVE

To evaluate the efficacy of cyclosporin in controlling the clinical signs associated with atopic dermatitis in dogs under Australian field conditions.

DESIGN

A multicentre prospective clinical investigation of the use of cyclosporin in 41 dogs with atopic dermatitis.

PROCEDURE

Dogs were treated with cyclosporin (5 mg/kg orally once daily with food) for 6 weeks. Four clinical parameters of severity of atopic dermatitis were measured on Day 0 and on Day 42 using a 0 to 4 scoring system. Individual variables were then combined to form a Global Score. Both client and clinician observed pruritus scores were combined to form a Pruritus Score. Pre- and post-treatment scores were statistically analysed. The difference in results between the two investigators was also recorded and analysed.

RESULTS

All dogs showed a marked reduction in pruritus and erythema during the 6-week treatment period. All dogs showed a significant (P < 0.001) improvement in clinical lesion scores and Global Score (P < 0.001). The mean percentage improvement in Global Score from Day 0 to Day 42 was 83.9%. The mean percentage improvement in Pruritus Score from Day 0 to Day 42 was 83%. The medication was well tolerated. Side effects such as vomiting, diarrhoea and soft stools were observed in four dogs. Another four dogs developed bacterial pyoderma during the trial period. There was no significant difference in results between the two centres.

CONCLUSION

Cyclosporin was well tolerated and efficacious in the symptomatic treatment of atopic dermatitis in dogs attending two veterinary dermatology referral centres in Australia, under Australian field conditions, when administered at 5 mg/kg/day for 6 weeks.

The role of preimplantation genetic diagnosis in the management of severe rhesus alloimmunization: first unaffected pregnancy: Case report

Rhesus (Rh) D alloimmunization may cause haemolytic disease of the fetus and newborn if the fetal Rh blood type is positive. Although the incidence of severe RhD alloimmunization has decreased with prophylactic anti-D immunoglobulin administration during and after pregnancy, sensitization still occurs in a small group of women. In such women, Rh disease will continue to be significant problem and for their babies who may be affected. Preimplantation genetic diagnosis (PGD) may be utilized to avoid materno-fetal blood group incompatibility in an RhD-sensitized woman. Biopsy of a single cell from early cleavage-stage embryos screening for RhD-negative embryos allows the transfer of only RhD-negative embryo(s) into the uterus. This avoids any complications related to haemolytic disease of the fetus and newborn. This article describes the first reported case of an unaffected pregnancy using PGD for Rh disease. IVF and embryo transfer resulted in a clinical pregnancy and the birth of a healthy girl confirmed to be blood type RhD negative. PGD in couples with a heterozygous RhD-positive male partner provides an option for avoiding haemolytic disease of the newborn in RhD alloimmunized mothers.

Molecular mechanism of activation and nuclear translocation of the mineralocorticoid receptor upon binding of pregnanesteroids

The mineralocorticoid receptor (MR) is primarily localized in the cytoplasm of the cell in the absence of ligand. The first step in the genomic-dependent mechanism of action of mineralocorticoids is the binding of steroid to the MR, which in turn triggers MR nuclear translocation. The regulation of hormone-binding to MR is complex and involves a multifactorial mechanism, making it difficult to determine the optimal structure of a steroid for activating the MR and promoting its nuclear translocation. Here we review the structure-activity relationship for several pregnanesteroids that possess various functional groups, and suggest that a flat conformation of the ligand rather than the presence of particular chemical groups is a critical parameter for the final biological effect in vivo. We also discuss how the MR undergoes differential conformational changes according to the nature of the bound ligand, which in turn affects the dynein-dependent retrograde rate of movement for the steroid/receptor complex.

Postmenopausal women who progress on fulvestrant ('Faslodex') remain sensitive to further endocrine therapy

PURPOSE

This retrospective evaluation of data from two randomized, multicenter trials examined whether tumor responses to further endocrine therapy were seen in postmenopausal women with advanced breast cancer who had progressed on both initial endocrine therapy, usually tamoxifen, and on the estrogen receptor (ER) antagonist fulvestrant ('Faslodex').

PATIENTS AND METHODS

A combined total of 423 patients received fulvestrant 250 mg as a monthly intramuscular injection. After progression on fulvestrant, some patients received another endocrine therapy. Responses to subsequent endocrine therapy were assessed using a questionnaire sent to the trial investigators. Best responses were classified as a complete or partial response (CR or PR), stable disease (SD) lasting > or = 24 weeks, or disease progression.

RESULTS

Follow-up data were available for 54 patients who derived clinical benefit (CB, defined as CR, PR or SD) from fulvestrant and who received subsequent endocrine therapy, resulting in a PR in 4 patients, SD in 21 patients, and disease progression in 29 patients. Data were available for 51 patients who derived no CB from fulvestrant and who received further endocrine therapy, resulting in a PR in 1 patient, SD in 17 patients, and disease progression in 33 patients. Aromatase inhibitors were used as subsequent endocrine therapy in > 80% of patients.

CONCLUSIONS

After progression on fulvestrant, patients may retain sensitivity to other endocrine agents. Fulvestrant provides an additional option to existing endocrine therapies for the treatment of advanced or metastatic breast cancer in postmenopausal women, and may provide the opportunity to extend the sequence of endocrine regimens before cytotoxic chemotherapy is required.

Double-blind, randomized trial comparing the efficacy and tolerability of fulvestrant versus anastrozole in postmenopausal women with advanced breast cancer progressing on prior endocrine therapy: results of a North American trial

PURPOSE

To compare the efficacy and tolerability of fulvestrant (formerly ICI 182,780) with anastrozole in the treatment of advanced breast cancer in patients whose disease progresses on prior endocrine treatment.

PATIENTS AND METHODS

In this double-blind, double-dummy, parallel-group study, postmenopausal patients were randomized to receive either an intramuscular injection of fulvestrant 250 mg once monthly or a daily oral dose of anastrozole 1 mg. The primary end point was time to progression (TTP). Secondary end points included objective response (OR) rate, duration of response (DOR), and tolerability.

RESULTS

Patients (n = 400) were followed for a median period of 16.8 months. Fulvestrant was as effective as anastrozole in terms of TTP (hazard ratio, 0.92; 95.14% confidence interval [CI], 0.74 to 1.14; P =.43); median TTP was 5.4 months with fulvestrant and 3.4 months with anastrozole. OR rates were 17.5% with both treatments. Clinical benefit rates (complete response + partial response + stable disease > or = 24 weeks) were 42.2% for fulvestrant and 36.1% for anastrozole (95% CI, -4.00% to 16.41%; P =.26). In responding patients, median DOR (from randomization to progression) was 19.0 months for fulvestrant and 10.8 months for anastrozole. Using all patients, DOR was significantly greater for fulvestrant compared with anastrozole; the ratio of average response durations was 1.35 (95% CI, 1.10 to 1.67; P < 0.01). Both treatments were well tolerated.

CONCLUSION

Fulvestrant was at least as effective as anastrozole, with efficacy end points slightly favoring fulvestrant. Fulvestrant represents an additional treatment option for postmenopausal women with advanced breast cancer whose disease progresses on tamoxifen therapy.

Breast cancer: a socioeconomic and racial comparison in northwest Louisiana

A tumor registry data review on breast cancer populations seen at two hospitals in North Louisiana was completed in order to determine if race is independent of socioeconomic status (SES) factors related to breast cancer stage at diagnosis. The North Louisiana tumor registry identified 1183 patients diagnosed with breast cancer between 1987 and 1991, 304 patients from Louisiana State University Health Science Center (LSUHSC), a state supported hospital providing predominantly indigent care, and 879 patients from a private hospital (PH) serving predominantly insured patients. Hospital site was used as a proxy for SES (LSUHSC low, PH high). The patient populations differed significantly by age, racial makeup, and stage at presentation. Both white and African-American patients seen at PH had more stage 0 disease compared with LSUHSC (9.2% and 2.7%). White patients seen at PH had more stage I cancer as compared to white patients at LSUHSC (31.3% and 19.2%) or African-American patients at either PH or LSUHSC (19.4% and 19.9%). The frequency of stage III/IV cancer was higher in African-American patients at both LSUHSC (30.1%) and PH (29.0%) and white patients at LSUHSC (24.0%) as compared to white patients at PH (14.7%). Two hundred and nine patients were available for individual interview and specific definition of SES. LSUHSC patients were predominantly indigent (83% indigent and without insurance), while only 10% of PH patients lacked insurance. This study provides further support that the SES of white patients influences breast cancer stage at presentation. African-American patients, however, presented with more advanced breast cancer stages regardless of SES. Factors influencing African-American patient's disease stage are not limited to defined SES factors. Further studies are needed to define barriers and develop intervention strategies.

Preparation and cytotoxicity toward cancer cells of mono(arylimino) derivatives of beta-lapachone

A regio- and stereospecific synthesis of monoarylimino o-quinones derived from beta-lapachone (1) was achieved by treatment of the quinone with a slight excess of an arylamine in the presence of an excess of triethylamine/titanium tetrachloride 4:1. Imine formation occurred exclusively at position 6, giving the Z diastereomer, as determined by single-crystal X-ray analysis. In vitro tests for cytotoxicity in 55 human cancer cell cultures showed a substantial loss in activity for the p-nitrophenylimine (5), whereas the phenylimine (2), p-methylphenylimine (3), and p-methoxyphenylimine (4) retained (or bettered) most of the cytotoxicity and selectivity of the parent quinone. Preliminary in vivo testing in hollow fiber assays against a standard panel of 12 human tumor cell lines showed that although beta-lapachone failed, compounds 2 and 3 had good scores with net cell kills.

Withanolides from Salpichroa origanifolia

Five new withanolides, 5 alpha,6 alpha:22,26:24,25-triepoxy-16 alpha,26-dihydroxy-18(13-->17)-abeo-ergosta-2,13-dien-1-one (salpichrolide N, 1), 5 alpha,6 alpha:22,26:24,25-triepoxi-15 alpha,26-dihydroxyergosta-2,16-dien-1-one (salpichrolide L, 2), 5 alpha,6 alpha:22,26-diepoxi-24,25,26-trihydroxy-17(13-->18)-abeo-ergosta-2,13,15,17-tetraen-1-one (salpichrolide M, 3a), 5 alpha,6 alpha:22,25:22,26-triepoxy-24-hydroxy-17(13-->18)-abeo-ergosta-2,13,15,17-tetraen-1-one (salpichrolide J, 4), and 5 alpha,6 alpha:22,26-diepoxy-22,24,25-trihydroxy-17(13-->18)-abeo-ergosta-2,13,15,17-tetraen-1-one (salpichrolide K, 5), were isolated from the leaves of Salpichroa origanifolia and characterized by a combination of spectroscopic (1D and 2D NMR, MS) and chemical methods.

Evaluation of respiratory gases and acid-base gradients in human fetal fluids and uteroplacental tissue between 7 and 16 weeks' gestation

OBJECTIVE

Our purpose was to evaluate the changes in intrauterine gases and acid-base gradients inside the human fetoplacental unit at 7 to 16 weeks' gestation.

STUDY DESIGN

Respiratory gases and acid-base values were recorded by means of a multiparameter sensor and samples from inside the exocoelomic or amniotic cavity, placental tissue, decidua, and fetal blood of 30 early pregnancies.

RESULTS

Before 11 weeks' gestation, placental PO(2) was 2.5 times lower than decidual PO(2). The PO(2) increased independently at both sites during gestation, but a PO(2) gradient of 13.3 mm Hg persisted during the fourth month. At 13 to 16 weeks, PO(2), oxygen saturation, and oxygen content gradients were observed between the fetal blood and the placenta and between the placenta and underlying decidual tissue. There was no fetoplacental gradient for pH and PCO(2) between 7 and 16 weeks, but fetal blood pH values were much lower and fetal PCO(2) values were much higher than those reported in older fetuses.

CONCLUSIONS

Early human placental tissue develops in a physiologically low-oxygen environment compared with uterine tissue. This may be necessary to allow specific placental metabolic activities and to protect both placental and fetal tissues against toxic oxygen metabolites.

Sesquiterpene lactone variability in Parthenium hysterophorus L

A population of Parthenium hysterophorus collected in Salta Argentina afforded two ambrosanolides, 2beta-hydroxycoronopilin and 1alpha,2beta,4beta-trihydroxypseudoguaian-6beta,12-olide, as well as five known others. Plants of the fructification from those transplanted from the Puna Argentina at 1200 m over the sea level produced hymenin.

Anastrozole is superior to tamoxifen as first-line therapy for advanced breast cancer in postmenopausal women: results of a North American multicenter randomized trial. Arimidex Study Group

PURPOSE

The efficacy and tolerability of anastrozole (Arimidex; AstraZeneca, Wilmington, DE, and Macclesfield, United Kingdom) and tamoxifen were compared as first-line therapy for advanced breast cancer in 353 postmenopausal women.

PATIENTS AND METHODS

The randomized, double-blind, multicenter study was designed to evaluate anastrozole 1 mg once daily relative to tamoxifen 20 mg once daily in patients with hormone receptor-positive tumors or tumors of unknown receptor status who were eligible for endocrine therapy. Primary end points were objective response (OR), defined as complete (CR) or partial (PR) response, time to progression (TTP), and tolerability.

RESULTS

Anastrozole was as effective as tamoxifen in terms of OR (21% v 17% of patients, respectively), with clinical benefit (CR + PR + stabilization > or = 24 weeks) observed in 59% of patients on anastrozole and 46% on tamoxifen (two-sided P =.0098, retrospective analysis). Anastrozole had a significant advantage over tamoxifen in terms of TTP (median TTP of 11.1 and 5.6 months for anastrozole and tamoxifen, respectively; two-sided P =.005). The tamoxifen:anastrozole hazards ratio was 1.44 (lower one-sided 95% confidence limit, 1.16). Both treatments were well tolerated. However, thromboembolic events and vaginal bleeding were reported in fewer patients who received anastrozole compared with those who received tamoxifen (4.1% v 8.2% [thromboembolic events] and 1.2% v 3.8% [vaginal bleeding], respectively).

CONCLUSION

Anastrozole satisfied the predefined criteria for equivalence to tamoxifen. Furthermore, we observed both a significant increase in TTP and a lower incidence of thromboembolic events and vaginal bleeding with anastrozole. These findings indicate that anastrozole should be considered as first-line therapy for postmenopausal women with advanced breast cancer.

Metal mediated protease inhibition: design and synthesis of inhibitors of the human cytomegalovirus (hCMV) protease

A versatile synthetic route to a novel series of bis-imidazolemethanes designed to inhibit the hCMV protease has been developed and a series of potential metal binding inhibitors has been identified. In selectivity assays, the compounds were highly specific for CMV protease and showed no inhibition (IC50 > 100 microM) of other prototypical serine proteases such as trypsin, elastase, and chymotrypsin. Although the presence of free zinc ions was found to be an absolute requirement for the in vitro biological activity of this class of inhibitor, the potency of the inhibitors could not be improved beyond the micromolar level.

Withanolides from Vassobia lorentzii

Eight new withanolides were isolated from the aerial parts of Vassobia lorentzii and characterized by spectroscopic methods and with the aid of molecular modeling. The compounds were identified as (17S,20R,22R)-5beta,6beta:18,20-diepoxy-18-hydro xy-1-oxowitha-2,5, 24-trienolide (1); (17S,20R,22R)-18,20-epoxy-4beta, 18-dihydroxy-1-oxowitha-2,5,24-trienolide (2); (17S,18R,20R, 22R)-4beta-hydroxy-18,20-epoxy-18-methoxy-1-oxowitha-2,5, 24-trienolide (3); (17S,18S,20R,22R)-4beta-hydroxy-18, 20-epoxy-18-methoxy-1-oxowitha-2,5,24-trienolide (4); (17S,20R, 22R)-4beta-hydroxy-18,20-epoxy-1,18-dioxowitha-2,5,24-tri enolide (5); (17S,18R,20R,22R)-18,20-epoxy-18-methoxy-1,4-dioxowitha++ +-2,5, 24-trienolide (6); (17S,18S,20R,22R)-18,20-epoxy-18-methoxy-1, 4-dioxowitha-2,5,24-trienolide (7); and (17S,20R,22R)-5beta, 6beta-epoxy-4beta,18,20-trihydroxy-1-oxowitha-2,24-die nolide (8). Compounds 1 and 2 were obtained as epimeric mixtures at C-18.

Antifeedant activity of withanolides from Salpichroa origanifolia on Musca domestica

The antifeedant effect of several salpichrolides on larvae of Musca domestica was investigated. Three naturally occurring compounds, salpichrolide A (1), salpichrolide C (2), and salpichrolide G (3), previously isolated from Salpichroa origanifolia, and two known (4, 6) and three new (5, 7, 8) synthetic analogues were tested. The maximal effect on development was observed for salpichrolide A (1), while salpichrolide G (3) was the most toxic. The content of the salpichrolides in S. origanifolia was monitored by HPLC during plant development, reaching a maximum during summer.