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Revisiones-Ciencias Básicas-Molecular, Bioquímica, Metabolismo & Genética *** Reviews-Basic Sciences-Molecular, Biochemistry, Metabolism & Genetics

 

AGENTES INMUNOSUPRESORES *** IMMUNOSUPPRESSIVE COMPOUNDS

(Conceptos / Keywords: Immunosuppressive comp; Muromonab-cd3; Sirolimus; Tacrolimus; Cyclosporine; Mycophenolic acid; Antilymphocyte serum; Immunosuppressive comp. used in oncology, etc).

 

Enero / January 2001 --- Marzo / March 2004

 

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The biomedical library© is a FREE service. All the information has been obtained from public sources, from web sites that do not require registration for their use, that do not require an agreement with their Terms of use, that provide free access for all, and are free of charge. The library (reviews, guides, protocols, medicine based medicine, etc) is arranged according to a patent that warrants Effiloop to catalogue the articles by fields of interest as well as to sort articles by true relevance (the first 200 reviews are provided). All the information is provided according to the freedom of speech and fair use laws. Only articles written in Spanish and/or English are included.

Enlace / Link

 

[1]

TÍTULO / TITLE:  - Integration of growth factor and nutrient signaling: implications for cancer biology.

REVISTA / JOURNAL:  - Mol Cell 2003 Aug;12(2):271-80.

AUTORES / AUTHORS:  - Shamji AF; Nghiem P; Schreiber SL

INSTITUCIÓN / INSTITUTION:  - Harvard Biophysics Program, Harvard University, 12 Oxford Street, Cambridge, MA 02138, USA.

RESUMEN / SUMMARY:  - Signaling networks that promote cell growth are frequently dysregulated in cancer. One regulatory network, which converges on effectors such as 4EBP1 and S6K1, leads to growth by promoting protein synthesis. Here, we discuss how this network is regulated by both extracellular signals, such as growth factors, and intracellular signals, such as nutrients. We discuss how mutations amplifying either type of signal can lead to tumor formation. In particular, we focus on the recent discovery that a tumor suppressor complex whose function is lost in tuberous sclerosis patients regulates the nutrient signal carried by the critical signaling protein TOR to the effectors 4EBP1 and S6K1. Finally, we describe how the small molecule rapamycin, which inhibits TOR and thereby the activation of these effectors, could be useful to treat tumors that have become dependent upon this pathway for growth.  N. Ref:: 80

 

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[2]

- Castellano -

TÍTULO / TITLE:La ruta de senalizacion CA++/calcineurina/NFAT en activacion endotelial y angiogenesis: efectos de la ciclosporina A. CA++/ calcineurin/NFAT signaling in endothelial activation and angiogenesis: effects od cyclosporin A .

REVISTA / JOURNAL:  - Nefrologia. Acceso gratuito al texto completo.

      ●● Enlace a la Editora de la Revista http://www.aulamedica.es/nefrologia/ 

      ●● Cita: Nefrologia: <> 2003;23 Suppl 3:44-8.

AUTORES / AUTHORS:  - Quesada AJ; Redondo JM

INSTITUCIÓN / INSTITUTION:  - Centro de Biologia Molecular Severo Ochoa, Consejo Superior de Investigaciones Cientificas, Universidad Autonoma de Madrid y Centro Nacional de Investigaciones Cardiovasculares (CNIC), Sinesio Delgado, 4 28049 Cantoblanco, Madrid. jmredondo@cbm.uam.es  N. Ref:: 31

 

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[3]

TÍTULO / TITLE:  - Identification of TOR signaling complexes: more TORC for the cell growth engine.

REVISTA / JOURNAL:  - Cell 2002 Oct 4;111(1):9-12.

AUTORES / AUTHORS:  - Abraham RT

INSTITUCIÓN / INSTITUTION:  - Program in Signal Transduction Research, Cancer Research Center, The Burnham Institute, 10901 North Torrey Pines Road, La Jolla, CA 92037, USA. abraham@burnham.org

RESUMEN / SUMMARY:  - The Target of Rapamycin (TOR) proteins function in signaling pathways that promote protein synthesis and cell growth. In yeast, TOR signaling is regulated by nutrient availability, whereas in metazoan cells TOR activities may be controlled by both nutrients and growth factors. The recent identification of novel TOR-interacting proteins has provided crucial insights into TOR regulation and function.  N. Ref:: 20

 

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[4]

TÍTULO / TITLE:  - Interleukin-2 receptor monoclonal antibodies in renal transplantation: meta-analysis of randomised trials.

REVISTA / JOURNAL:  - British Medical J (BMJ). Acceso gratuito al texto completo.

      ●● Enlace a la Editora de la Revista http://bmj.com/search.dtl 

      ●● Cita: British Medical J. (BMJ): <> 2003 Apr 12;326(7393):789.

      ●● Enlace al texto completo (gratuito o de pago) 1136/bmj.326.7393.789

AUTORES / AUTHORS:  - Adu D; Cockwell P; Ives NJ; Shaw J; Wheatley K

INSTITUCIÓN / INSTITUTION:  - Department of Nephrology, Queen Elizabeth Hospital, Birmingham, B15 2TH. dwomoa.adu@uhb.nhs.uk

RESUMEN / SUMMARY:  - OBJECTIVE: To study the effect of interleukin-2 receptor monoclonal antibodies on acute rejection episodes, graft loss, deaths, and rate of infection and malignancy in patients with renal transplants. DESIGN: Meta-analysis of published data. DATA SOURCES: Medline, Embase, and Cochrane library for years 1996-2003 plus search of medical editors’ trial amnesty and contact with manufacturers of the antibodies. SELECTION OF STUDIES: Randomised controlled trials comparing interleukin-2 receptor antibodies with placebo or no additional treatment in patients with renal transplants receiving ciclosporin based immunosuppression. RESULTS: Eight randomised controlled trials involving 1871 patients met the selection criteria (although only 1858 patients were analysed). Interleukin-2 receptor antibodies significantly reduced the risk of acute rejection (odds ratio 0.51, 95% confidence interval 0.42 to 0.63). There were no significant differences in the rate of graft loss (0.78, 0.58 to 1.04), mortality (0.75, 0.46 to 1.23), overall incidence of infections (0.97, 0.77 to 1.24), incidence of cytomegalovirus infections (0.81, 0.62 to 1.04), or risk of malignancies at one year (0.82, 0.39 to 1.70). The different antibodies had a similar sized effect on acute rejection (test for heterogeneity P=0.7): anti-Tac (0.37, 0.16 to 0.89), BT563 (0.37, 0.1 to 1.38), basiliximab (0.56, 0.44 to 0.72), and daclizumab (0.46, 0.32 to 0.67). The reduction in acute rejections was similar for all ciclosporin based immunosuppression regimens (test for heterogeneity P=1.0). CONCLUSIONS: Adding interleukin-2 receptor antibodies to ciclosporin based immunosuppression reduces episodes of acute rejection at six months by 49%. There is no evidence of an increased risk of infective complications. Longer follow up studies are needed to confirm whether interleukin-2 receptor antibodies improve long term graft and patient survival.

 

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[5]

TÍTULO / TITLE:  - Novel therapeutic molecular targets for prostate cancer: the mTOR signaling pathway and epidermal growth factor receptor.

REVISTA / JOURNAL:  - J Urol 2004 Feb;171(2 Pt 2):S41-3; discussion S44.

      ●● Enlace al texto completo (gratuito o de pago) 1097/01.ju.0000108100.53239.b7

AUTORES / AUTHORS:  - Tolcher AW

INSTITUCIÓN / INSTITUTION:  - Director Clinical Research, Institute for Drug Development Cancer Therapy and Research Center, San Antonio, Texas, USA.

RESUMEN / SUMMARY:  - PURPOSE: The scientific rationale and existing evidence for the use of novel molecular targets in the chemoprevention of cancer are reviewed, with special attention to prostate cancer. MATERIALS AND METHODS: A search for relevant literature on basic science and clinical trials was conducted using PubMed/MEDLINE. RESULTS: The emergence of molecularly targeted therapies for advanced malignancies creates an important opportunity to examine these agents for the chemoprevention of prostate cancer. Two critical targets in the proliferation and malignant transformation of normal cells, the PI3/Akt signal transduction pathway and the epidermal growth factor receptor, are currently the focus of several novel investigational therapies that are in late stage phase II and phase III studies. CONCLUSIONS: Research to date supports consideration of these novel molecular targets as future agents in the chemoprevention of prostate cancer.  N. Ref:: 28

 

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[6]

TÍTULO / TITLE:  - The target of rapamycin (TOR) proteins.

REVISTA / JOURNAL:  - Proc Natl Acad Sci U S A. Acceso gratuito al texto completo a partir de los 6 meses de la fecha de publicación.

      ●● Enlace a la Editora de la Revista http://www.pnas.org/ 

      ●● Cita: Proc Natl Acad Sci USA (PNAS): <> 2001 Jun 19;98(13):7037-44.

      ●● Enlace al texto completo (gratuito o de pago) 1073/pnas.121145898

AUTORES / AUTHORS:  - Raught B; Gingras AC; Sonenberg N

INSTITUCIÓN / INSTITUTION:  - Department of Biochemistry and McGill Cancer Centre, McGill University, 3655 Promenade Sir-William-Osler, Montreal, QC H3G 1Y6 Canada.

RESUMEN / SUMMARY:  - Rapamycin potently inhibits downstream signaling from the target of rapamycin (TOR) proteins. These evolutionarily conserved protein kinases coordinate the balance between protein synthesis and protein degradation in response to nutrient quality and quantity. The TOR proteins regulate (i) the initiation and elongation phases of translation, (ii) ribosome biosynthesis, (iii) amino acid import, (iv) the transcription of numerous enzymes involved in multiple metabolic pathways, and (v) autophagy. Intriguingly, recent studies have also suggested that TOR signaling plays a critical role in brain development, learning, and memory formation.  N. Ref:: 132

 

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[7]

TÍTULO / TITLE:  - Regulation of translation initiation by FRAP/mTOR.

REVISTA / JOURNAL:  - Genes Dev. Acceso gratuito al texto completo a partir de 1 año de la fecha de publicación.

      ●● Enlace a la Editora de la Revista http://www.genesdev.org/ 

      ●● Cita: Genes & Development: <> 2001 Apr 1;15(7):807-26.

      ●● Enlace al texto completo (gratuito o de pago) 1101/gad.887201

AUTORES / AUTHORS:  - Gingras AC; Raught B; Sonenberg N

INSTITUCIÓN / INSTITUTION:  - Department of Biochemistry, McGill University, Montreal, Quebec H3G 1Y6, Canada.  N. Ref:: 236

 

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[8]

TÍTULO / TITLE:  - Rapamycin plays a new role as differentiator of vascular smooth muscle phenotype. focus on “The mTOR/p70 S6K1 pathway regulates vascular smooth muscle differentiation”.

REVISTA / JOURNAL:  - Am J Physiol Cell Physiol. Acceso gratuito al texto completo.

      ●● Enlace a la Editora de la Revista http://ajpcell.physiology.org/contents-by-date.0.shtml 

      ●● Cita: Am J Physiol Cell Physiol: <> 2004 Mar;286(3):C480-1.

      ●● Enlace al texto completo (gratuito o de pago) 1152/ajpcell.00526.2003

AUTORES / AUTHORS:  - Lucchesi PA  N. Ref:: 12

 

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[9]

TÍTULO / TITLE:  - CD3-specific antibody-induced active tolerance: from bench to bedside.

REVISTA / JOURNAL:  - Nat Rev Immunol 2003 Feb;3(2):123-32.

      ●● Enlace al texto completo (gratuito o de pago) 1038/nri1000

AUTORES / AUTHORS:  - Chatenoud L

INSTITUCIÓN / INSTITUTION:  - Centre de l’Association Claude Bernard sur les Maladies Autoimmunes and Hopital Necker Enfants Malades IRNEM, 161 Rue de Sevres, 75015 Paris, France. chatenoud@necker.fr

RESUMEN / SUMMARY:  - Although they were used initially as non-specific immunosuppressants in transplantation, CD3-specific monoclonal antibodies have elicited renewed interest owing to their capacity to induce immune tolerance. In mouse models of autoimmune diabetes, CD3-specific antibodies induce stable disease remission by restoring tolerance to pancreatic beta-cells. This phenomenon was extended recently to the clinic—preservation of beta-cell function in recently diagnosed patients with diabetes was achieved by short-term administration of a CD3-specific antibody. CD3-specific antibodies arrest ongoing disease by rapidly clearing pathogenic T cells from the target. Subsequently, they promote long-term T-cell-mediated active tolerance. Recent data indicate that transforming growth factor-beta-dependent CD4+CD25+ regulatory T cells might have a central role in this effect.  N. Ref:: 117

 

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[10]

TÍTULO / TITLE:  - Neuroimmunophilins: novel neuroprotective and neuroregenerative targets.

REVISTA / JOURNAL:  - Ann Neurol 2001 Jul;50(1):6-16.

AUTORES / AUTHORS:  - Guo X; Dillman JF 3rd; Dawson VL; Dawson TM

INSTITUCIÓN / INSTITUTION:  - Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.

RESUMEN / SUMMARY:  - Cyclosporin A (CsA) and FK506 (tacrolimus) are immunosuppresants that are widely used in organ transplantation. CsA is an 11-member cyclic peptide, whereas FK506 is a macrolide antibiotic. Recently, these powerful and useful compounds have become of great interest to neuroscientists for their unique neuroprotective and neuroregenerative effects. These drugs and nonimmunosuppressive analogs protect neurons from the effects of glutamate excitotoxicity, focal ischemia, and 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-induced dopaminergic cell death. They also stimulate functional recovery of neurons in a variety of neurologic injury paradigms. These drugs exert their effects via immunophilins, the protein receptors for these agents. The immunophilin ligands show particular promise as a novel class of neuroprotective and neuroregenerative agents that have the potential to treat a variety of neurologic disorders.  N. Ref:: 102

 

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[11]

TÍTULO / TITLE:  - New agents in acute myeloid leukemia and other myeloid disorders.

REVISTA / JOURNAL:  - Cancer 2004 Feb 1;100(3):441-54.

      ●● Enlace al texto completo (gratuito o de pago) 1002/cncr.11935

AUTORES / AUTHORS:  - Ravandi F; Kantarjian H; Giles F; Cortes J

INSTITUCIÓN / INSTITUTION:  - Department of Leukemia, The University of Texas M D Anderson Cancer Center, Houston, Texas 77030, USA. fravandi@mdanderson.org

RESUMEN / SUMMARY:  - Over the past several decades, improvements in chemotherapeutic agents and supportive care have resulted in significant progress in treating patients with acute myeloid leukemia (AML). More recently, advances in understanding the biology of AML have resulted in the identification of new therapeutic targets. The success of all-trans-retinoic acid in acute promyelocytic leukemia and of imatinib mesylate in chronic myeloid leukemia have demonstrated that targeted therapy may be more effective and less toxic when well defined targets are available. At the same time, understanding mechanisms of drug resistance and means to overcome them has led to modification of some of the existing cytotoxic agents. Rational design and conduct of clinical trials is necessary to ensure that the full potential of these new agents is realized.  N. Ref:: 140

 

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[12]

TÍTULO / TITLE:  - The transplantation of hematopoietic stem cells after non-myeloablative conditioning: a cellular therapeutic approach to hematologic and genetic diseases.

REVISTA / JOURNAL:  - Immunol Res 2003;28(1):13-24.

AUTORES / AUTHORS:  - Maris M; Storb R

INSTITUCIÓN / INSTITUTION:  - Fred Hutchinson Cancer Research Center, and University of Washington, Seattle, WA, USA. mmaris@fhcrc.org

RESUMEN / SUMMARY:  - Originally, allogeneic hematopoietic stem cell transplantation (HSCT) was viewed as a form of rescue from the marrow lethal effects of high doses of chemo-radiotherapy used to both eradicate malignancy and to provide sufficient immunosuppression to ensure allogeneic engraftment. Clear evidence of a therapeutic graft-versus-tumor (GVT) effect mediated by allogeneic effector cells (T cells) has prompted the exploration of HSCT regimens that rely solely upon host immunosuppression (non-myeloablative) to facilitate allogeneic donor engraftment. The engrafted donor effector cells are then used to accomplish the task of eradicating host malignant cells. The non-myeloblative regimen developed in Seattle uses 2 Gy total body irradiation (TBI) before transplant followed by postgrafting cyclosporine (CSP) and mycophenolate mofetil (MMF). This regimen resulted in initial mixed donor-host chimerism in all patients with hematologic malignancies and genetic disorders who received HLA-matched sibling allografts. The 17% incidence of graft rejection was reduced to 3% with the addition of fludarabine, 30 mg/m2/day on d -4, -3, and -2. The non-myeloablative combination of fludarabine/TBI has also been successful at achieving high engraftment rates in recipients of 10 of 10 HLA antigen matched unrelated donor HSCTs in patients with hematologic malignancies. By reducing acute toxicities relative to conventional HSCT, most patients have received their pre- and post-HSCT therapy almost exclusively as outpatients. Acute and chronic GVHD occur after non-myeloablative HSCT, but the incidence and severity appear less compared to conventional HSCT. As in conventional transplants, immune dysregulation from GVHD and its treatment and delayed reconstitution of immune function continue to present risks to patients who have otherwise undergone successful non-myeloablative HSCT. Cellular therapeutic effects have been observed after non-myeloablative HSCT such as correction of inherited genetic disorders, and eradication of hematologic malignant diseases and renal cell carcinoma via GVT responses.  N. Ref:: 52

 

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[13]

TÍTULO / TITLE:  - Treatment of idiopathic nephrosis by immunophillin modulation.

REVISTA / JOURNAL:  - Nephrol Dial Transplant. Acceso gratuito al texto completo a partir de los 2 años de la fecha de publicación.

      ●● Enlace a la Editora de la Revista http://ndt.oupjournals.org/ 

      ●● Cita: Nephrology Dialysis Transplantation: <> 2003 Aug;18 Suppl 6:vi79-86.

AUTORES / AUTHORS:  - Meyrier A

INSTITUCIÓN / INSTITUTION:  - Service de Nephrologie, Hopital Europeen Georges Pompidou, 20 rue Leblanc, F-75015 Paris, France. alain.meyrier@brs.ap-hop-paris.fr

RESUMEN / SUMMARY:  - Until 1985, glucocorticoids and cytotoxic drugs were the only treatments available for idiopathic nephrotic syndrome (nephrosis), that is, minimal change disease (MCD) and focal segmental glomerulosclerosis (FSGS). Trials of cyclosporine (CsA) treatment of nephrosis, the rationale of which was based on pathophysiologic considerations, have shown that this immunophillin modulator is effective in inducing and maintaining remission in patients suffering from idiopathic nephrotic syndrome. It appears that the best results, in the order of 80% remission rate, are obtained in steroid-sensitive cases, essentially MCD, and that in steroid-resistant FSGS the drug obtains remission in no more than 20% of the cases. Addition of glucocorticoids increases the success rate to approximately 30% of cases. Renal toxicity is proportional to previous impairment of renal function, primary renal disease (FSGS vs MCD) dosage >5.5 mg/kg/day and duration of treatment. The better bioavailability of the new formulation of CsA (Neoral), implies that the former dosage recommendations be reconsidered for distinctly lower figures. Repeat renal biopsy after 1 year of continuous CsA treatment is advisable, as stable serum creatinine levels may be falsely reassuring. CsA dependency is the rule during the first year of treatment. However, in some 25% of cases stable remission may be maintained after slow tapering off following 3-4 years of treatment. Other immunophillin modulators have been tried in the treatment of idiopathic nephrotic syndrome. Despite few preliminary reports indicating some success of tacrolimus the effects of this drug do not seem convincingly superior to CsA in terms of remission rate, toxicity and dependency. Rapamycin has not been tried in the treatment of nephrosis. Anecdotal cases of de novo FSGS induced by rapamycin in transplanted patients might indicate that this drug is in fact contraindicated in the treatment of nephrosis.  N. Ref:: 36

 

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[14]

TÍTULO / TITLE:  - In vitro generation of IL-10-producing regulatory CD4+ T cells is induced by immunosuppressive drugs and inhibited by Th1- and Th2-inducing cytokines.

REVISTA / JOURNAL:  - Immunol Lett 2003 Jan 22;85(2):135-9.

AUTORES / AUTHORS:  - O’Garra A; Barrat FJ

INSTITUCIÓN / INSTITUTION:  - Division of Immunoregulation, The National Institute for Medical Research (NIMR), The Ridgeway, Mill Hill, NW7 1AA, London, UK.  N. Ref:: 40

 

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[15]

TÍTULO / TITLE:  - Renal transplantation: can we reduce calcineurin inhibitor/stop steroids? Evidence based on protocol biopsy findings.

REVISTA / JOURNAL:  - J Am Soc Nephrol. Acceso gratuito al texto completo a partir de 1 año de la fecha de publicación.

      ●● Enlace a la Editora de la Revista http://www.jasn.org/ 

      ●● Cita: Journal of the American Society of Nephrology: <> 2003 Mar;14(3):755-66.

AUTORES / AUTHORS:  - Gotti E; Perico N; Perna A; Gaspari F; Cattaneo D; Caruso R; Ferrari S; Stucchi N; Marchetti G; Abbate M; Remuzzi G

INSTITUCIÓN / INSTITUTION:  - Department of Medicine and Transplantation, Ospedali Riuniti di Bergamo, Mario Negri Institute for Pharmacological Research, Italy.

RESUMEN / SUMMARY:  - How to combine antirejection drugs and which is the optimal dose of steroids and calcineurin inhibitors beyond the first year after kidney transplantation to maintain adequate immunosuppression without major side effects are far from clear. Kidney transplant patients on steroid, cyclosporine (CsA), and azathioprine were randomized to per-protocol biopsy (n = 30) or no-biopsy (n = 29) 1 to 2 yr posttransplant. Steroid or CsA were discontinued or reduced on the basis of biopsy to establish effects on drug-related complications, acute rejection, and graft function over 3 yr of follow-up. Serum creatinine, GFR (plasma clearance of iohexol), RPF (renal clearance of p-aminohippurate), CsA pharmacokinetics, and adverse events were monitored yearly. At the end, patients underwent a second biopsy. Per-protocol biopsy histology revealed no lesions (n = 5, steroid withdrawal), CsA nephropathy (n = 13, CsA discontinuation/reduction), or chronic rejection (n = 12, standard therapy). Reducing the drug regimen led to overall fewer side effects related to immunosuppression as compared with standard therapy or no-biopsy. Steroids were safely stopped with no acute rejection or graft loss. Complete CsA discontinuation was associated with acute rejection in the first four patients. Lowering CsA to low target CsA trough (30 to 70 ng/ml) never led to acute rejection or major renal function deterioration. Biopsy patients on conventional regimen had no acute rejection, one graft loss, no significant change in GFR, and significant RPF decline. No-biopsy controls: no acute rejection, one graft loss, significant decline of GFR and RPF. By serial biopsy analysis, severe lesions did not develop in patients with steroid discontinuation in contrast to patients on standard therapy over follow-up. CsA reduction did not adversely affect histology. Per-protocol biopsy more than 1 yr after kidney transplantation is a safe procedure to guide change of drug regimen and to lower the risk of major side effects.

 

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[16]

TÍTULO / TITLE:  - Mammalian target of rapamycin inhibition as therapy for hematologic malignancies.

REVISTA / JOURNAL:  - Cancer 2004 Feb 15;100(4):657-66.

      ●● Enlace al texto completo (gratuito o de pago) 1002/cncr.20026

AUTORES / AUTHORS:  - Panwalkar A; Verstovsek S; Giles FJ

INSTITUCIÓN / INSTITUTION:  - Section of Developmental Therapeutics, Department of Leukemia, University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA.

RESUMEN / SUMMARY:  - The mammalian target of rapamycin (mTOR) is a downstream effector of the phosphatidylinositol 3-kinase (PI3K)/Akt (protein kinase B) signaling pathway, which mediates cell survival and proliferation. mTOR regulates essential signal-transduction pathways, is involved in the coupling of growth stimuli with cell cycle progression, and initiates mRNA translation in response to favorable nutrient environments. mTOR is involved in regulating many aspects of cell growth, including membrane traffic, protein degradation, protein kinase C signaling, ribosome biogenesis, and transcription. Because mTOR activates both the 40S ribosomal protein S6 kinase (p70s6k) and the eukaryotic initiation factor 4E-binding protein 1, its inhibitors cause G1-phase cell cycle arrest. Inhibitors of mTOR also prevent cyclin dependent kinase (CDK) activation, inhibit retinoblastoma protein phosphorylation, and accelerate the turnover of cyclin D1, leading to a deficiency of active CDK4/cyclin D1 complexes, all of which may help cause G1-phase arrest. It is known that the phosphatase and tensin homologue tumor suppressor gene (PTEN) plays a major role in embryonic development, cell migration, and apoptosis. Malignancies with PTEN mutations, which are associated with constitutive activation of the PI3K/Akt pathway, are relatively resistant to apoptosis and may be particularly sensitive to mTOR inhibitors. Rapamycin analogs with relatively favorable pharmaceutical properties, including CCI-779, RAD001, and AP23573, are under investigation in patients with hematologic malignancies.  N. Ref:: 116

 

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[17]

TÍTULO / TITLE:  - Cholesteryl ester transfer protein facilitates the movement of water-insoluble drugs between lipoproteins: a novel biological function for a well-characterized lipid transfer protein.

REVISTA / JOURNAL:  - Biochem Pharmacol 2002 Dec 15;64(12):1669-75.

AUTORES / AUTHORS:  - Kwong M; Wasan KM

INSTITUCIÓN / INSTITUTION:  - Division of Pharmaceutics and Biopharmaceutics, Faculty of Pharmaceutical Sciences, The University of British Columbia, 2146 East Mall Avenue, Vancouver, BC, Canada V6T 1Z3.

RESUMEN / SUMMARY:  - This review article addresses the recently discovered finding that cholesteryl ester transfer protein (CETP) can facilitate the transfer of water-insoluble drugs between different lipoprotein subclasses. This protein, which is often referred to as lipid transfer protein I (LTP I), is involved in the lipid regulation of lipoproteins. It is responsible for the facilitated transfer of core lipoprotein lipids, cholesteryl ester and triglycerides, and approximately one-third of the coat lipoprotein lipid, phosphatidylcholine, between different plasma lipoproteins. The human body appears to recognize exogenous water-insoluble drugs as lipid-like particles, which suggests that these compounds may interact with lipoproteins just like endogenous plasma lipids, and thus their transfer between lipoproteins may be facilitated by plasma CETP. Patients with a variety of diseases (i.e. diabetes, cancer, AIDS) often exhibit hypo- and/or hypercholesterolemia and triglyceridemia, commonly referred to as dyslipidemias, which result in changes in their plasma lipoprotein-lipid composition and concentration. The interaction of water-insoluble drugs with these dyslipidemic lipoproteins may be responsible for the differences seen in the pharmacokinetics and pharmacodynamics of the drug within different diseased patient populations. It is possible that these differences may be linked to the ability of CETP to transfer these compounds from one lipoprotein to another. This review examines the current understanding of the relationship between CETP activity and the lipoprotein distribution of a number of compounds (e.g. amphotericin B and cyclosporine A). It further suggests that additional research will expand our understanding of the role of CETP to explain other functions in lipophilic drug distribution and metabolism.  N. Ref:: 45

 

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[18]

TÍTULO / TITLE:  - Clinical development of mammalian target of rapamycin inhibitors.

REVISTA / JOURNAL:  - Hematol Oncol Clin North Am 2002 Oct;16(5):1101-14.

AUTORES / AUTHORS:  - Dancey JE

INSTITUCIÓN / INSTITUTION:  - Cancer Treatment Evaluation Program, Division of Cancer Treatment and Diagnosis, Investigational Drug Branch/CTEP/DCTD/NCI, 6130 Executive Boulevard, EPN 7131, Rockville, MD 20854, USA. danceyj@ctep.nci.nih.gov

RESUMEN / SUMMARY:  - Rapamycin and CCI-779 have significant in vitro and in vivo anti-proliferative activity against a broad range of human tumor cell lines, justifying the clinical evaluation of this class of agent in cancer patients. Preliminary results from phase I studies of CCI-779 suggest that the agent is well tolerated and has anti-tumor activity. The challenge to investigators is to efficiently determine what role this class of agent will play in the treatment of cancer patients.  N. Ref:: 69

 

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[19]

TÍTULO / TITLE:  - Treatment of nephrotic syndrome in children and controlled trials.

REVISTA / JOURNAL:  - Nephrol Dial Transplant. Acceso gratuito al texto completo a partir de los 2 años de la fecha de publicación.

      ●● Enlace a la Editora de la Revista http://ndt.oupjournals.org/ 

      ●● Cita: Nephrology Dialysis Transplantation: <> 2003 Aug;18 Suppl 6:vi75-8.

AUTORES / AUTHORS:  - Filler G

INSTITUCIÓN / INSTITUTION:  - Department of Paediatrics, Division of Nephrology, Children’s Hospital of Eastern Ontario, University of Ottawa, Canada. filler@cheo.on.ca

RESUMEN / SUMMARY:  - AIM: To determine the sequential therapy of childhood nephrotic syndrome (NS) with presumed minimal change nephropathy using the evidence from clinical trials. METHODS: Meta-analysis of 22 randomized controlled trials was performed, using frequency of relapse and side effects of therapeutic regimes. RESULTS: A meta-analysis of seven trials comparing duration of therapy for initial onset showed that duration of at least 3 months significantly reduced the risk of relapse at 12-24 months (relative risk 0.73; 95% confidence interval 0.60-0.89) without an increase in adverse events. Five trials were performed for steroid treatment of relapse. Deflazacort reduced relapses during therapy, but is not generally available. No difference was observed when comparing single and divided dosing of prednisone. Frequency of relapses could not be influenced by duration of relapse therapy. Alternate day therapy was more effective than intermittent use of prednisone. Two studies out of five on cyclophosphamide or chlorambucil showed consistently that alkylating agents should be used before cyclosporine as alternative therapy to steroids. CONCLUSIONS: Children with initial onset of NS should be treated with prednisone at a dose of 60 mg/m(2)/day for 6 weeks, followed by a dose of 40 mg/m(2)/48 h for at least another 6 weeks. If steroid toxicity for treatment of relapsing NS requires alternative treatment, cyclophosphamide (2 mg/kg/day for at least 8 weeks) remains the drug of choice with a curative potential. If children still relapse after alkylating agents, levamisole may serve as an alternative only for frequent relapsing NS, whereas steroid-dependent NS should be treated with cyclosporine.

 

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[20]

TÍTULO / TITLE:  - Donor-specific tolerance in fully major histocompatibility major histocompatibility complex-mismatched limb allograft transplants under an anti-alphabeta T-cell receptor monoclonal antibody and cyclosporine A protocol.

REVISTA / JOURNAL:  - Transplantation 2003 Dec 27;76(12):1662-8.

      ●● Enlace al texto completo (gratuito o de pago) 1097/01.TP.0000105343.49626.6F

AUTORES / AUTHORS:  - Siemionow MZ; Izycki DM; Zielinski M

INSTITUCIÓN / INSTITUTION:  - Department of Plastic Surgery, Cleveland Clinic Foundation, A60, 9500 Euclid Avenue, Cleveland, OH 44195, USA. siemiom@ccf.org

RESUMEN / SUMMARY:  - BACKGROUND: Recent studies have demonstrated that treatment with alphabeta-T-cell receptor (TCR) monoclonal antibody and cyclosporine A (CsA) can extend survival in composite tissue allografts (CTA). The purpose of this study was to induce tolerance in fully major histocompatibility complex (MHC)-mismatched rat limb allografts under 7 days of a combined alphabeta-TCR-CsA protocol. METHODS: The authors performed 30 hind-limb allotransplantations across the MHC barrier between Brown Norway donors (BN; RT1n) and Lewis recipients (LEW; RT1l). Isograft and allograft controls received no treatment. The experimental groups received monotherapy of alphabeta-TCR and CsA or a combination of alphabeta-TCR and CsA for 7 days only. Donor-specific tolerance and immunocompetence were determined by standard skin grafting in vivo and mixed lymphocyte reaction (MLR) in vitro. The efficacy of immunosuppressive therapy and the level of donor-specific chimerism were determined by flow cytometry. RESULTS: Long-term survival (>350 days) was achieved in allograft recipients (n=6) under the 7-day protocol of combined alphabeta-TCR-CsA. Donor-specific tolerance and immunocompetence of long-term chimeras were confirmed by acceptance of skin grafts from the donors and rejection of the third-party alloantigens (AxC Irish). At day 120, MLR demonstrated unresponsiveness to the host and donor antigens but strong reactivity against third-party alloantigens. Flow cytometry confirmed the high efficacy of immunosuppressive treatment and the development of donor-specific chimerism (7.6% of CD4+-RT1n+ cells, 1.3% of CD8+-RT1n+ cells, and 16.5% of CD45RA+-RT1n+ cells) in the periphery of tolerated recipients. CONCLUSIONS: Combined therapy of alphabeta-TCR-CsA for 7 days resulted in tolerance induction in fully MHC-mismatched rat hind-limb allografts. Tolerance was directly associated with stable, donor-specific chimerism.

 

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[21]

TÍTULO / TITLE:  - Dimerizer-regulated gene expression.

REVISTA / JOURNAL:  - Curr Opin Biotechnol 2002 Oct;13(5):459-67.

AUTORES / AUTHORS:  - Pollock R; Clackson T

INSTITUCIÓN / INSTITUTION:  - ARIAD Gene Therapeutics, 26 Landsdowne Street, Cambridge, MA 02139, USA. roy.pollock@ariad.com

RESUMEN / SUMMARY:  - Control of gene expression using small molecules is a powerful research tool and has clinical utility in the context of regulated gene therapy. Use of chemical inducers of dimerization, or dimerizers, for this purpose has several advantages, including tight regulation, modularity to facilitate iterative improvements, and assembly from human proteins to minimize immune responses in clinical applications. Recent developments include the use of the rapamycin-based dimerizer system to regulate the expression of endogenous genes, the generation of new chemical dimerizers based on FK506, dexamethasone and methotrexate, and progress towards the clinical use of adeno-associated virus and adenovirus vectors regulated by rapamycin analogs.  N. Ref:: 40

 

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[22]

TÍTULO / TITLE:  - The fission yeast TOR proteins and the rapamycin response: an unexpected tale.

REVISTA / JOURNAL:  - Curr Top Microbiol Immunol 2004;279:85-95.

AUTORES / AUTHORS:  - Weisman R

INSTITUCIÓN / INSTITUTION:  - Department of Molecular Microbiology and Biotechnology, Faculty of Life Sciences, Tel-Aviv University, 69978 Tel-Aviv, Israel. ronitt@post.tau.ac.il

RESUMEN / SUMMARY:  - The TOR proteins are known as key regulators of cell growth in response to nutritional and mitogenic signals and as targets for the immunosuppressive and anti-cancerous drug rapamycin. The fission yeast Schizosaccharomyces pombe has two TOR homologues, tor1+ and tor2+. Despite their structural similarity, these genes have distinct functions: tor1+ is required under starvation, extreme temperatures, and osmotic or oxidative stress conditions, whereas tor2+ is required under normal growth conditions. Surprisingly, rapamycin does not seem to inhibit the S. pombe TOR-related functions. Rapamycin specifically inhibits sexual development in S. pombe, and this seems to stem from direct inhibition of the S. pombe FKBP12 homologue. Why S. pombe cells are resistant to rapamycin during the growth phase is as yet unclear and awaits further analysis of the TOR-dependent signaling pathways.  N. Ref:: 27

 

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[23]

TÍTULO / TITLE:  - Composite tissue allotransplantation in chimeric hosts part II. A clinically relevant protocol to induce tolerance in a rat model.

REVISTA / JOURNAL:  - Transplantation 2003 Dec 15;76(11):1548-55.

      ●● Enlace al texto completo (gratuito o de pago) 1097/01.TP.0000085288.12571.65

AUTORES / AUTHORS:  - Prabhune KA; Gorantla VS; Perez-Abadia G; Francois CG; Vossen M; Laurentin-Perez LA; Breidenbach WC; Wang GG; Anderson GL; Pidwell DJ; Barker JH; Maldonado C

INSTITUCIÓN / INSTITUTION:  - Division of Plastic and Reconstructive Surgery, University of Louisville, Louisville, Kentucky, USA.

RESUMEN / SUMMARY:  - BACKGROUND: We and others have shown that mixed allogeneic chimerism induces donor-specific tolerance to composite tissue allografts across major histocompatibility complex barriers without the need for immunosuppression. However, a delay period between bone marrow transplantation and limb allotransplantation is required, making such protocols impractical for clinical application. This study eliminates this delay period in a rat hind limb allotransplantation model by performing mixed allogeneic chimerism induction and transplantation “simultaneously.” METHODS: Group 1 included controls in which naive Wistar Furth (WF) hosts received ACI hind limbs. Group 2 included (ACI-->WF) chimeras that received limbs from third-party donors (Fisher), and group 3 included chimeras that received irradiated (1,050 cGy) ACI limbs. In group 4, WF hosts conditioned with 950 cGy received irradiated (1,050 cGy) ACI limbs followed by infusion of 100 x 10(6) ACI T-cell-depleted bone marrow cells and immunotherapy (tacrolimus and mycophenolate mofetil) for 28 days. Group 5 animals received the same treatment as group 4 animals without immunotherapy. RESULTS: The rats in groups 1 and 2 rejected their limbs within 10 days. Only one rat in group 4 survived to the end of the study. Groups 3 and 5 demonstrated long-term limb survival without rejection or graft-versus-host disease. High levels of donor chimerism (>80%) were achieved and maintained throughout the study. Mixed lymphocyte reaction assays in both groups revealed donor-specific hyporesponsiveness with vigorous third-party reactivity. CONCLUSIONS: This study demonstrated that infusion of donor bone marrow cells into conditioned hosts immediately after limb transplantation results in stable mixed chimerism, robust tolerance, and reliable limb allograft survival.

 

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[24]

TÍTULO / TITLE:  - mTOR as a positive regulator of tumor cell responses to hypoxia.

REVISTA / JOURNAL:  - Curr Top Microbiol Immunol 2004;279:299-319.

AUTORES / AUTHORS:  - Abraham RT

INSTITUCIÓN / INSTITUTION:  - Program in Signal Transduction Research, The Burnham Institute, 10901 North Torrey Pines Road, La Jolla, CA 92037, USA. abraham@burnham.org

RESUMEN / SUMMARY:  - Rapamycin is a clinically approved immunosuppressive agent that has recently shown promising antitumor activities in human patients. In contrast to many conventional chemotherapeutic agents, rapamycin displays a remarkably high level of selectivity for certain types of tumors. The pharmacological activities of rapamycin are attributable to the functional inhibition of a single target protein, termed the mammalian target of rapamycin (mTOR). Because mTOR is widely expressed in both normal and transformed cells, variations in mTOR expression levels are likely not a primary determinant of tumor sensitivity to rapamycin. However, recent studies highlighted an intriguing link between cancer cell sensitivity to rapamycin and deregulated signaling through the phosphoinositide (PI) 3-kinase pathway. These findings have prompted a search for cancer-related responses that are jointly regulated by the PI 3-kinase signaling cascade and mTOR. The oxygen-regulated transcription factor, hypoxia-induced factor (HIF)-1, has emerged as a candidate target for both of these two highly interactive signaling proteins. Here we review evidence that mTOR functions as a positive regulator of HIF-1-dependent responses to hypoxic stress in human cancer cells.  N. Ref:: 71

 

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[25]

TÍTULO / TITLE:  - TGF-beta expression in protocol transplant liver biopsies: a comparative study between cyclosporine-A (CyA) and tacrolimus (FK 506) immunosuppression.

REVISTA / JOURNAL:  - Transplant Proc 2001 Feb-Mar;33(1-2):1378-80.

AUTORES / AUTHORS:  - Mohamed MA; Burt AD; Robertson H; Kirby JA; Talbot D

INSTITUCIÓN / INSTITUTION:  - Transplant Immunobiology Group, Department of Surgery, University of Newcastle, NE2 4HH, Newcastle Upon Tyne, UK.

 

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[26]

TÍTULO / TITLE:  - CD30+ T-cell lymphoma in a patient with psoriasis treated with ciclosporin and infliximab.

REVISTA / JOURNAL:  - Br J Dermatol 2003 Jul;149(1):170-3.

AUTORES / AUTHORS:  - Mahe E; Descamps V; Grossin M; Fraitag S; Crickx B

INSTITUCIÓN / INSTITUTION:  - Department of Dermatology, Bichat-Claude Bernard Hospital, 46 Rue Henri-Huchard, Paris Cedex 18, France. emmanuel.mahe@bch.ap-hop-paris.fr

RESUMEN / SUMMARY:  - There is a known relationship between the use of immunosuppressive therapies and the development of lymphoproliferative malignancies. These lymphomas are mainly B-cell nonHodgkin’s lymphomas associated with Epstein-Barr virus. Most cases concern classical immunosuppressive treatments including ciclosporin and methotrexate. A relationship between the new antitumour necrosis factor (TNF)-alpha agents and lymphoproliferative malignancies is debated. Patients with psoriasis on immunosuppressive therapies, mainly ciclosporin, are considered to have a low risk of developing lymphoid proliferation. We report a patient with erythrodermic psoriasis treated with ciclosporin and infliximab who developed a CD30+ T-cell lymphoma. This lymphoma regressed after stopping these treatments. In this case, the anti-TNF-alpha agent may have played a role in association with ciclosporin in the development of the lymphoproliferative disorder. Whereas the combination of anti-TNF-alpha therapies with methotrexate has been well studied, their combination with ciclosporin has been evaluated only in a few patients. Psoriatic patients who may require anti-TNF-alpha treatment have often been or will be treated with ciclosporin. The combination of ciclosporin and anti-TNF-alpha warrants further investigation.  N. Ref:: 17

 

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[27]

TÍTULO / TITLE:  - Elucidating TOR signaling and rapamycin action: lessons from Saccharomyces cerevisiae.

REVISTA / JOURNAL:  - Microbiol Mol Biol Rev. - Acceso gratuito al texto completo a partir de 1 año de la fecha de publicación.

      ●● Enlace a la Editora de la Revista http://mmbr.asm.org/ 

      ●● Cita: Microbiology & Molecular Biology Reviews: <> 2002 Dec;66(4):579-91, table of contents.

AUTORES / AUTHORS:  - Crespo JL; Hall MN

INSTITUCIÓN / INSTITUTION:  - Division of Biochemistry, Biozentrum, University of Basel, CH-4056 Basel, Switzerland.

RESUMEN / SUMMARY:  - TOR (target of rapamycin) is a phosphatidylinositol kinase-related protein kinase that controls cell growth in response to nutrients. Rapamycin is an immunosuppressive and anticancer drug that acts by inhibiting TOR. The modes of action of TOR and rapamycin are remarkably conserved from S. cerevisiae to humans. The current understanding of TOR and rapamycin is derived largely from studies with S. cerevisiae. In this review, we discuss the contributions made by S. cerevisiae to understanding rapamycin action and TOR function.  N. Ref:: 171

 

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[28]

TÍTULO / TITLE:  - Structures of calcineurin and its complexes with immunophilins-immunosuppressants.

REVISTA / JOURNAL:  - Biochem Biophys Res Commun 2003 Nov 28;311(4):1095-102.

AUTORES / AUTHORS:  - Ke H; Huai Q

INSTITUCIÓN / INSTITUTION:  - Department of Biochemistry and Biophysics and Lineberger Comprehensive Cancer Center, The University of North Carolina, Chapel Hill, NC 27599-7260, USA. hke@med.unc.edu

RESUMEN / SUMMARY:  - Calcineurin (CN) is a Ca(2+)/calmodulin-dependent serine/threonine protein phosphatase and is involved in many physiological processes such as T-cell activation and cardiac hypertrophy. The crystal structures of CN and its complexes with FKBP12-FK506 and cyclophilin-cyclosporin showed that the two structurally unrelated immunophilins-immunosuppressants bind to a common composite surface made up of the residues from both catalytic subunit and regulatory subunit of CN. The recognition of the immunophilins and immunosuppressive drugs is achieved by common but few distinct CN residues. However, the binding pattern of FKBP12-FK506 such as hydrogen bonding is significantly different from that of CyPA-CsA. This common but distinct recognition may indicate capacity of the composition surface for binding of other inhibitory proteins. The recognition site and the active site are adjacent and form an “L” shaped cleft. This implies that the immunophilin recognition site may also serve as a recognition site to define the narrow substrate specificity of calcineurin.  N. Ref:: 61

 

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[29]

TÍTULO / TITLE:  - Multidrug resistance reversal agents.

REVISTA / JOURNAL:  - J Med Chem 2003 Nov 6;46(23):4805-17.

      ●● Enlace al texto completo (gratuito o de pago) 1021/jm030183a

AUTORES / AUTHORS:  - Robert J; Jarry C

INSTITUCIÓN / INSTITUTION:  - Institut Bergonie, 229, Cours de l’Argonne, 33076 Bordeaux Cedex, France. robert@bergonie.org  N. Ref:: 151

 

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[30]

TÍTULO / TITLE:  - Prevention by dietary (n-6) polyunsaturated phosphatidylcholines of intrahepatic cholestasis induced by cyclosporine A in animals.

REVISTA / JOURNAL:  - Life Sci 2003 Jun 13;73(4):381-92.

AUTORES / AUTHORS:  - Chanussot F; Benkoel L

INSTITUCIÓN / INSTITUTION:  - INSERM U. 476, Faculte de Medecine, 27 bd Jean Moulin, 13385 Marseille cedex 05, France. Francoise.Chanussot@medecine.univ-mrs.fr

RESUMEN / SUMMARY:  - Previous findings showed that dietary (n-6) polyunsaturated phosphatidylcholines (vegetable lecithin) could efficiently prevent intrahepatic cholestasis induced by cyclosporine A in rats. Mechanistic studies showed that expressions in rat liver of Na(+), K(+)-ATPase, Ca(2+), Mg(2+)-ATPase and F-actin were both decreased by drug administration and both enhanced by (n-6) lecithin enriched diet. There is a possible direct effect of phosphatidylcholines, vectors of polyunsaturated fatty acids provided by the metabolism of the dietary lecithin, on the aforesaid hepatic parameters. Such modulations by drug and diet result in reversed modifications of membrane composition and fluidity. Final outcome is decreased and enhanced bile lipid secretion by cyclosporine and vegetable lecithin enriched diet respectively. Moreover, we advance the hypothesis of a bypass process including a separate and functional actin-independent way for the non micellar and phospholipid-dependent secretion of bile lipids. The relationships between the ATPases, the microfilament components such as F-actin and the different transporters still remain to be clarified. Furthermore, one can speculate on beneficial effects in humans of diets enriched in vegetable lecithins that might prevent cholestasis induced by cyclosporine A.  N. Ref:: 75

 

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[31]

TÍTULO / TITLE:  - Calcineurin inhibitor-free CD28 blockade-based protocol protects allogeneic islets in nonhuman primates.

REVISTA / JOURNAL:  - Diabetes. Acceso gratuito al texto completo a partir de 1 año de la fecha de publicación.

      ●● Enlace a la Editora de la Revista http://diabetes.diabetesjournals.org/ 

      ●● Cita: Diabetes: <> 2002 Feb;51(2):265-70.

AUTORES / AUTHORS:  - Adams AB; Shirasugi N; Durham MM; Strobert E; Anderson D; Rees P; Cowan S; Xu H; Blinder Y; Cheung M; Hollenbaugh D; Kenyon NS; Pearson TC; Larsen CP

INSTITUCIÓN / INSTITUTION:  - Emory Transplant Center, Department of Surgery, Emory University School of Medicine, Atlanta, Georgia 30322, USA.

RESUMEN / SUMMARY:  - Recent success using a steroid-free immunosuppressive regimen has renewed enthusiasm for the use of islet transplantation to treat diabetes. Toxicities associated with the continued use of a calcineurin inhibitor may limit the wide-spread application of this therapy. Biological agents that block key T-cell costimulatory signals, in particular the CD28 pathway, have demonstrated extraordinary promise in animal models. LEA29Y (BMS-224818), a mutant CTLA4-Ig molecule with increased binding activity, was evaluated for its potential to replace tacrolimus and protect allogeneic islets in a preclinical primate model. Animals received either the base immunosuppression regimen (rapamycin and anti-IL-2R monoclonal antibody [mAb]) or the base immunosuppression and LEA29Y. Animals receiving the LEA29Y/rapamycin/anti-IL-2R regimen (n = 5) had significantly prolonged islet allograft survival (204, 190, 216, 56, and >220 days). In contrast, those animals receiving the base regimen alone (n = 2) quickly rejected the transplanted islets at 1 week (both at 7 days). The LEA29Y-based regimen prevented the priming of anti-donor T- and B-cell responses, as detected by interferon-gamma enzyme-linked immunospot and allo-antibody production, respectively. The results of this study suggest that LEA29Y is a potent immunosuppressant that can effectively prevent rejection in a steroid-free immunosuppressive protocol and produce marked prolongation of islet allograft survival in a preclinical model.

 

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[32]

TÍTULO / TITLE:  - Nutrient signaling through TOR kinases controls gene expression and cellular differentiation in fungi.

REVISTA / JOURNAL:  - Curr Top Microbiol Immunol 2004;279:53-72.

AUTORES / AUTHORS:  - Rohde JR; Cardenas ME

INSTITUCIÓN / INSTITUTION:  - Department of Molecular Genetics and Microbiology, Duke University Medical Center, Durham, NC 27710, USA.

RESUMEN / SUMMARY:  - The TOR kinases were first identified in Saccharomyces cerevisiae as the targets of the immunosuppressive drug rapamycin. Subsequent studies employing rapamycin as a tool in yeast have given us insight into the structure and function of the TOR kinases, as well as the biological role of the TOR signaling program in transmitting nutrient signals to promote cell growth. One of the major advances from this area has been in defining an unexpected role for TOR signaling in the regulation of transcription. The identification of target genes subject to regulation by TOR has provided a platform for the dissection of the signaling events downstream of the TOR kinases. Studies aimed at understanding TOR-regulated transcription have begun to shed light on how TOR signaling cooperates with other signaling programs. In addition, the TOR pathway regulates the developmental program of pseudohyphal differentiation in concert with highly conserved MAP kinase and PKA signaling programs. Remarkably, rapamycin also blocks filamentation in a number of important human and plant pathogens and the mechanism of rapamycin action is conserved in Candida albicans and Cryptococcus neoformans. The antimicrobial properties of less immunosuppressive analogs of rapamycin hold promise for the development of an effective antifungal therapy.  N. Ref:: 65

 

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[33]

TÍTULO / TITLE:  - Signaling pathways involved in translational control of protein synthesis in skeletal muscle by leucine.

REVISTA / JOURNAL:  - J Nutr. Acceso gratuito al texto completo a partir de 1 año de la fecha de publicación.

      ●● Enlace a la Editora de la Revista http://www.nutrition.org/ 

      ●● Cita: Journal of Nutrition: <> 2001 Mar;131(3):856S-860S.

AUTORES / AUTHORS:  - Anthony JC; Anthony TG; Kimball SR; Jefferson LS

INSTITUCIÓN / INSTITUTION:  - Department of Cellular and Molecular Physiology, P.O. Box 850, The Pennsylvania State University College of Medicine, Hershey, PA 17033, USA.

RESUMEN / SUMMARY:  - Numerous reports established that in skeletal muscle the indispensable branched-chain amino acid leucine is unique in its ability to initiate signal transduction pathways that modulate translation initiation. Oral administration of leucine stimulates protein synthesis in association with hyperphosphorylation of the translational repressor, eukaryotic initiation factor (eIF) 4E binding protein 1 (4E-BP1), resulting in enhanced availability of the mRNA cap-binding protein eIF4E, for binding eIF4G and forming the active eIF4F complex. In addition, leucine enhances phosphorylation of the 70-kDa ribosomal protein S6 kinase (S6K1). These results suggest that leucine upregulates protein synthesis in skeletal muscle by enhancing both the activity and synthesis of proteins involved in mRNA translation. The stimulatory effects of leucine on translation initiation are mediated in part through the protein kinase mammalian target of rapamycin (mTOR), where both insulin signaling and leucine signaling converge to promote a maximal response.  N. Ref:: 34

 

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[34]

TÍTULO / TITLE:  - A benefit-risk assessment of basiliximab in renal transplantation.

REVISTA / JOURNAL:  - Drug Saf. Acceso gratuito al texto completo.

      ●● Enlace a la Editora de la Revista http://www.csmwm.org/ 

      ●● Cita: Drug Safety: <> 2004;27(2):91-106.

AUTORES / AUTHORS:  - Boggi U; Danesi R; Vistoli F; Del Chiaro M; Signori S; Marchetti P; Del Tacca M; Mosca F

INSTITUCIÓN / INSTITUTION:  - Division of General Surgery and Transplants, Department of Oncology, Transplants and Advanced Technologies in Medicine, University of Pisa, Pisa, Italy. uboggi@med.unipi.it

RESUMEN / SUMMARY:  - Interleukin-2 (IL-2) and its receptor (IL-2R) play a central role in T lymphocyte activation and immune response after transplantation. Research on the biology of IL-2R allowed the identification of key signal transduction pathways involved in the generation of proliferative and antiapoptotic signals in T cells. The alpha-chain of the IL-2R is a specific peptide against which monoclonal antibodies have been raised, with the aim of blunting the immune response by means of inhibiting proliferation and inducing apoptosis in primed lymphocytes. Indeed, basiliximab, one of such antibodies, has proved to be effective in reducing the episodes of acute rejection after kidney and pancreas transplantation. The use of basiliximab was associated with a significant reduction in the incidence of any treated rejection episodes after kidney transplantation in the two major randomised studies (placebo 52.2% vs basiliximab 34.2% at 6 months, European study; placebo 54.9% vs basiliximab 37.6% at 1 year, US trial). Basiliximab and equine antithymocyte globulin (ATG) administration resulted in a similar rate of biopsy-proven acute rejection at 6 months (19% for both) and at 12 months (19% and 20%, respectively). The use of basiliximab appears not to be associated with an increased incidence of adverse events as compared with placebo in immunosuppressive regimens, including calcineurin inhibitors, mycophenolate mofetil or azathioprine and corticosteroids, and its safety profile is superior to ATG. Moreover, a similar occurrence of infections is noted in selected studies (65.5% after basiliximab vs 65.7% of controls), including cytomegalovirus infection (17.3% vs 14.5%), and cytokine-release syndrome is not observed. Finally, economic analysis demonstrated lower costs of overall treatment in patients treated with basiliximab. Therefore, the use of basiliximab entails a very low risk, allows safe reduction of corticosteroid dosage and reduces the short- and mid-term rejection rates. However, the improvement in the long-term survival of kidney grafts in patients treated according to modern immunosuppressive protocols is still to be demonstrated. These conclusions are based on a systematic review of the scientific literature, indexed on Medline database, concerning the mechanism of action, therapeutic activity, safety and pharmacoeconomic evaluation of basiliximab in renal transplantation.  N. Ref:: 62

 

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[35]

TÍTULO / TITLE:  - Role of leucine in the regulation of mTOR by amino acids: revelations from structure-activity studies.

REVISTA / JOURNAL:  - J Nutr. Acceso gratuito al texto completo a partir de 1 año de la fecha de publicación.

      ●● Enlace a la Editora de la Revista http://www.nutrition.org/ 

      ●● Cita: Journal of Nutrition: <> 2001 Mar;131(3):861S-865S.

AUTORES / AUTHORS:  - Lynch CJ

INSTITUCIÓN / INSTITUTION:  - Department of Cellular and Molecular Physiology, The Pennsylvania State University College of Medicine, 500 University Drive, Hershey, PA 17033, USA. clynch@psu.edu

RESUMEN / SUMMARY:  - In this study an overview is presented of the mTOR signaling pathway and its regulation by amino acids, particularly L-leucine. Our laboratory is studying amino acid regulation of mTOR in adipocytes. Potential roles for mTOR in adipocytes that were previously posited include hypertrophic growth, leptin secretion, protein synthesis and adipose tissue morphogenesis. A current area of interest in the field is how amino acids regulate mTOR and which amino acids are regulatory. Revelations concerning mechanism and recognition are emerging from different laboratories that examined the structural requirements for stimulation and inhibition of the mTOR signaling pathway by leucine and amino acid analogs. In adipocytes and some other cell types, leucine appears to be the main regulatory amino acid. However, this is not uniformly the case. In those cells where mTOR is regulated by several amino acids, there is evidence that the mechanism of mTOR activation may be different from cells where mainly leucine is regulatory. Furthermore, in tissues where leucine regulates mTOR, the possible existence of different tissue-specific leucine recognition sites may be indicated.  N. Ref:: 47

 

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[36]

TÍTULO / TITLE:  - Drug-eluting stents and glycoprotein IIb/IIIa inhibitors: combination therapy for the future.

REVISTA / JOURNAL:  - Am Heart J 2003 Oct;146(4 Suppl):S13-7.

      ●● Enlace al texto completo (gratuito o de pago) 1016/j.ahj.2003.09.004

AUTORES / AUTHORS:  - Leon MB; Bakhai A

RESUMEN / SUMMARY:  - BACKGROUND: Although coronary stenting has improved the results of coronary interventions compared to coronary angioplasty alone, in-stent restenosis remains a significant limitation of this procedure. Drug-eluting stents with or without glycoprotein IIb/IIIa inhibitor therapy represent an additional advance in the evolution of this strategy. METHODS: We review the currently available trials comparing studies of non-drug-eluting and drug-eluting stents using sirolimus and paclitaxel agents and their derivatives. RESULTS: Ten studies are available that compare drug-eluting to traditional non-drug-eluting stents. A variety of antiplatelet regimes have been used. The majority of these studies are in the process of being published. No head-to-head studies comparing different drug-eluting stents are available. CONCLUSIONS: Drug-eluting stents using sirolimus and paclitaxel in combination with enhanced antiplatelet strategies represent an important advantage over non-drug-eluting stents for the reduction of in-stent restenosis. The rate at which drug-eluting stents are adapted into widespread practice depends heavily on whether they are safe, efficacious, and cost-effective in various clinical settings.  N. Ref:: 28

 

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[37]

TÍTULO / TITLE:  - Tissue factor and coronary artery disease.

REVISTA / JOURNAL:  - Cardiovasc Res 2002 Feb 1;53(2):313-25.

AUTORES / AUTHORS:  - Moons AH; Levi M; Peters RJ

INSTITUCIÓN / INSTITUTION:  - Department of Cardiology, Academic Medical Center, Room F3-236, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.

RESUMEN / SUMMARY:  - Plaque disruption with superimposed thrombosis is the main cause of acute coronary events such as acute myocardial infarction and unstable angina. Among other factors, tissue factor seems to play an important role determining plaque thrombogenicity. Tissue factor is a potent initiator of the coagulation cascade situated within the vessel wall and is highly exposed to the blood after plaque rupture. Several mediators involved in the process of atherosclerotic plaque formation are capable of inducing tissue factor expression in cells such as monocytes, macrophages and endothelial cells, which under normal conditions do not express tissue factor or to a limited extent only. The increased expression of tissue factor is not limited to the plaque but is also found in circulating monocytes in patients with acute coronary syndromes. In addition, studies have shown an important contribution of tissue factor in the pathogenesis of thrombosis and restenosis after balloon angioplasty. Recent basic studies focus on the therapeutic inhibition of tissue factor. Specific and non-specific inhibitors of tissue factor or the tissue factor/factor VIIa complex have been developed or identified, and have been tested in experimental studies. Clinical studies are currently being initiated. In this review, we present the current knowledge on the role of tissue factor in atherosclerosis, arterial intervention and potential pharmacological approaches, with focus on acute coronary syndromes.  N. Ref:: 162

 

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[38]

- Castellano -

TÍTULO / TITLE:Las inmunofilinas: agentes neuroprotectores y promotores de la regeneracion neural. Immunophilins: neuroprotective agents and promoters of neural regeneration.

REVISTA / JOURNAL:  - Neurologia. Acceso gratuito al texto completo.

      ●● Enlace a la Editora de la Revista http://www.stmeditores.com/Revistas/ffasciculo.php?Mw==&MTk=&MjUy 

      ●● Cita: Neurologia: <> 2002 Apr;17(4):200-13.

AUTORES / AUTHORS:  - Udina E; Navarro X

INSTITUCIÓN / INSTITUTION:  - Grupo de Neuroplasticidad y Regeneracion, Departamento de Biologia Celular, Fisiologia e Inmunologia, Universitat Autonoma de Barcelona, Bellaterra, España.

RESUMEN / SUMMARY:  - Immunophilins are a family of proteins mainly known because they act as receptors of the immunosuppressant drugs cyclosporin A (CsA) and FK506. Immunophilins serve several general functions, including regulation of mitochondrial permeability, modulation of ion channels stability and acting as chaperones for a variety of proteins. However, immunophilins are also present at high density in the nervous system. CsA, FK506 and other derivatives inhibit the function of immunophilins and, through bloking or activating several intracellular pathways, it has been shown that they exert neuroprotective effects in different experimental models of ischemia, Parkinson’s disease and excitotoxic insults. Moreover, FK506 also has neuroregenerative effects, by enhancing the axonal regeneration rate after lesions of the peripheral nervous system. The development of new agents that selectively bind to immunophilins opens new interesting perspectives for the therapy of degenerative diseases and injuries of the nervous system.  N. Ref:: 100

 

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[39]

TÍTULO / TITLE:  - Protein phosphatase 2A on track for nutrient-induced signalling in yeast.

REVISTA / JOURNAL:  - Mol Microbiol. Acceso gratuito al texto completo a partir de los 2 años de la fecha de publicación.

      ●● Enlace a la Editora de la Revista http://www.blackwell-synergy.com/ 

      ●● Cita: Molecular Microbiology: <> 2002 Feb;43(4):835-42.

AUTORES / AUTHORS:  - Zabrocki P; Van Hoof C; Goris J; Thevelein JM; Winderickx J; Wera S

INSTITUCIÓN / INSTITUTION:  - Laboratorium voor Moleculaire Celbiologie, K.U.Leuven, Kasteelpark Arenberg 31, B-3001 Leuven-Heverlee, Flanders, Belgium.

RESUMEN / SUMMARY:  - Early studies identified two bona fide protein phosphatase 2A (PP2A)-encoding genes in Saccharomyces cerevisiae, designated PPH21 and PPH22. In addition, three PP2A-related phosphatases, encoded by PPH3, SIT4 and PPG1, have been identified. All share as much as 86% sequence similarity at the amino acid level. This review will focus primarily on Pph21 and Pph22, but some aspects of Sit4 regulation will also be discussed. Whereas a role for PP2A in yeast morphology and cell cycle has been readily recognized, uncovering its function in yeast signal transduction is a more recent breakthrough. Via their interaction with phosphorylated Tap42, PP2A and Sit4 play a pivotal role in target of rapamycin (TOR) signalling. PPH22 overexpression mimics overactive cAMP-PKA (protein kinase A) signalling and PP2A and Sit4 might represent ceramide signalling targets. The methylation of its catalytic subunit stabilizes the heterotrimeric form of PP2A and might counteract TOR signalling. We will show how these new elements could lead us to understand the role and regulation of PP2A in nutrient-induced signalling in baker’s yeast.  N. Ref:: 41

 

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[40]

TÍTULO / TITLE:  - mTOR as a target for cancer therapy.

REVISTA / JOURNAL:  - Curr Top Microbiol Immunol 2004;279:339-59.

AUTORES / AUTHORS:  - Houghton PJ; Huang S

INSTITUCIÓN / INSTITUTION:  - Department of Molecular Pharmacology, St. Jude Children’s Research Hospital, 332 N. Lauderdale, Memphis, TN 38105-2794, USA. peter.houghton@stjude.org

RESUMEN / SUMMARY:  - The target of rapamycin, mTOR, acts as a sensor for mitogenic stimuli, such as insulin-like growth factors and cellular nutritional status, regulating cellular growth and division. As many tumors are driven by autocrine or paracrine growth through the type-I insulin-like growth factor receptor, mTOR is potentially an attractive target for molecular-targeted treatment. Further, a rationale for anticipating tumor-selective activity based on transforming events frequently identified in malignant disease is becoming established.  N. Ref:: 73

 

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[41]

TÍTULO / TITLE:  - Serine-threonine protein phosphatase inhibitors: development of potential therapeutic strategies.

REVISTA / JOURNAL:  - J Med Chem 2002 Mar 14;45(6):1151-75.

AUTORES / AUTHORS:  - McCluskey A; Sim AT; Sakoff JA

INSTITUCIÓN / INSTITUTION:  - School of Biological & Chemical Science, Medicinal Chemistry Group, The University of Newcastle, Callaghan, NSW 2308, Australia. amcclusk@mail.newcastle.edu.au  N. Ref:: 329

 

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[42]

TÍTULO / TITLE:  - Inflammatory myopathies: clinical, diagnostic and therapeutic aspects.

REVISTA / JOURNAL:  - Muscle Nerve 2003 Apr;27(4):407-25.

      ●● Enlace al texto completo (gratuito o de pago) 1002/mus.10313

AUTORES / AUTHORS:  - Mastaglia FL; Garlepp MJ; Phillips BA; Zilko PJ

INSTITUCIÓN / INSTITUTION:  - Centre for Neuromuscular and Neurological Disorders, University of Western Australia, Queen Elizabeth II Medical Centre, Nedlands, Australia. flmast@cyllene.uwa.edu.au

RESUMEN / SUMMARY:  - The three major forms of immune-mediated inflammatory myopathy are dermatomyositis (DM), polymyositis (PM), and inclusion-body myositis (IBM). They each have distinctive clinical and histopathologic features that allow the clinician to reach a specific diagnosis in most cases. Magnetic resonance imaging is sometimes helpful, particularly if the diagnosis of IBM is suspected but has not been formally evaluated. Myositis-specific antibodies are not helpful diagnostically but may be of prognostic value; most antibodies have low sensitivity. Muscle biopsy is mandatory to confirm the diagnosis of an inflammatory myopathy and to allow unusual varieties such as eosinophilic, granulomatous, and parasitic myositis, and macrophagic myofasciitis, to be recognized. The treatment of the inflammatory myopathies remains largely empirical and relies upon the use of corticosteroids, immunosuppressive agents, and intravenous immunoglobulin, all of which have nonselective effects on the immune system. Further controlled clinical trials are required to evaluate the relative efficacy of the available therapeutic modalities particularly in combinations, and of newer immunosuppressive agents (mycophenolate mofetil and tacrolimus) and cytokine-based therapies for the treatment of resistant cases of DM, PM, and IBM. Improved understanding of the molecular mechanisms of muscle injury in the inflammatory myopathies should lead to the development of more specific forms of immunotherapy for these conditions.  N. Ref:: 256

 

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[43]

TÍTULO / TITLE:  - Mitochondrial permeability transition in acute neurodegeneration.

REVISTA / JOURNAL:  - Biochimie 2002 Feb-Mar;84(2-3):241-50.

AUTORES / AUTHORS:  - Friberg H; Wieloch T

INSTITUCIÓN / INSTITUTION:  - Laboratory for Experimental Brain Research, Wallenberg Neuroscience Center, BMC A13, 221 84 Lund, Sweden.

RESUMEN / SUMMARY:  - Acute neurodegeneration in man is encountered during and following stroke, transient cardiac arrest, brain trauma, insulin-induced hypoglycemia and status epilepticus. All these severe clinical conditions are characterized by neuronal calcium overload, aberrant cell signaling, generation of free radicals and elevation of cellular free fatty acids, conditions that favor activation of the mitochondrial permeability transition pore (mtPTP). Cyclosporin A (CsA) and its analog N-methyl-valine-4-cyclosporin A (MeValCsA) are potent blockers of the mtPTP and protect against neuronal death following excitotoxicity and oxygen glucose deprivation. Also, CsA and MeValCsA diminish cell death following cerebral ischemia, trauma, and hypoglycemia. Here we present data that strongly imply the mtPT in acute neurodegeneration in vivo. Compounds that readily pass the blood-brain-barrier (BBB) and block the mtPT may be neuroprotective in stroke.  N. Ref:: 100

 

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[44]

TÍTULO / TITLE:  - Calcineurin-free protocols with basiliximab induction allow patients included in “old to old” programs achieve standard kidney transplant function.

REVISTA / JOURNAL:  - Transplant Proc 2003 Jun;35(4):1326-7.

AUTORES / AUTHORS:  - Emparan C; Laukotter M; Wolters H; Dame C; Heidenreich S; Senninger N

INSTITUCIÓN / INSTITUTION:  - Department of Surgery, Division of Transplantation, Uniklinikum Munster, Munster, Germany. cemparan@teleline.es

RESUMEN / SUMMARY:  - INTRODUCTION: The EuroTransplant “old to old” program establishes that patients older than 60 years can receive offers of organs from donors older than 60 years. The compromised function of these organs makes it a priority to preserve their initial kidney function. HYPOTHESIS: Calcineurin-sparing protocols using anti-IL-2 receptor (IL-2R) antibody induction (Simulect) may benefit initial kidney function in these patients, as assessed by the rates of delayed graft function and of rejection during the first month after transplant. PATIENTS AND METHODS: A cohort of 15 consecutive elderly patients were prospectively compared with 30 cadaveric kidney transplants in younger recipients. Study patients were induced with Simulect (20 mg, 30 minutes before reperfusion and 4 days after transplantation) and steroids, delaying the introduction of CsA until the serum creatinine was below 3 mg/dL. The other cohort of patients were immunosuppressed with tacrolimus (trough 8 to 12), mycophenolats mofetil (MMF, 1 g/d), and an identical taper of steroids. The analysis compared donor and recipient ages, mean cold ischemic time, incidence of initial kidney function (diuresis in the first 24 h) serum creatinine levels, glomerular filtration rate (GFR), number of dialysis sessions, and rejection rate in the two groups. RESULTS: Except for the donor and recipient ages (72 vs 54 in donors, and 67 versus 52 years in recipients), no significant differences were observed between the groups among the rates of acute rejection (6.6% vs 13.2%), delayed graft function (13.2% required dialysis), or infection (6.6%). Within 1 month all 45 grafts showed primary function with equal creatinine levels (mean 1.65). CONCLUSIONS: Calcineurin-free protocols using IL-2 therapy as the initial suppression allow patients in the “old to old” ET program to display equal results to cadaveric kidney transplants with initial treatment with calcineurin antagonists.

 

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[45]

TÍTULO / TITLE:  - Measle virus-infected dendritic cells develop immunosuppressive and cytotoxic activities.

REVISTA / JOURNAL:  - Immunobiology 2001 Dec;204(5):629-38.

AUTORES / AUTHORS:  - Vidalain PO; Azocar O; Rabourdin-Combe C; Servet-Delprat C

INSTITUCIÓN / INSTITUTION:  - Immunobiologie Fondamentale et Clinique, CERVI-INSERM, Lyon, France. servet@cervi-lyon.inserm.fr

RESUMEN / SUMMARY:  - Measle virus (MV) infection induces a transient but profound immunosuppression characterized by a panlymphopenia which occasionally results in opportunistic infections responsible for a high rate of mortality in malnourished children. MV can encounter human dendritic cells (DC) in the respiratory mucosa or in the secondary lymphoid organs. After a brief presentation of DCs, we review progress in understanding the immunobiology of MV-infected DCs that could account for MV-induced immunosuppression. In addition, we develop the newly described TRAIL-mediated cytotoxic function of DCs that is turned on by MV infection, but also by interferons or double-stranded RNA (poly (I:C)). Finally, we propose a model where the measles-associated lymphopenia could be mediated by TRAIL and the measles-induced immunosuppression could be transiently prolonged by Fas-mediated destruction of DCs.  N. Ref:: 38

 

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[46]

TÍTULO / TITLE:  - Antiproliferative prostaglandins and the MRP/GS-X pump role in cancer immunosuppression and insight into new strategies in cancer gene therapy.

REVISTA / JOURNAL:  - Biochem Pharmacol 2001 Oct 1;62(7):811-9.

AUTORES / AUTHORS:  - Homem de Bittencourt PI Jr; Curi R

INSTITUCIÓN / INSTITUTION:  - Department of Physiology, Institute of Basic Health Sciences, Federal University of Rio Grande do Sul, Rua Sarmento Leite 500, 90050-170, Porto Alegre, RS, Brazil. pauloivo@vortex.ufrgs.br

RESUMEN / SUMMARY:  - A dramatic complication in late-stage cancer patients is host immunosuppression. Cyclopentenone prostaglandins (CP-PGs) overproduced in cancer may impair the function of the immune system. These agents, if produced at high concentrations, are powerful cytostatic and cytotoxic compounds that may arrest cell proliferation and immune response in cancer. Lymphoid tissues of tumor-bearing animals accumulate large amounts of CP-PGs, whereas the tumor tissue does not. This may be because cancer cells are able to overexpress multidrug resistance-associated protein (Mg(2+)-dependent vanadate-sensitive GS-conjugate export ATPase, MRP/GS-X pump), which extrudes CP-PGs to the extracellular space as glutathione S-conjugates. In contrast, MRP/GS-X pump activity is disproportionately low in lymphocytes. This led us to propose the transfection of lymphocytes with multidrug resistance-associated protein genes (MRP) for further autologous transfusion or direct in vivo delivery to lymphocytes by using adenovirus-retrovirus chimeras in order to restore immune system function in cancer, at least partially. We are currently evaluating MRP-transfected lymphocyte (MTL) therapy, using Walker 256 tumor-bearing rats as a model.  N. Ref:: 49

 

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[47]

TÍTULO / TITLE:  - Cytokine and anti-cytokine therapies for inflammatory bowel disease.

REVISTA / JOURNAL:  - Curr Pharm Des 2003;9(14):1107-13.

AUTORES / AUTHORS:  - Ogata H; Hibi T

INSTITUCIÓN / INSTITUTION:  - Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.

RESUMEN / SUMMARY:  - Although the pathogenesis of inflammatory bowel disease (IBD) remains elusive, it appears that there is chronic activation of the immune and inflammatory cascade in genetically susceptible individuals. Current disease management guidelines have therefore focused on the use of anti-inflammatory agents, aminosalicylates and corticosteroids. These conventional therapies continue to be a first choice in the management of IBD. Immunomodulators, such as azathioprine, 6-mercaptopurine, methotrexate or cyclosporin, are demonstrating increasing importance against steroid-resistant and steroid-dependent patients. However, some patients are still refractory to these therapies. Recent advances in the understanding of the pathophysiological conditions of IBD have provided new immune system modulators as therapeutic tools. Other immunosuppressive agents including FK506 and thalidomide have expanded the choice of medical therapies available for certain subgroups of patients. Furthermore, biological therapies have begun to assume a prominent role. Studies with chimeric monoclonal anti-TNF-alpha antibody treatment have been reported with dramatic successes. However, observations in larger numbers of treated patients are needed to explicate fully the safety of or risks posed by this agent such as developing lymphoma, or other malignancies. Another anti-inflammatory cytokine-therapy includes anti anti-IL-6R, anti-IL-12 or toxin-conjugated anti IL-7R, recombinant cytokines (IL-10 or IL-11). Given the diversity of proinflammatory products under its control, NF-kappaB may be viewed as a master switch in lymphocytes and macrophages, regulating inflammation and immunity. Although some of them still need more confirmatory studies, those immune therapies will provide new insights into cell-based and gene-based treatment against IBD in near future.  N. Ref:: 46

 

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[48]

TÍTULO / TITLE:  - Amino acid transport regulates blastocyst implantation.

REVISTA / JOURNAL:  - Biol Reprod. Acceso gratuito al texto completo a partir de los 2 años de la fecha de publicación.

      ●● Enlace a la Editora de la Revista http://www.biolreprod.org/ 

      ●● Cita: Biol Reprod: <> 2003 Oct;69(4):1101-8. Epub 2003 Jun 11.

      ●● Enlace al texto completo (gratuito o de pago) 1095/biolreprod.103.018010

AUTORES / AUTHORS:  - Martin PM; Sutherland AE; Van Winkle LJ

INSTITUCIÓN / INSTITUTION:  - Department of Cell Biology, University of Virginia, Charlottesville, Virginia, USA.

RESUMEN / SUMMARY:  - Mouse blastocyst outgrowth in vitro and probably implantation in vivo require amino acid signaling via the target of rapamycin (TOR) pathway. This signaling does not simply support protein synthesis and trophoblast differentiation. Rather, it regulates development of trophoblast protrusive activity and may act as a developmental checkpoint for implantation. Moreover, intracellular amino acids per se are insufficient to elicit TOR signaling. Instead, de novo transport of amino acids, and particularly of leucine, stimulate mTOR activity at the blastocyst stage. The activity of the broad-scope and yet leucine-selective amino acid transport system B0,+ could produce such increases in intracellular amino acid concentrations. For example, system B0,+ uses a Na+ gradient to drive amino acid uptake, and the Na+ concentration in uterine secretions increases by nearly two-fold about 18 h before implantation. The resultant mTOR signaling could trigger polyamine, insulin-like growth factor II, and nitric oxide production in blastocysts and the increased cell motility sometimes associated with synthesis of these bioactive molecules.  N. Ref:: 106

 

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[49]

TÍTULO / TITLE:  - Potassium channels in T lymphocytes: toxins to therapeutic immunosuppressants.

REVISTA / JOURNAL:  - Toxicon 2001 Sep;39(9):1269-76.

AUTORES / AUTHORS:  - George Chandy K; Cahalan M; Pennington M; Norton RS; Wulff H; Gutman GA

INSTITUCIÓN / INSTITUTION:  - Department of Physiology and Biophysics, University of California Irvine, Room 291, John Irvine Smith Hall, Medical School, Irvine, CA92697, USA. gchandy@uci.edu  N. Ref:: 60

 

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[50]

TÍTULO / TITLE:  - Targeted cancer therapy and immunosuppression using radiolabeled monoclonal antibodies.

REVISTA / JOURNAL:  - Semin Oncol 2004 Feb;31(1):68-82.

AUTORES / AUTHORS:  - Bethge WA; Sandmaier BM

INSTITUCIÓN / INSTITUTION:  - Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA.

RESUMEN / SUMMARY:  - Radioimmunotherapy (RIT) as a means to target radiation therapy to tumor cells or to specifically suppress host immunity specifically in the setting of allogeneic transplantation is a promising new strategy in the armory of today’s oncologist. Different approaches of RIT such as injection of a stable radioimmunoconjugate or the use of pretargeting are available. The choice of the radionuclide used for RIT depends on its radiation characteristics with respect to the malignancy or cells targeted. beta-Emitters with their lower energy and longer path length are more suitable for targeting bulky, solid tumors, whereas alpha-emitters with their high linear energy transfer and short path length are better suited to target cells or tumors of the hematologic system. Encouraging results have been obtained using these approaches treating patients with hematologic malignancies. While the results in solid tumors are somewhat less favorable, new strategies for patients with minimal residual disease (MRD), using adjuvant and locoregional treatment, are currently being investigated. In this report, we outline basic principles of RIT, give an overview of available radioimmunoconjugates and their clinical applications with special emphasis on their use in hematologic malignancies, including use in conditioning regimens for stem cell transplantation (SCT).  N. Ref:: 99

 

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[51]

TÍTULO / TITLE:  - TOR inhibitors and cardiac allograft vasculopathy: is inhibition of intimal thickening an adequate surrogate of benefit?

REVISTA / JOURNAL:  - J Heart Lung Transplant 2003 May;22(5):501-4.

AUTORES / AUTHORS:  - Mehra MR; Uber PA

INSTITUCIÓN / INSTITUTION:  - Cardiomyopathy and Heart Transplantation Center, Ochsner Clinic Foundation, New Orleans, Louisiana 70121, USA. mmehra@ochsner.org  N. Ref:: 30

 

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[52]

TÍTULO / TITLE:  - The TOR kinases link nutrient sensing to cell growth.

REVISTA / JOURNAL:  - J Biol Chem. Acceso gratuito al texto completo a partir de 1 año de la fecha de publicación.

      ●● Enlace a la Editora de la Revista http://www.jbc.org/ 

      ●● Cita: J. of Biological Chemistry: <> 2001 Mar 30;276(13):9583-6. Epub 2001 Feb 2.

      ●● Enlace al texto completo (gratuito o de pago) 1074/jbc.R000034200

AUTORES / AUTHORS:  - Rohde J; Heitman J; Cardenas ME

INSTITUCIÓN / INSTITUTION:  - Departments of Genetics, Howard Hughes Medical Institute, Duke University Medical Center, Durham, North Carolina 27710, USA.

RESUMEN / SUMMARY:  - Rapamycin is an immunosuppressive natural product that inhibits the proliferation of T-cells in response to nutrients and growth factors. Rapamycin binds to the peptidyl-prolyl isomerase FKBP12 and forms protein-drug complexes that inhibit signal transduction by the TOR kinases. The FKBP12 and TOR proteins are conserved from fungi to humans, and in both organisms the TOR signaling pathway plays a role in nutrient sensing. In response to nitrogen sources or amino acids, TOR regulates both transcription and translation, enabling cells to appropriately respond to growth-promoting signals. Rapamycin is having a profound impact on clinical medicine and was approved as an immunosuppressant for transplant recipients in 1999. Ongoing clinical studies address new clinical applications for rapamycin as an antiproliferative drug for chemotherapy and invasive cardiology.  N. Ref:: 74

 

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[53]

TÍTULO / TITLE:  - Transmitting the signal of excess nitrogen in Saccharomyces cerevisiae from the Tor proteins to the GATA factors: connecting the dots.

REVISTA / JOURNAL:  - FEMS Microbiol Rev 2002 Aug;26(3):223-38.

AUTORES / AUTHORS:  - Cooper TG

INSTITUCIÓN / INSTITUTION:  - Department of Molecular Sciences, University of Tennessee, 858 Madison Ave., Memphis, TN 38163, USA. tcooper@utmem.edu

RESUMEN / SUMMARY:  - Major advances have recently occurred in our understanding of GATA factor-mediated, nitrogen catabolite repression (NCR)-sensitive gene expression in Saccharomyces cerevisiae. Under nitrogen-rich conditions, the GATA family transcriptional activators, Gln3 and Gat1, form complexes with Ure2, and are localized to the cytoplasm, which decreases NCR-sensitive expression. Under nitrogen-limiting conditions, Gln3 and Gat1 are dephosphorylated, move from the cytoplasm to the nucleus, in wild-type but not rna1 and srp1 mutants, and increase expression of NCR-sensitive genes. ‘Induction’ of NCR-sensitive gene expression and dephosphorylation of Gln3 (and Ure2 in some laboratories) when cells are treated with rapamycin implicates the Tor1/2 signal transduction pathway in this regulation. Mks1 is posited to be a negative regulator of Ure2, positive regulator of retrograde gene expression and to be itself negatively regulated by Tap42. In addition to Tap42, phosphatases Sit4 and Pph3 are also argued by some to participate in the regulatory pathway. Although a treasure trove of information has recently become available, much remains unknown (and sometimes controversial) with respect to the precise biochemical functions and regulatory pathway connections of Tap42, Sit4, Pph3, Mks1 and Ure2, and how precisely Gln3 and Gat1 are prevented from entering the nucleus. The purpose of this review is to provide background information needed by students and investigators outside of the field to follow and evaluate the rapidly evolving literature in this exciting field.  N. Ref:: 61

 

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[54]

TÍTULO / TITLE:  - Interactions between cyclosporin and lipid-lowering drugs: implications for organ transplant recipients.

REVISTA / JOURNAL:  - Drugs 2003;63(4):367-78.

AUTORES / AUTHORS:  - Asberg A

INSTITUCIÓN / INSTITUTION:  - Laboratory for Renal Physiology, Section of Nephrology, Medical Department, The National Hospital, Oslo, Norway. anderas@klinmed.uio.no

RESUMEN / SUMMARY:  - Dyslipidaemia is more frequent in solid organ transplant recipients than in the general population, primarily as a result of immunosuppressive drug treatment. Both cyclosporin and corticosteroids are associated with dyslipidaemic adverse effects. In order to reduce the overall cardiovascular risk in these patients, lipid-lowering drugs have become widely used, especially HMG-CoA reductase inhibitors (statins). Cyclosporin, as well as most statins (lovastatin, simvastatin, atorvastatin and pravastatin) are metabolised by cytochrome P450 (CYP)3A4, so a bilateral pharmacokinetic interaction between these drugs is theoretically possible. However, results from several studies show that statins do not induce increased systemic exposure of cyclosporin. A small (but not clinically relevant) reduction in systemic exposure of cyclosporin has actually been shown in many studies. Cyclosporin-treated patients on the other hand show several-fold higher systemic exposure of all statins, both those that are metabolised by CYP3A4 and fluvastatin (metabolised by CYP2C9). Therefore, the mechanism for this interaction does not seem to be solely caused by inhibition of CYP3A4 metabolism, but it is probably also a result of inhibition of statin-transport in the liver, at least in part. Other lipid-lowering drugs, such as fibric acid derivatives, bile acid sequestrants, probucol, fish oils and orlistat are also used in solid organ transplant recipients. Most of them do not interact with cyclosporin, but there are reports indicating that both probucol and orlistat may reduce cyclosporin bioavailablility to a clinically relevant degree. There is no information on possible interaction effects of cyclosporin on the pharmacokinetics of lipid-lowering drugs other than statins, but it is not likely that any clinical relevant interference exists with fish oil, orlistat, probucol or bile acid sequestrants.  N. Ref:: 71

 

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[55]

TÍTULO / TITLE:  - European best practice guidelines for renal transplantation. Section IV: Long-term management of the transplant recipient. IV.3.1 Long-term immunosuppression. Late steroid or cyclosporine withdrawal.

REVISTA / JOURNAL:  - Nephrol Dial Transplant. Acceso gratuito al texto completo a partir de los 2 años de la fecha de publicación.

      ●● Enlace a la Editora de la Revista http://ndt.oupjournals.org/ 

      ●● Cita: Nephrology Dialysis Transplantation: <> 2002;17 Suppl 4:19-20.

RESUMEN / SUMMARY:  - GUIDELINES: A. In order to reduce or avoid long-term serious adverse effects of corticosteroids, such as bone fractures, diabetes mellitus, arterial hypertension, osteoporosis and eye complications, steroid withdrawal should be considered. B. Steroid withdrawal is safe only in a proportion of graft recipients and is recommended only in low-risk patients. The efficacy of the remaining immunosuppression should be considered. C. After steroid withdrawal, graft function has to be monitored very carefully because of the risk of a delayed but continuous loss of function due to chronic graft dysfunction. In the case of functional deterioration or dysfunction, steroids should be re-administered. D. Cyclosporine withdrawal might be considered in order to ameliorate nephrotoxicity, arterial hypertension, lipid disorders and hypertrichosis. This can be carried out with no significant long-term risk of progressive graft loss. The efficacy of the remaining immunosuppression should be considered. After cyclosporine withdrawal, careful monitoring for acute rejection is recommended.

 

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[56]

TÍTULO / TITLE:  - Fluorescence polarization detection for affinity capillary electrophoresis.

REVISTA / JOURNAL:  - Electrophoresis 2002 Mar;23(6):903-8.

      ●● Enlace al texto completo (gratuito o de pago) 1002/1522-2683(200203)23:6<903::AID-ELPS903>3.0.CO;2-2 [pii]

AUTORES / AUTHORS:  - Le XC; Wan QH; Lam MT

INSTITUCIÓN / INSTITUTION:  - Environmental Health Sciences Program, Department of Public Health Sciences, Faculty of Medicine, University of Alberta, Edmonton, Alberta T6G 2G3, Canada. xc.le@ualberta.ca

RESUMEN / SUMMARY:  - Affinity capillary electrophoresis (ACE) with laser-induced fluorescence polarization (LIFP) detection is described, with examples of affinity interaction studies. Because fluorescence polarization is sensitive to changes in the rotational motion arising from molecular association or dissociation, ACE-LIFP is capable of providing information on the formation of affinity complexes prior to or during CE separation. Unbound, small fluorescent probes generally have little fluorescence polarization because of rapid rotation of the molecule in solution. When the small fluorescent probe is bound to a larger affinity agent, such as an antibody, the fluorescence polarization (and anisotropy) increases due to slower motion of the much larger complex molecule in the solution. Fluorescence polarization results are obtained by simultaneously measuring fluorescence intensities of vertical and horizontal polarization planes. Applications of CE-LIFP to both strong and weak binding systems are discussed with antibody-antigen and DNA-protein binding as examples. For strong affinity binding, such as between cyclosporine and its antibody, complexes are formed prior to CE-LIFP analysis. For weaker binding, such as between single-stranded DNA and its binding protein, the single-stranded DNA binding protein is added to the CE separation buffer to enhance dynamic formation of affinity complexes. Both fluorescence polarization (and anisotropy) and mobility shift results are complementary and are useful for immunoassays and binding studies.  N. Ref:: 25

 

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[57]

TÍTULO / TITLE:  - A novel pathway regulating the mammalian target of rapamycin (mTOR) signaling.

REVISTA / JOURNAL:  - Biochem Pharmacol 2002 Oct 1;64(7):1071-7.

AUTORES / AUTHORS:  - Chen J; Fang Y

INSTITUCIÓN / INSTITUTION:  - Department of Cell and Structural Biology, University of Illinois at Urbana-Champaign, 601 South Goodwin Avenue, B107, Urbana, IL 61801, USA. jiechen@uiuc.edu

RESUMEN / SUMMARY:  - Originally discovered as an anti-fungal agent, the bacterial macrolide rapamycin is a potent immunosuppressant and a promising anti-cancer drug. In complex with its cellular receptor, the FK506-binding protein (FKBP12), rapamycin binds and inhibits the function of the mammalian target of rapamycin (mTOR). By mediating amino acid sufficiency, mTOR governs signaling to translational regulation and other cellular functions by converging with the phosphatidylinositol 3-kinase (PI3K) pathway on downstream effectors. Whether mTOR receives mitogenic signals in addition to nutrient-sensing has been an unresolved issue, and the mechanism of action of rapamycin remained unknown. Our recent findings have revealed a novel link between mitogenic signals and mTOR via the lipid second messenger phosphatidic acid (PA), and suggested a role for mTOR in the integration of nutrient and mitogen signals. A molecular mechanism for rapamycin inhibition of mTOR signaling is proposed, in which a putative interaction between PA and mTOR is abolished by rapamycin binding. Collective evidence further implicates the regulation of the rapamycin-sensitive signaling circuitry by phospholipase D, and potentially by other upstream regulators such as the conventional protein kinase C, the Rho and ARF families of small G proteins, and calcium ions. As the mTOR pathway has been demonstrated to be an important anti-cancer target, the identification of new components and novel regulatory modes in mTOR signaling will facilitate the future development of diagnostic and therapeutic strategies.  N. Ref:: 67

 

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[58]

TÍTULO / TITLE:  - ATP-binding cassette transporters and calcineurin inhibitors: potential clinical implications.

REVISTA / JOURNAL:  - Transplant Proc 2001 May;33(3):2420-1.

AUTORES / AUTHORS:  - van Gelder T; Klupp J; Sawamoto T; Christians U; Morris RE

INSTITUCIÓN / INSTITUTION:  - Department of Internal Medicine (T.vG.), University Hospital Rotterdam, Rotterdam, The Netherlands. vangelder@INW1.AZR.NL  N. Ref:: 17

 

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[59]

TÍTULO / TITLE:  - Recent developments in inflammatory bowel disease.

REVISTA / JOURNAL:  - Med Clin North Am 2002 Nov;86(6):1497-523.

AUTORES / AUTHORS:  - Su C; Lichtenstein GR

INSTITUCIÓN / INSTITUTION:  - Division of Gastroenterology, Department of Medicine, Hospital of the University of Pennsylvania, University of Pennsylvania School of Medicine, Third Floor Ravdin Building, 3400 Spruce Street, Philadelphia, PA 19104-4283, USA.

RESUMEN / SUMMARY:  - The evolving medical armamentarium holds promise for more precise and effective therapies for IBD. The experience with anti-TNF therapy, particularly infliximab, illustrates the potential efficacy of therapies targeted at specific mediators or pathways involved in the pathogenesis. Advances in molecular technology have enabled the development of novel and potentially effective targeted therapies. Equally important is the increasing scientific understanding of the pathogenesis of IBD, which will likely improve the ability to stratify disease and to select therapies based on genotypic, immunologic, and phenotypic profiles in the future.  N. Ref:: 191

 

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[60]

TÍTULO / TITLE:  - Neonatal toxic shock syndrome-like exanthematous disease (NTED).

REVISTA / JOURNAL:  - Pediatr Int 2003 Apr;45(2):233-7.

AUTORES / AUTHORS:  - Takahashi N

INSTITUCIÓN / INSTITUTION:  - Department of Pediatrics, Jichi Medical School, Tochigi-ken, Tokyo Women’s Medical University, Tokyo, Japan. naoto-t@jichi.ac.jp

RESUMEN / SUMMARY:  - The author and colleagues recently discovered an emerging neonatal infectious disease: neonatal toxic shock syndrome-like exanthematous disease (NTED), which is induced by the superantigen toxic shock syndrome toxin-1 (TSST-1), produced by methicillin-resistant Staphylococcus aureus (MRSA). The massively expanded Vbeta2+ T cells were rapidly deleted in the peripheral blood of patients with NTED. A marked depletion of Vbeta2+ T cells was also observed in the peripheral blood before the expansion of these T cells. Anergy is specifically induced in the TSST-1 reactive T cells of patients with NTED. Rapid recovery from NTED without complications is expected to be related to the induction of immunologic tolerance in neonatal patients. Anti-TSST-1 IgG antibody of maternal origin was found to play a protective role in preventing the development of NTED. The number of hospitals that have experience caring for patients with NTED has increased threefold in the past 5 years. Most MRSA isolates from neonatal intensive care units in Japan were found to be a single clone of coagulase type II and to possess TSST-1 and staphylococcal enterotoxin C genes. The timing and increased incidence of NTED suggest the emergence of a new MRSA clone. By recognizing that TSST-1 can induce NTED, healthcare providers may give increased attention to this disease in neonatal wards.  N. Ref:: 43

 

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[61]

TÍTULO / TITLE:  - Basiliximab: a review of its use as induction therapy in renal transplantation.

REVISTA / JOURNAL:  - Drugs 2003;63(24):2803-35.

AUTORES / AUTHORS:  - Chapman TM; Keating GM

INSTITUCIÓN / INSTITUTION:  - Adis International Limited, Auckland, New Zealand. demail@adis.co.nz

RESUMEN / SUMMARY:  - Basiliximab (Simulect), a chimeric (human/murine) monoclonal antibody, is indicated for the prevention of acute organ rejection in adult and paediatric renal transplant recipients in combination with other immunosuppressive agents.Basiliximab significantly reduced acute rejection compared with placebo in renal transplant recipients receiving dual- (cyclosporin microemulsion and corticosteroids) or triple-immunotherapy (azathioprine- or mycophenolate mofetil-based); graft and patient survival rates at 12 months were similar. Significantly more basiliximab than placebo recipients were free from the combined endpoint of death, graft loss or acute rejection 3 years, but not 5 years, after transplantation.The incidence of adverse events was similar in basiliximab and placebo recipients, with no increase in the incidence of infection, including cytomegalovirus (CMV) infection. Malignancies or post-transplant lymphoproliferative disorders after treatment with basiliximab were rare, with a similar incidence to that seen with placebo at 12 months or 5 years post-transplantation. Rare cases of hypersensitivity reactions to basiliximab have been reported.The efficacy of basiliximab was similar to that of equine antithymocyte globulin (ATG) and daclizumab, and similar to or greater than that of muromonab CD3. Basiliximab was as effective as rabbit antithymocyte globulin (RATG) in patients at relatively low risk of acute rejection, but less effective in high-risk patients. Numerically or significantly fewer patients receiving basiliximab experienced adverse events considered to be related to the study drug than ATG or RATG recipients. The incidence of infection, including CMV infection, was similar with basiliximab and ATG or RATG.Basiliximab plus baseline immunosuppression resulted in no significant differences in acute rejection rates compared with baseline immunosuppression with or without ATG or antilymphocyte globulin in retrospective analyses conducted for small numbers of paediatric patients. Limited data from paediatric renal transplant recipients suggest a similar tolerability profile to that in adults. Basiliximab appears to allow the withdrawal of corticosteroids or the use of corticosteroid-free or calcineurin inhibitor-sparing regimens in renal transplant recipients.Basiliximab did not increase the overall costs of therapy in pharmacoeconomic studies.CONCLUSION: Basiliximab reduces acute rejection without increasing the incidence of adverse events, including infection and malignancy, in renal transplant recipients when combined with standard dual- or triple-immunotherapy. The overall incidence of death, graft loss or acute rejection was significantly reduced at 3 years; there was no significant difference for this endpoint 5 years after transplantation. Malignancy was not increased at 5 years. The overall efficacy, tolerability, ease of administration and cost effectiveness of basiliximab make it an attractive option for the prophylaxis of acute renal transplant rejection.  N. Ref:: 85

 

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[62]

TÍTULO / TITLE:  - Pharmacokinetics of tacrolimus-based combination therapies.

REVISTA / JOURNAL:  - Nephrol Dial Transplant. Acceso gratuito al texto completo a partir de los 2 años de la fecha de publicación.

      ●● Enlace a la Editora de la Revista http://ndt.oupjournals.org/ 

      ●● Cita: Nephrology Dialysis Transplantation: <> 2003 May;18 Suppl 1:i12-5.

AUTORES / AUTHORS:  - Undre NA

INSTITUCIÓN / INSTITUTION:  - Fujisawa GmbH, Neumarkter Str. 61, D-81673 Munich, Germany. nas.undre@fujisawa.de

RESUMEN / SUMMARY:  - This paper reviews the pharmacokinetics of tacrolimus, with special reference to its combination with adjunctive immunosuppressants. Oral bioavailability of tacrolimus, which is variable between patients, averages approximately 25%. This is largely due to extrahepatic metabolism of tacrolimus in the gastrointestinal epithelium. Nevertheless, intra-patient variability is low, as evidenced by the small number of dose changes required to maintain patients within the recommended tacrolimus target levels. Tacrolimus is distributed extensively in the body with most partitioned outside the blood compartment. Concentrations of tacrolimus in blood are used as a surrogate marker of clinically relevant concentration of the drug at the site(s) of action. Convenient whole-blood sampling within a +/-2-h window around 12 h post-dose (C(min)) is highly predictive of systemic exposure to tacrolimus and is thus used to optimise therapy. Sampling at other time-points offers no advantage over C(min) monitoring. The interactions of tacrolimus with other immunosuppressive agents are well characterized. After cessation of concomitant corticosteroid treatment, exposure to tacrolimus increases by approximately 25%. In contrast, there is no pharmacokinetic interaction between mycophenolate mofetil (MMF) and tacrolimus. Therefore, systemic exposure to the active metabolite of MMF, mycophenolic acid, is higher with MMF-tacrolimus combination than with MMF-cyclosporin combination. Therefore, 1 g/day MMF may be an adequate maintenance dose in tacrolimus-based regimens. Co-administration of tacrolimus and sirolimus, while having no effect on exposure to sirolimus, results in reduced exposure to tacrolimus at sirolimus doses of 2 mg/day and above. In conclusion, tacrolimus levels should be monitored when sirolimus is co-administered at doses >2 mg/day and after cessation of corticosteroid treatment.  N. Ref:: 13

 

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[63]

- Castellano -

TÍTULO / TITLE:La enfermedad linfoproliferativa difusa postrasplante renal y su relacion con el virus Epstein-Barr. Experiencia de un centro. Diffuse lymphoproliferative disease after renal transplantation and its relation with Epstein-Barr virus. Experience at one center.

REVISTA / JOURNAL:  - Nefrologia. Acceso gratuito al texto completo.

      ●● Enlace a la Editora de la Revista http://www.aulamedica.es/nefrologia/ 

      ●● Cita: Nefrologia: <> 2002;22(5):463-9.

AUTORES / AUTHORS:  - Franco A; Jimenez L; Aranda I; Alvarez L; Gonzalez M; Rocamora N; Olivares J

INSTITUCIÓN / INSTITUTION:  - Servicio de Nefrologia Hospital General Alicante Maestro Alonso, 109 03010 Alicante. franco_ant@gva.es

RESUMEN / SUMMARY:  - Post-transplant lymphoproliferative disorders (PTLD) are a group of heterogeneous lymphoid proliferations in chronic immunosuppressed recipients which appear to be related to Epstein Barr Virus (EBV). Receptor EBV seronegativity, use of antilymphocyte antibodies and CMV disease have been identified as risk factors that may tigger development of PTLD. We have studied the incidence of PTLD and its relationship with EBV in 588 adult renal transplant recipients who were transplanted in our hospital from 1988 to 2001. We have also evaluated the diagnostic and therapeutic methods used, the risk factors and outcome of the patients who developed PTLD. We identified 8 recipients (4 males and 4 females), range from 18 to 67 years (mean age 45.6 years) with a median time between grafting and PTLD of 4.1 years (0.1-7 years), who developed PTLD (1.3%). Only 1 patient received OKT3 and had CMV disease, two of them (25%) had been treated with hight doses of prednisolone, another was EBV seronegative, but the rest of them (50%) had no risk factors. Two patients were diagnosed at autopsy, the diagnosis of 5 was based on the histology of biopsy and the last one by CT scans of chest-abdomen and cytology. The presence of EBV in the lymphoproliferative cells was assessed in 5 out of the 7 studied patients (71.4%). The outcome of our recipients was poor. Five out of 8 patients died shortly after diagnosis as a direct consecuence of PTLD and another of an infectious complication of the treatment (75%). The 2 patients alive started dialysis and 1 of them died 2 years later of a non-related cause. In conclusion, PTLD is a relatively frequent disease with a poor prognosis in renal transplant patients. It seems to have a close relationship with EBV and can develop in the absence of the classical risk factors.  N. Ref:: 18

 

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[64]

TÍTULO / TITLE:  - TOR action in mammalian cells and in Caenorhabditis elegans.

REVISTA / JOURNAL:  - Curr Top Microbiol Immunol 2004;279:115-38.

AUTORES / AUTHORS:  - Long X; Muller F; Avruch J

INSTITUCIÓN / INSTITUTION:  - Diabetes Research Laboratory, Department of Molecular Biology, Land Medicine Massachusetts General Hospital, Boston, MA 02114, USA.

RESUMEN / SUMMARY:  - The p70 S6 kinase (p70 S6K) was the first signaling element in mammalian cells shown to be inhibited by rapamycin. The activity of the p70 S6K in mammalian cell is upregulated by extracellular amino acids (especially leucine) and by signals from receptor tyrosine kinases (RTKs), primarily through activation of the type 1A PI-3 kinase. The amino acid-/rapamycin-sensitive input and the PI-3 kinase input are co-dominant but largely independent, in that deletion of the amino-terminal and carboxy-terminal noncatalytic sequences flanking the p70 S6K catalytic domain renders the kinase insensitive to inhibition by both rapamycin and by withdrawal of amino acids, whereas this p70 S6K mutant remains responsive to activation by RTKs and to inhibition by wortmannin. At a molecular level, this dual control of p70 S6K activity is attributable to phosphorylation of the two p70 S6K sites: The Ptd Ins 3,4,5P3-dependent kinasel (PDK1) phosphorylates p70 S6K at a Thr on the activation loop, whereas mTOR phosphorylates a Thr located in a hydrophobic motif carboxyterminal to the catalytic domain. Together these two phosphorylations engender a strong, positively cooperative activation of p70 S6K, so that each is indispensable for physiologic regulation. Like RTKs, the p70 S6K appears early in metazoan evolution and comes to represent an important site at which the more ancient, nutrient-responsive TOR pathway converges with the RTK/PI-3 kinase pathway in the control of cell growth. Dual regulation of p70 S6K is seen in Drosophila; however, this convergence is not yet evident in Caenorhabditis elegans, wherein nutrient activation of the insulin receptor (InsR) pathway negatively regulates dauer development and longevity, whereas the TOR pathway regulates overall mRNA translation through effectors distinct from p70 S6K, as in yeast. The C. elegans TOR and InsR pathways show none of the cross- or convergent regulation seen in mammalian cells. The nature of the elements that couple nutrient sufficiency to TOR activity remain to be discovered, and the mechanisms by which RTKs influence TOR activity in mammalian cells require further study. One pathway for RTK control involves the tuberous sclerosis complex, which is absent in C. elegans, but of major importance in Drosophila and higher metazoans.  N. Ref:: 98

 

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[65]

- Castellano -

TÍTULO / TITLE:Alteraciones del metabolismo oseo tras el trasplante renal. Bone metabolism alterations after kidney transplantation.

REVISTA / JOURNAL:  - Nefrologia. Acceso gratuito al texto completo.

      ●● Enlace a la Editora de la Revista http://www.aulamedica.es/nefrologia/ 

      ●● Cita: Nefrologia: <> 2003;23 Suppl 2:122-6.

AUTORES / AUTHORS:  - Torres A; Garcia S; Barrios Y; Hernandez D; Lorenzo V

INSTITUCIÓN / INSTITUTION:  - Servicio de Nefrologia, Unidad de Investigacion, Hospital Universitario de Canarias, Instituto Reina Sofia de Investigacion. atorres@ull.es

RESUMEN / SUMMARY:  - Early after renal transplantation (RT) a rapid decrease in bone mineral density at the lumbar spine, femoral neck, and femoral shaft has been documented. In addition, an appreciable proportion of patients still remain losing bone late after RT. As a consequence, RT patients are at a high risk of bone fractures as compared to general population. Most fractures involve appendicular skeleton, particularly the feet and ankles, and the diabetic patient is at increased risk of fractures. Thus, early institution of preventive measures and treatment of established osteoporosis are central. The major cause of post-transplantation bone loss is corticosteroid treatment, and this should be used at the lower dose compatible with graft survival. Preexisting hyperparathyroidism also affects the early cancellous bone loss at the spine, and post-transplantation bone loss reflects variable individual susceptibility, resembling the polygenic determination of bone mineral density in general. Clinical trials have demonstrated that bisphosphonates or vitamin D plus calcium supplementation, prevent post-transplantation bone loss during the first 6-12 months. However, their role in preventing bone fractures has not been proven. Finally, recommendations for management, prevention and treatment, are summarized.  N. Ref:: 24

 

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[66]

TÍTULO / TITLE:  - Efficacy and toxicity of a protocol using sirolimus, tacrolimus and daclizumab in a nonhuman primate renal allotransplant model.

REVISTA / JOURNAL:  - Am J Transplant 2002 Apr;2(4):381-5.

AUTORES / AUTHORS:  - Montgomery SP; Mog SR; Xu H; Tadaki DK; Hirshberg B; Berning JD; Leconte J; Harlan DM; Hale D; Kirk AD

INSTITUCIÓN / INSTITUTION:  - NIDDK/Navy Transplantation and Autoimmunity Branch, Naval Medical Research Center, Bethesda, Maryland 20892, USA.

RESUMEN / SUMMARY:  - A regimen combining sirolimus, tacrolimus, and daclizumab has recently been shown to provide adequate immunosuppression for allogeneic islet transplantation in humans, but remains unproven for primarily vascularized allografts. We evaluated this regimen for renal allograft transplantation in mismatched nonhuman primates. Dosages of sirolimus and tacrolimus were adjusted for trough levels of 10-15 ng/mL and 4-6 ng/mL, respectively. Treated monkeys (n = 5) had significantly prolonged allograft survival, with a mean survival of 36 days vs. 7 days in untreated controls (n = 6, p = 0.008). Four of five treated animals, but none of the controls, developed fibrinoid vascular necrosis of the small intestine. A review of gut histology from animals on other immunosuppressive protocols performed by our laboratory suggested that these lesions were a result of sirolimus exposure. In summary, this regimen prolongs the survival of vascularized renal allografts, but is limited by profound GI toxicity in rhesus macaques.

 

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[67]

TÍTULO / TITLE:  - Treatment responses of childhood aplastic anaemia with chromosomal aberrations at diagnosis.

REVISTA / JOURNAL:  - Br J Haematol 2002 Jul;118(1):313-9.

AUTORES / AUTHORS:  - Ohga S; Ohara A; Hibi S; Kojima S; Bessho F; Tsuchiya S; Ohshima Y; Yoshida N; Kashii Y; Nishimura S; Kawakami K; Nishikawa K; Tsukimoto I

INSTITUCIÓN / INSTITUTION:  - Aplastic Anaemia Committee of the Japanese Society of Paediatric Haematology, Tokyo, Japan. ohgas@pediatr.med.kyushu-u.ac.jp

RESUMEN / SUMMARY:  - The clinical outcome of childhood aplastic anaemia (AA) with aberrant cytogenetic clones at diagnosis was surveyed. Among 198 children with newly diagnosed AA registered with the AA Committee of the Japanese Society of Paediatric Hematology between 1994 and 1998, cytogenetic studies of bone marrow (BM) cells were completed in 159 patients. Apart from one Robertsonian translocation, seven patients (4.4%) showed clonal chromosomal abnormalities in hypoplastic BM without myelodysplastic features. The patients included six girls and one boy with a median age of 11 years (range 5-14 years). Six patients had del(6), del(5), del(13), del(20), or -7, and one showed add(9). Four patients responded to the first immunosuppressive therapy (IST: cyclosporin A plus anti-thymocyte globulin) and one obtained a spontaneous remission. Cytogenetic abnormalities remained in two patients with an IST response. On the other hand, two patients showed no IST response. One did not respond to repeat IST and died of acute graft-versus-host disease after an unrelated-BM transplant. Another obtained a complete response after a successful BM transplant. No haematological findings at diagnosis predicted the treatment response. No significant morphological changes developed during the course of the illness. A literature review revealed that half of 24 AA patients with chromosomal abnormalities responded to the first IST, and that +6 was the sole predictable marker for IST unresponsiveness. These results suggest that IST can be applied as the initial therapy for AA with cytogenetic abnormalities in the absence of completely matched donors.  N. Ref:: 32

 

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[68]

TÍTULO / TITLE:  - Treatment of membranous nephropathy.

REVISTA / JOURNAL:  - Nephrol Dial Transplant. Acceso gratuito al texto completo a partir de los 2 años de la fecha de publicación.

      ●● Enlace a la Editora de la Revista http://ndt.oupjournals.org/ 

      ●● Cita: Nephrology Dialysis Transplantation: <> 2001;16 Suppl 5:8-10.

AUTORES / AUTHORS:  - Ponticelli C; Passerini P

INSTITUCIÓN / INSTITUTION:  - Division of Nephrology, Ospedale Maggiore di Milano, Italy.

RESUMEN / SUMMARY:  - Several therapeutic approaches have been tried in patients with membranous nephropathy. Corticosteroids have been largely used, but a meta-analysis of the available controlled trials did not show any benefit of corticosteroids either in favouring remission of the nephrotic syndrome or in preventing renal dysfunction. Controversial results have been obtained with cytotoxic agents. Unfortunately, most of the available trials were small in size and had short-term follow-ups. Three controlled trials evaluated the role of a 6-month treatment with methylprednisolone and chlorambucil. The first trial showed that the 10-year renal survival rate was 92% in treated patients compared with 60% in untreated controls. A second trial compared the effects of methylprednisolone/chlorambucil with those of methylprednisolone alone. The combined treatment achieved remission of nephrotic syndrome in 64% of cases vs 38% in patients given steroids alone. A third trial showed equivalent results in patients randomized to be given methylprednisolone/chlorambucil or methylprednisolone/cyclophosphamide. A number of non-controlled studies and a randomized trial also showed the efficacy of cyclosporine in reducing proteinuria. In many but not all cases, proteinuria reappeared when cyclosporine was stopped. In conclusion, although the treatment of membranous nephropathy remains difficult, some therapeutical approaches have proved to favour remission and protect renal function  N. Ref:: 53

 

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[69]

TÍTULO / TITLE:  - Inhibitors of mammalian target of rapamycin as novel antitumor agents: from bench to clinic.

REVISTA / JOURNAL:  - Curr Opin Investig Drugs 2002 Feb;3(2):295-304.

AUTORES / AUTHORS:  - Huang S; Houghton PJ

INSTITUCIÓN / INSTITUTION:  - Department of Molecular Pharmacology, St Jude Children’s Research Hospital, Memphis, TN 38105-2794, USA.

RESUMEN / SUMMARY:  - Rapamycin and its derivatives, CCI-779 and RAD-001, inhibit the mammalian target of rapamycin (mTOR), downregulating translation of specific mRNAs required for cell cycle progression from G1 to S phase. Preclinically, mTOR inhibitors potently suppress growth and proliferation of numerous tumor cell lines in culture or when grown in mice as xenografts. CCI-779 and RAD-001 are being developed as antitumor drugs and are undergoing clinical trials. Clinically, CCI-779 has shown evidence of antitumor activity but induced relatively mild side effects in patients. Here we discuss potential antitumor mechanisms and resistance mechanisms of mTOR inhibitors, and summarize the current status of these compounds as novel antitumor agents.  N. Ref:: 90

 

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[70]

TÍTULO / TITLE:  - Regulation of translation via TOR signaling: insights from Drosophila melanogaster.

REVISTA / JOURNAL:  - J Nutr. Acceso gratuito al texto completo a partir de 1 año de la fecha de publicación.

      ●● Enlace a la Editora de la Revista http://www.nutrition.org/ 

      ●● Cita: Journal of Nutrition: <> 2001 Nov;131(11):2988S-93S.

AUTORES / AUTHORS:  - Miron M; Sonenberg N

INSTITUCIÓN / INSTITUTION:  - Department of Biochemistry and McGill Cancer Center, McGill University, Montreal, Quebec, Canada.

RESUMEN / SUMMARY:  - The target of rapamycin (TOR) proteins are large protein kinases evolutionarily conserved from yeast to human. A large body of evidence demonstrates that TOR proteins function in a nutrient-sensing checkpoint whose role is to restrict growth under conditions of low nutrient availability. Under such conditions, TOR blocks the transmission of growth-promoting signals from extracellular stimuli. Recent data obtained by genetic studies in the fruit fly Drosophila melanogaster demonstrate the importance of both insulin-like signaling and TOR signaling in promoting growth. Importantly, these studies identified a major downstream target of TOR and insulin-like signaling as the translational machinery.  N. Ref:: 63

 

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[71]

TÍTULO / TITLE:  - Mitochondrial involvement in the point of no return in neuronal apoptosis.

REVISTA / JOURNAL:  - Biochimie 2002 Feb-Mar;84(2-3):223-31.

AUTORES / AUTHORS:  - Chang LK; Putcha GV; Deshmukh M; Johnson EM Jr

INSTITUCIÓN / INSTITUTION:  - Department of Neurology, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8103, St. Louis, MO 63110-1031, USA.

RESUMEN / SUMMARY:  - Programmed cell death (PCD) contributes to development, maintenance, and pathology in various tissues, including the nervous system. Many molecular, biochemical, and genetic events occur within cells undergoing PCD. Some of these events are incompatible with long-term cell survival because they have irreversible, catastrophic consequences. The onset of such changes marks the point of no return, a decisive regulatory event termed ‘the commitment-to-die.’ In this review, we discuss events that underlie the commitment-to-die in nerve growth factor-deprivation-induced death of sympathetic neurons. Findings in this model system implicate the mitochondrion as an important site of regulation for the commitment-to-die in the presence or absence of caspase inhibition.  N. Ref:: 57

 

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[72]

TÍTULO / TITLE:  - T-cell receptor-derived peptides in immunoregulation and therapy of retrovirally induced immunosuppression.

REVISTA / JOURNAL:  - Crit Rev Immunol 2001;21(1-3):57-74.

AUTORES / AUTHORS:  - Marchalonis JJ; Robey IF; Edmundson AB; Sepulveda RT; Watson RR

INSTITUCIÓN / INSTITUTION:  - Microbiology and Immunology, College of Medicine, University of Arizona, Tucson 85724, USA. dianah@u.arizona.edu

RESUMEN / SUMMARY:  - Retrovirally infected humans and mice showed progressive acquired immunodeficiency accompanied by the production of elevated levels of autoantibodies directed against T-cell receptor variable-domain epitopes. Epitope mapping analyses indicated that a major determinant recognized was defined by a 16-mer peptide containing the entire CDR1 segment and part of the FR2 region of human Vbeta8, and that both species showed reactivity to the same sequence. Either prophylactic or therapeutic administration of this peptide to retrovirus-infected C57/BL/6 mice normalized the balance of T(H)1- and T(H)2-type helper activity and restored the resistance to infection by the opportunistic parasite Cryptosporidium. Administration of the peptide did not generate significantly increased levels of autoantibody, but had a profound effect on T-cell activity as well as other aspects of inflammation, including NK-cell activity. A 16-mer derived from the Jbeta sequence showed similar functional effects on T cells from retrovirus-infected mice. Direct binding of the VbetaCDR1 peptide to recombinant TCR Valpha/Vbeta constructs, as well as to IgM natural autoantibodies, suggests that the cell surface receptor for the peptide is the alpha/beta TCR on T cells and surface IgM in B cells. The Vbeta CDR1 peptide stimulated division of murine splenocytes in vitro, stimulated the production of the T(H)1 cytokine IL-2, and synergized with the T-cell mitogen concanavalin A in proliferation and IL-2 production. These studies indicate that administration of peptides derived from T-cell receptor variable domains to animals immunosuppressed as a result of retroviral infection has a profound immunomodulatory effect enhancing overall T-cell functional capacity, particularly with respect to the cytokine production characteristic of T(H)1-type cells. Our studies are interpreted in the context of other recent investigations of immunomodulatory peptides.  N. Ref:: 69

 

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[73]

TÍTULO / TITLE:  - P-glycoprotein in acute myeloid leukaemia: therapeutic implications of its association with both a multidrug-resistant and an apoptosis-resistant phenotype.

REVISTA / JOURNAL:  - Leuk Lymphoma 2002 Jun;43(6):1221-8.

AUTORES / AUTHORS:  - Pallis M; Turzanski J; Higashi Y; Russell N

INSTITUCIÓN / INSTITUTION:  - Academic Haematology, Nottingham City Hospital, Nottingham, UK. monica.pallis@nottingham.ac.uk

RESUMEN / SUMMARY:  - P-glycoprotein (Pgp) expression is an independent prognostic factor for response to remission-induction chemotherapy in acute myeloblastic leukaemia, particularly in the elderly. There are several potential agents for modulating Pgp-mediated multi-drug resistance, such as cyclosporin A and PSC833, which are currently being evaluated in clinical trials. An alternative therapeutic strategy is to increase the use of drugs which are unaffected by Pgp. However, in this review, we explain why this may be more difficult than it appears. Evidence from in vitro studies of primary AML blasts supports the commonly held supposition that chemoresistance may be linked to apoptosis-resistance. We have found that Pgp has a drug-independent role in the inhibition of in vitro apoptosis in AML blasts. Modulation of cytokine efflux, signalling lipids and intracellular pH have all been suggested as ways by which Pgp may affect cellular resistance to apoptosis; these are discussed in this review. For a chemosensitising agent to be successful, it may be more important for it to enhance apoptosis than to increase drug uptake.  N. Ref:: 95

 

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[74]

TÍTULO / TITLE:  - The potential of antibody-based immunosuppressive agents for corneal transplantation.

REVISTA / JOURNAL:  - Immunol Cell Biol 2003 Apr;81(2):93-105.

AUTORES / AUTHORS:  - Thiel MA; Coster DJ; Williams KA

INSTITUCIÓN / INSTITUTION:  - Department of Ophthalmology, Flinders University of South Australia, Adelaide, Australia.

RESUMEN / SUMMARY:  - Corneal transplantation is a sight-restorative procedure but its success is limited by irreversible graft rejection, which accounts for up to 50 per cent of failures. The normal eye is an immune-privileged site. Multiple mechanisms maintain ocular privilege, including the blood-eye barrier, the lack of blood vessels and lymphatics in the normal cornea, the relative paucity of mature antigen-presenting cells in the central cornea, the presence of immunomodulatory factors in ocular fluids, and the constitutive expressive of CD95L (Fas ligand) within the eye. However, privilege can be eroded by the sequelae of inflammation and neovascularization. Corneal graft rejection in humans is currently suppressed with topical glucocorticosteroids, which are moderately effective. Systemically administered immunosuppressive therapy is of limited efficacy and may be accompanied by unacceptable morbidity. Alternative therapies are needed to improve outcomes. Corneal graft rejection is primarily a cell-mediated response controlled by the CD4+ T cell, and thus CD4 and costimulatory molecule blockade are appealing targets for new therapeutic interventions. A number of monoclonal antibodies have shown promise as immunosuppressants to prolong corneal graft survival in experimental animal models, and may eventually prove to be useful adjuncts to corticosteroids.  N. Ref:: 205

 

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[75]

TÍTULO / TITLE:  - Old and new tools to dissect calcineurin’s role in pressure-overload cardiac hypertrophy.

REVISTA / JOURNAL:  - Cardiovasc Res 2002 Feb 1;53(2):294-303.

AUTORES / AUTHORS:  - Zhang W

INSTITUCIÓN / INSTITUTION:  - Department of Internal Medicine/Hypertension Division, The University of Texas Southwestern Medical Center at Dallas, Dallas, TX 75390-8586, USA. wzhang@mednet.swmed.edu

RESUMEN / SUMMARY:  - In the last several years, a number of experiments have implicated a pivotal role of the calcium/calmodulin-calcineurin dependent pathway as a final common signaling mechanism by which diverse hypertrophic stimuli converge to mediate hypertrophic responses in cardiomyocytes. Calcineurin inhibitors, i.e. cyclosporine A (CsA) and FK506, can interrupt the pathway, thereby preventing cardiac hypertrophy. The data that convincingly support this novel hypothesis were derived either from in vitro studies in cultured cardiomyocytes or from in vivo studies in transgenic mice. However, when the hypothesis was tested in clinically relevant animal models of cardiac hypertrophy, controversial results and conclusions emerged. In conventional models of cardiac hypertrophy, two questions remain to be answered: (1) whether calcineurin is activated in hypertrophied cardiac muscle, and (2) whether calcineurin inhibitors prevent cardiac hypertrophy. In addition, clinical observations have revealed that calcineurin inhibitors appear to exert pro-hypertrophic effects in organ transplant recipients. The controversies suggest that current calcineurin inhibitors are blunt tools for testing the hypothesis in pressure-overload hypertrophy in vivo, because there are so many confounding effects that are associated with systemic administration of the drugs. As such, new genetic approaches may overcome some of the problems associated with pharmacological inhibitors. This invited review will focus on the controversies surrounding the ability of calcineurin inhibition to prevent conventional (pressure-overload) cardiac hypertrophy and the new genetic approaches to address the question.  N. Ref:: 93

 

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[76]

TÍTULO / TITLE:  - Regulation of glycogen synthesis in human muscle cells.

REVISTA / JOURNAL:  - Biochem Soc Trans. Acceso gratuito al texto completo a partir de 1 año de la fecha de publicación.

      ●● Enlace a la Editora de la Revista http://bst.portlandpress.com/bst//default.htm 

      ●● Cita: Biochemical Society Transactions: <> 2001 Aug;29(Pt 4):537-41.

AUTORES / AUTHORS:  - Yeaman SJ; Armstrong JL; Bonavaud SM; Poinasamy D; Pickersgill L; Halse R

INSTITUCIÓN / INSTITUTION:  - School of Biochemistry and Genetics, Medical School, University of Newcastle, Newcastle upon Tyne NE2 4HH, UK. s.j.yeaman@ncl.ac.uk

RESUMEN / SUMMARY:  - Glucose uptake into muscle and its subsequent storage as glycogen is a crucial factor in energy homeostasis in skeletal muscle. This process is stimulated acutely by insulin and is impaired in both insulin-resistant states and in type 2 diabetes mellitus. A signalling pathway involving protein kinase B and glycogen synthase kinase 3 seems certain to have a key role in stimulating glycogen synthesis but other signalling pathways also contribute, including a rapamycin-sensitive pathway stimulated by amino acids. Although glycogen synthesis is one of the classical insulin-regulated pathways, it is also regulated in an insulin-independent manner; for example glycogen synthesis in muscle is stimulated significantly after strenuous exercise, with much of this stimulation being independent of the involvement of insulin. Evidence suggests that glucose and the glycogen content of the muscle have a key role in this stimulation but the molecular mechanism has yet to be fully explained.  N. Ref:: 24

 

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[77]

TÍTULO / TITLE:  - Immunophilins in nervous system degeneration and regeneration.

REVISTA / JOURNAL:  - Curr Top Med Chem 2003;3(12):1376-82.

AUTORES / AUTHORS:  - Avramut M; Achim CL

INSTITUCIÓN / INSTITUTION:  - Department of Pathology, School of Medicine, University of Pittsburgh, S-433 Biomedical Science Tower, 200 Lothrop Street, Pittsburgh, PA 15213, USA. avramut@pitt.edu

RESUMEN / SUMMARY:  - Immunophilins are receptors for immunosuppressive drugs like cyclosporin A, FK506, rapamycin and their non- immunosuppressive analogs, which are collectively referred to as “immunophilin ligands” (IPL). Cyclosporin A binds to a class of IP called cyclophilins, whereas the receptors for FK506 and rapamycin belong to the family of FK506- binding proteins (FKBP). The latter are designated according to their molecular weight: FKBP12, 25, 52 etc. FKBP levels in the rat brain are up to 50 times higher than in the immune system. FKBP12 is associated with IP3 and ryanodine receptors present on the endoplasmic reticulum and plays a role in stabilizing calcium release. It has also been proposed to be a modulator of the TGFbeta receptor activity. Crush injury of facial or sciatic nerves in rat leads to markedly increased FKBP12 levels in the respective nerve nuclei and this increase is related to nerve regeneration. Cyclophilin A protects cells from death following expression of mutant Cu/ Zn superoxide dismutase, which is associated with familial amyotrophic lateral sclerosis. Our recent studies show that FKBP12 and FKBP52 are expressed in the human nervous system, especially in the substantia nigra- deep gray matter axis. In neurodegenerative diseases, FKBP12 levels increase in neurons situated in areas of pathology. This IP colocalizes with synaptophysin and alpha- synuclein, suggesting that it may become a novel marker of pathology. Immunophilins participate in axonal transport, synaptic vesicle assembly and may play a role in neuroprotection against abnormal protein aggregation, suggesting a potential avenue of therapeutic interventions.  N. Ref:: 62

 

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[78]

TÍTULO / TITLE:  - Treatment of atopic dermatitis and impact on quality of life: a review with emphasis on topical non-corticosteroids.

REVISTA / JOURNAL:  - Pharmacoeconomics 2003;21(3):159-79.

AUTORES / AUTHORS:  - Schiffner R; Schiffner-Rohe J; Landthaler M; Stolz W

INSTITUCIÓN / INSTITUTION:  - Department of Dermatology, University of Regensburg, Regensburg, Germany. jr.schiffner@t-online.de

RESUMEN / SUMMARY:  - Atopic dermatitis (AD) is a chronic skin disease with increasing prevalence and rising costs. Stigmatisation and pruritus are only some aspects of potential quality-of-life (QOL) impairments. AD is not curable and repeated treatments are often necessary. At present, treatment with topically-applied corticosteroids is state-of-the-art for mild to moderate flare-ups. However, many patients are worried about the use of corticosteroids due to the widespread fear of adverse effects. In this review the present literature is analysed concerning impact on quality of life for topically-applicable alternatives to the state-of-the-art treatment. For comparison reasons, data from other treatment modalities are additionally given. Characteristics of studies were analysed using ‘general’ (year and mode of publication, type and aim of study, number of patients, and clinical measurement) and ‘QOL specific’ criteria (type and number of QOL measurements including relevance for study aim and age group, validation in used language, sensitivity to change, and improvement at end of study). QOL data are published only in the minority of studies evaluating treatment efficacy and do not cover the variety of possible therapies. Data are available for tacrolimus, pimecrolimus, UVA/UVB combination and UVB narrowband (topical non-corticosteroidal treatments), as well as for topical corticosteroids, cyclosporin, and inpatient treatment. All studies provided a marked improvement in quality of life after therapy. One study assessed quality of life after a treatment-free follow-up period obtaining a clear increase in impact on quality of life. Since studies used different QOL measurements and vary in inclusion criteria, treatment schedules and presentation of results, a comparison of QOL improvement is not recommended. A single randomised study compared topically applied non-corticosteroidal treatment (UVA/UVB combination) with another treatment modality (cyclosporin) and found no difference in QOL improvement. At present, there is a clear lack of controlled randomised studies evaluating different active treatment modalities and their impact on quality of life. Consensus meetings are desirable to formulate guidelines for the selection and correct use of QOL measurements. Patients’ fear of side effects (e.g. concerning corticosteroids) should be integrated in QOL questionnaires for evaluation of possible compliance problems and real costs. Since relapse after treatment is frequent in AD, QOL measurements should also be performed after a treatment-free follow-up period. At present, we can not answer the question ‘which treatment best improves quality of life in AD?’.  N. Ref:: 128

 

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[79]

TÍTULO / TITLE:  - St John’s Wort supplements endanger the success of organ transplantation.

REVISTA / JOURNAL:  - Arch Surg 2002 Mar;137(3):316-9.

AUTORES / AUTHORS:  - Ernst E

INSTITUCIÓN / INSTITUTION:  - Department of Complementary Medicine, School of Sport and Health Sciences, University of Exeter, 25 Victoria Park Rd, Exeter EX2 4NT, England. E.Ernst@ex.ac.uk

RESUMEN / SUMMARY:  - HYPOTHESIS: St John’s wort is one of the most popular herbal medicines, and health care professionals often are unaware that their patients take such supplements. St John’s wort causes a decrease in cyclosporine levels, thus endangering the success of organ transplantations. DESIGN: Systematic review. METHODS: Five independent computerized literature searches were conducted to identify all reports of such interactions. Data were extracted and are summarized in narrative form. RESULTS: Eleven case reports and 2 case series were located. In most instances, causality between St John’s wort and the clinical or biochemical result is well established. The mechanism of interaction between St John’s wort and cyclosporine has been recently elucidated and involves both P-glycoprotein and cytochrome P 450 3A4 expression. Collectively these data leave little doubt that St John’s wort interacts with cyclosporine, causing a decrease of cyclosporine blood levels and leading in several cases to transplant rejection. CONCLUSIONS: St John’s wort can endanger the success of organ transplantations. Adequate information may be the best way to avoid future incidences.  N. Ref:: 33

 

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[80]

TÍTULO / TITLE:  - Engineered CD3 antibodies for immunosuppression.

REVISTA / JOURNAL:  - Clin Exp Immunol 2003 Sep;133(3):307-9.

AUTORES / AUTHORS:  - Renders L; Valerius T  N. Ref:: 30

 

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[81]

TÍTULO / TITLE:  - St John’s wort (Hypericum perforatum): drug interactions and clinical outcomes.

REVISTA / JOURNAL:  - Br J Clin Pharmacol 2002 Oct;54(4):349-56.

AUTORES / AUTHORS:  - Henderson L; Yue QY; Bergquist C; Gerden B; Arlett P

INSTITUCIÓN / INSTITUTION:  - Pharmacovigilance Group, Medicines Control Agency, UK. leigh.henderson@mca.gsi.gov.uk

RESUMEN / SUMMARY:  - AIMS: The aim of this work is to identify the medicines which interact with the herbal remedy St John’s wort (SJW), and the mechanisms responsible. METHODS: A systematic review of all the available evidence, including worldwide published literature and spontaneous case reports provided by healthcare professionals and regulatory authorities within Europe has been undertaken. RESULTS: A number of clinically significant interactions have been identified with prescribed medicines including warfarin, phenprocoumon, cyclosporin, HIV protease inhibitors, theophylline, digoxin and oral contraceptives resulting in a decrease in concentration or effect of the medicines. These interactions are probably due to the induction of cytochrome P450 isoenzymes CYP3A4, CYP2C9, CYP1A2 and the transport protein P-glycoprotein by constituent(s) in SJW. The degree of induction is unpredictable due to factors such as the variable quality and quantity of constituent(s) in SJW preparations. In addition, possible pharmacodynamic interactions with selective serotonin re-uptake inhibitors and serotonin (5-HT(1d)) receptor-agonists such as triptans used to treat migraine were identified. These interactions are associated with an increased risk of adverse reactions. CONCLUSIONS: In Sweden and the UK the potential risks to patients were judged to be significant and therefore information about the interactions was provided to health care professionals and patients. The product information of the licensed medicines involved has been amended to reflect these newly identified interactions and SJW preparations have been voluntarily labelled with appropriate warnings.  N. Ref:: 44

 

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[82]

TÍTULO / TITLE:  - Calcineurin phosphatase in signal transduction: lessons from fission yeast.

REVISTA / JOURNAL:  - Genes Cells 2002 Jul;7(7):619-27.

AUTORES / AUTHORS:  - Sugiura R; Sio SO; Shuntoh H; Kuno T

INSTITUCIÓN / INSTITUTION:  - Division of Molecular Pharmacology and Pharmacogenomics, Department of Genome Sciences, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan.

RESUMEN / SUMMARY:  - Calcineurin (protein phosphatase 2B), the only serine/threonine phosphatase under the control of Ca2+/calmodulin, is an important mediator in signal transmission, connecting the Ca2+-dependent signalling to a wide variety of cellular responses. Furthermore, calcineurin is specifically inhibited by the immunosuppressant drugs cyclosporin A and tacrolimus (FK506), and these drugs have been a powerful tool for identifying many of the roles of calcineurin. Calcineurin is enriched in the neural tissues, and also distributes broadly in other tissues. The structure of the protein is highly conserved from yeast to man. The combined use of powerful genetics and of specific calcineurin inhibitors in fission yeast Schizosaccharomyces pombe (S. pombe) identified new components of the calcineurin pathway, and defined new roles of calcineurin in the regulation of the many cellular processes. Recent data has revealed functional interactions in which calcineurin phosphatase is involved, such as the cross-talk between the Pmk1 MAP kinase signalling, or the PI signalling. Calcineurin also participates in membrane traffic and cytokinesis of fission yeast through its functional connection with members of the small GTPase Rab/Ypt family, and Type II myosin, respectively. These findings highlight the potential of fission yeast genetic studies to elucidate conserved elements of signal transduction cascades.  N. Ref:: 51

 

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[83]

TÍTULO / TITLE:  - FTY720: targeting G-protein-coupled receptors for sphingosine 1-phosphate in transplantation and autoimmunity.

REVISTA / JOURNAL:  - Curr Opin Immunol 2002 Oct;14(5):569-75.

AUTORES / AUTHORS:  - Brinkmann V; Lynch KR

INSTITUCIÓN / INSTITUTION:  - Novartis Pharma AG Transplantation Research WSJ-386.101, CH-4002 Basel, Switzerland. volker.brinkmann@pharma.novartis.com

RESUMEN / SUMMARY:  - The novel immunomodulator FTY720 is remarkably effective in models of transplantation and autoimmunity. Recent data show that phosphorylated FTY720 is an agonist at four sphingosine 1-phosphate receptors. Stimulation of sphingosine 1-phosphate receptors leads to sequestration of lymphocytes in secondary lymphatic tissues and thus away from inflammatory lesions and graft sites.  N. Ref:: 44

 

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[84]

TÍTULO / TITLE:  - The mucosa of the small intestine: how clinically relevant as an organ of drug metabolism?

REVISTA / JOURNAL:  - Clin Pharmacokinet 2002;41(4):235-53.

AUTORES / AUTHORS:  - Doherty MM; Charman WN

INSTITUCIÓN / INSTITUTION:  - Department of Pharmaceutics, Victorian College of Pharmacy, Monash University, 381 Royal Parade, Parkville, Victoria 3052, Australia. margaret.doherty@vcp.monash.edu.au

RESUMEN / SUMMARY:  - The intestinal mucosa is capable of metabolising drugs via phase I and II reactions. Increasingly, as a result of in vitro and in vivo (animal and human) data, the intestinal mucosa is being implicated as a major metabolic organ for some drugs. This has been supported by clinical studies of orally administered drugs (well-known examples include cyclosporin, midazolam, nifedipine and tacrolimus) where intestinal drug metabolism has significantly reduced oral bioavailability. This review discusses the intestinal properties and processes that contribute to drug metabolism. An understanding of the interplay between the processes controlling absorption, metabolism and P-glycoprotein-mediated efflux from the intestinal mucosa into the intestinal lumen facilitates determination of the extent of the intestinal contribution to first-pass metabolism. The clinical relevance of intestinal metabolism, however, depends on the relative importance of the metabolic pathway involved, the therapeutic index of the drug and the inherent inter- and intra-individual variability. This variability can stem from genetic (metabolising enzyme polymorphisms) and/or non-genetic (including concomitant drug and food intake, route of administration) sources. An overwhelming proportion of clinically relevant drug interactions where the intestine has been implicated as a major contributor to first-pass metabolism involve drugs that undergo cytochrome P450 (CYP) 3A4-mediated biotransformation and are substrates for the efflux transporter P-glycoprotein. Much work is yet to be done in characterising the clinical impact of other enzyme systems on drug therapy. In order to achieve this, the first-pass contributions of the intestine and liver must be successfully decoupled.  N. Ref:: 130

 

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[85]

TÍTULO / TITLE:  - Transplantation: toxicokinetics and mechanisms of toxicity of cyclosporine and macrolides.

REVISTA / JOURNAL:  - Curr Opin Investig Drugs 2003 Nov;4(11):1287-96.

AUTORES / AUTHORS:  - Serkova N; Christians U

INSTITUCIÓN / INSTITUTION:  - Department of Anesthesiology, Clinical Research & Development, University of Colorado Health Sciences Center, 4200 East Ninth Ave, Room UH-2122, Campus Box B113, Denver, CO 80262, USA.

RESUMEN / SUMMARY:  - For over two decades, calcineurin inhibitors (CIs) have been the mainstay of immunosuppressive therapy following solid-organ transplantation. However, CI nephrotoxicity is one of the main contributors to chronic kidney allograft dysfunction. A novel class of immunosuppressants that inhibit the kinase mammalian target of rapamycin (mTOR), although not nephrotoxic themselves, enhance CI nephrotoxicity. The biochemical basis of CI toxicity and their toxicodynamic interaction with mTOR inhibitors is still poorly understood. Studies using a magnetic resonance spectroscopy-based metabonomic approach indicate that CI toxicity is caused by drug-induced mitochondrial dysfunction and that mTOR inhibitors enhance the negative effects of CIs on cell energy metabolism.  N. Ref:: 77

 

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[86]

TÍTULO / TITLE:  - Risk factors for and management of post-transplantation cardiovascular disease.

REVISTA / JOURNAL:  - BioDrugs 2001;15(4):261-78.

AUTORES / AUTHORS:  - Fellstrom B

INSTITUCIÓN / INSTITUTION:  - Department of Medical Sciences, University Hospital, SE-751 85 Uppsala, Sweden. bengt.fellstrom@medsci.uu.se

RESUMEN / SUMMARY:  - The mortality rates due to cardiovascular disease (CVD) in transplant recipients are greater than in the general population. CVD is a major cause of both graft loss and patient death in renal transplant recipients, and improving cardiovascular health in transplant recipients will presumably help to extend both patient and graft survival. Further studies are needed to better evaluate the effectiveness of risk modification on subsequent CVD morbidity and mortality. There is no reason to consider risk factors for CVD such as hyperlipidaemia, hypertension and diabetes mellitus in transplant recipients differently from in the general population. In addition, there are specific transplantation risk factors such as acute rejection episodes and the use of immunosuppressive drugs. It is obvious that several of the immunosuppressive agents used today have disadvantageous influences on risk factors for CVD such as hyperlipidaemia, hypertension and post-transplantation diabetes mellitus (PTDM), but the relative importance of immunosuppressant-induced increases in these risk factors is basically unknown. This may be a strong argument for the selective use and individual tailoring of immunosuppressive agents based upon the risk factor profile of the patient, without jeopardising the function of the graft. Hyperlipidaemia is common after transplantation, and immunosuppression with corticosteroids, cyclosporin, or sirolimus (rapamycin) causes different types of post-transplantation hyperlipidaemia. However, to date, no studies have demonstrated that lipid lowering strategies significantly reduce CVD morbidity or mortality and improve allograft survival in transplant recipients. Several studies using preventive or interventional approaches are ongoing and will be reported in the near future. Post-transplantation hypertension appears to be a major risk factor determining graft and patient survival, and immunosuppressive agents have different effects on hypertension. Controlled studies support the opinion that post-transplantation hypertension must be treated as strictly as in a population with essential hypertension, diabetes mellitus, or chronic renal failure. As increasing numbers of immunosuppressive agents become available for use, we may be in a better position to tailor immunosuppressive therapy to the individual patient, avoiding the use of diabetogenic drugs, drug combinations, or inappropriate doses in patients susceptible to PTDM. Multiple acute rejection episodes have also been demonstrated to be a risk factor for CVD - a strong argument for the use of immunosuppressive drugs to reduce acute rejection. Until we have a better understanding from ongoing landmark studies on the management of CVD, presently available therapy to reduce risk factors needs to be used together with individual tailoring of immunosuppressive therapy with the aim of reducing CVD in these patients.  N. Ref:: 138

 

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[87]

TÍTULO / TITLE:  - The role of phosphatases in TOR signaling in yeast.

REVISTA / JOURNAL:  - Curr Top Microbiol Immunol 2004;279:19-38.

AUTORES / AUTHORS:  - Duvel K; Broach JR

INSTITUCIÓN / INSTITUTION:  - Department of Molecular Biology, Princeton University, Princeton, NJ 08544, USA.

RESUMEN / SUMMARY:  - The TOR pathway controls cellular functions necessary for cell growth and proliferation of yeast and larger eukaryotes. The search for members of the TOR signaling cascade in yeast led to the discovery of type 2A protein phosphatases (PP2A) as important players within the pathway. We describe the roles in yeast of PP2A and the closely related phosphatase, Sit4, and then focus on complexes formed between the catalytic subunit of these phosphatases and Tap42, a direct target of the Tor protein kinases in yeast. Recent results suggest that Tap42 mediates many of the Tor functions in yeast, especially those involved in transcriptional modulation. However, whether Tap42 executes its function by inhibiting phosphatase activity or by activating phosphatases is still uncertain. In addition, Tor affects some transcriptional and physiological processes through Tap42 independent pathways. Thus, Tor proteins use multiple mechanisms to regulate transcriptional and physiological processes in yeast.  N. Ref:: 46

 

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[88]

TÍTULO / TITLE:  - Raptor and mTOR: subunits of a nutrient-sensitive complex.

REVISTA / JOURNAL:  - Curr Top Microbiol Immunol 2004;279:259-70.

AUTORES / AUTHORS:  - Kim DH; Sabatini DM

INSTITUCIÓN / INSTITUTION:  - Whitehead Institute for Biomedical Research, Nine Cambridge Center, Cambridge, MA 02142, USA.

RESUMEN / SUMMARY:  - mTOR/RAFT1/FRAP is the target of the FKBP12-rapamycin complex as well as a central component of a nutrient- and hormone-sensitive pathway that controls cellular growth. Recent work reveals that mTOR interacts with a novel evolutionarily conserved protein that we named raptor, for “regulatory associated protein of mTOR.” Raptor has several roles in the mTOR pathway. It is necessary for nutrient-mediated activation of the downstream effector S6K1 and increases in cell size. In addition, under conditions that repress the mTOR pathway, the association of raptor with mTOR is strengthened, leading to a decrease in mTOR kinase activity. Raptor is a critical component of the mTOR pathway that regulates cell growth in response to nutrient levels by associating with mTOR.  N. Ref:: 40

 

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[89]

TÍTULO / TITLE:  - A prospective study of rapid corticosteroid elimination in simultaneous pancreas-kidney transplantation: comparison of two maintenance immunosuppression protocols: tacrolimus/mycophenolate mofetil versus tacrolimus/sirolimus.

REVISTA / JOURNAL:  - Transplantation 2002 Jan 27;73(2):169-77.

AUTORES / AUTHORS:  - Kaufman DB; Leventhal JR; Koffron AJ; Gallon LG; Parker MA; Fryer JP; Abecassis MM; Stuart FP

INSTITUCIÓN / INSTITUTION:  - Department of Surgery, Division of Transplantation, Northwestern University Medical School, 675 N. St. Clair Street, Galter Pavilion, Suite 17-200, Chicago, IL 60611, USA.

RESUMEN / SUMMARY:  - BACKGROUND: We examined the feasibility of rapid corticosteroid elimination in simultaneous pancreas kidney transplantation. METHODS: Forty consecutive simultaneous pancreas-kidney (SPK) transplant recipients were enrolled in a prospective study in which antithymocyte globulin induction and 6 days of corticosteroids were administered along with tacrolimus and MMF (n=20) or tacrolimus and sirolimus (n=20). Mean+/-SD follow-up for recipients receiving tacrolimus/MMF and tacrolimus/sirolimus were 12.7+/-3.9 and 13.4+/-2.9 months, respectively. Patient and graft survival, and rejection rates were compared to an historical control group (n=86; mean follow-up 41.5+/-15.4 months) of SPK recipients that received induction and tacrolimus, MMF, and corticosteroids. RESULTS: Demographic characteristics of recipient and donor variables were similar among all groups. The 1-year actuarial patient, kidney, and pancreas survival rates in the 40 SPK transplant recipients with rapid corticosteroid elimination were 100, 100, and 100%, respectively. In the historical control group the 1-year actual patient, kidney, and pancreas survival rates were 96.5, 93.0, and 91.9%, respectively. The 1-year rejection-free survival rate recipients in the rapid steroid elimination group collectively was 97.5 vs 80.2% in the historical control group (P=0.034). At 6 and 12 months posttransplant the serum creatinine values remained stable in all groups. CONCLUSIONS: We conclude that chronic corticosteroid exposure is not required in SPK transplant recipients receiving antithymocyte globulin induction and maintenance immuno-suppression consisting of either tacrolimus and mycophenolate mofetil or tacrolimus and sirolimus.

 

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[90]

TÍTULO / TITLE:  - The potential of chitosan in ocular drug delivery.

REVISTA / JOURNAL:  - J Pharm Pharmacol 2003 Nov;55(11):1451-63.

      ●● Enlace al texto completo (gratuito o de pago) 1211/0022357022476

AUTORES / AUTHORS:  - Alonso MJ; Sanchez A

INSTITUCIÓN / INSTITUTION:  - Department of Pharmacy and Pharmaceutical Technology, Faculty of Pharmacy, University of Santiago de Compostela, 15782 Santiago de Compostela, España. ffmjalon@usc.es

RESUMEN / SUMMARY:  - This paper presents an overview of the potential of chitosan-based systems for improving the retention and biodistribution of drugs applied topically onto the eye. Besides its low toxicity and good ocular tolerance, chitosan exhibits favourable biological behaviour, such as bioadhesion- and permeability-enhancing properties, and also interesting physico-chemical characteristics, which make it a unique material for the design of ocular drug delivery vehicles. The review summarizes the techniques for the production of chitosan gels, chitosan-coated colloidal systems and chitosan nanoparticles, and describes their mechanism of action upon contact with the ocular mucosa. The results reported until now have provided evidence of the potential of chitosan gels for enhancing and prolonging the retention of drugs on the eye surface. On the other hand, chitosan-based colloidal systems were found to work as transmucosal drug carriers, either facilitating the transport of drugs to the inner eye (chitosan-coated colloidal systems containing indometacin) or their accumulation into the corneal/conjunctival epithelia (chitosan nanoparticles containing ciclosporin). Finally, the tolerance, toxicity and biodegradation of the carriers under evaluation were reviewed.  N. Ref:: 75

 

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[91]

TÍTULO / TITLE:  - Rejection rate in living donor kidney transplantation with and without basiliximab in tacrolimus/mycophenolate mofetil-based protocol.

REVISTA / JOURNAL:  - Transplant Proc 2003 Mar;35(2):653-4.

AUTORES / AUTHORS:  - Rahamimov R; Yussim A; After T; Lustig S; Bar-Nathan N; Shaharabani E; Shapira Z; Shabthai E; Mor E

INSTITUCIÓN / INSTITUTION:  - Department of Transplantation, Rabin Medical Center, Beilinson Campus, Petah-Tiqwa, Israel. rutir@clalit.org.il

 

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[92]

TÍTULO / TITLE:  - B19 virus infection in renal transplant recipients.

REVISTA / JOURNAL:  - J Clin Virol. Acceso gratuito al texto completo.

      ●● Enlace a la Editora de la Revista http://www.elsevier.com/gej-ng/29/46/32/show/Products/VIRUSINT/index.htt 

      ●● Cita: J Clinical Virology: <> 2003 Apr;26(3):361-8.

AUTORES / AUTHORS:  - Cavallo R; Merlino C; Re D; Bollero C; Bergallo M; Lembo D; Musso T; Leonardi G; Segoloni GP; Ponzi AN

INSTITUCIÓN / INSTITUTION:  - Virology Unit, Department of Public Health and Microbiology, University of Turin, Via Santena 9, 10126, Turin, Italy. rossana.cavallo@unito.it

RESUMEN / SUMMARY:  - BACKGROUND: B19 virus infection with persistent anaemia has been reported in organ transplant recipients. Detection of B19 virus DNA in serum is the best direct marker of active infection. OBJECTIVE: The present study evaluated the incidence and clinical role of active B19 virus infection in renal transplant recipients presenting with anaemia. STUDY DESIGN: Forty-eight such recipients were investigated by nested PCR on serum samples. The controls were 21 recipients without anaemia. Active HCMV infection was also investigated as a marker of high immunosuppression. RESULTS AND CONCLUSIONS: In 11/48 (23%) patients B19 virus DNA was demonstrated in serum versus only 1/21 (5%) of the controls. Ten of these 11 patients had already been seropositive at transplantation and active infection occurred in eight of them during the first 3 months after transplantation. The remaining patient experienced a primary infection 9 months after transplantation. Eight (73%) of these 11 patients displayed a concomitant HCMV infection and four (36%) showed increasing serum creatinine levels but none developed glomerulopathy; 3/11 (27%) recovered spontaneously from anaemia whereas 8/11 (73%) needed therapy. In conclusion, the relatively high occurrence (23%) of B19 virus infection in patients presenting with anaemia, suggests that it should be considered in the differential diagnosis of persistent anaemia in renal transplant recipients. Presence of the viral DNA should be assessed early from transplantation and the viral load should be monitored to follow persistent infection and better understand the relation between active infection and occurrence of anaemia, and to assess the efficacy of IVIG therapy and/or immunosuppression reduction in clearing the virus.  N. Ref:: 56

 

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[93]

TÍTULO / TITLE:  - A mitochondrial perspective on cell death.

REVISTA / JOURNAL:  - Trends Biochem Sci 2001 Feb;26(2):112-7.

AUTORES / AUTHORS:  - Bernardi P; Petronilli V; Di Lisa F; Forte M

INSTITUCIÓN / INSTITUTION:  - Dept. of Biomedical Sciences, Viale Giuseppe Colombo 3, I-35121, Padova, Italy. bernardi@civ.bio.unipd.it

RESUMEN / SUMMARY:  - The role of mitochondria as crucial participants in cell death programs is well established, yet the mechanisms responsible for the release of mitochondrial activators and the role of BCL2 family proteins in this process remain controversial. Here, we point out the limitations of current approaches used to monitor the physiological responses of mitochondria during cell death, the implications arising from modern views of mitochondrial structure, and briefly assess two proposed mechanisms for the release of mitochondrial proteins during apoptosis.  N. Ref:: 50

 

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[94]

TÍTULO / TITLE:  - Molecular diagnosis of an Enterocytozoon bieneusi human genotype C infection in a moderately immunosuppressed human immunodeficiency virus seronegative liver-transplant recipient with severe chronic diarrhea.

REVISTA / JOURNAL:  - J Clin Microbiol. Acceso gratuito al texto completo a partir de los 6 meses de la fecha de publicación.

      ●● Enlace a la Editora de la Revista http://jcm.asm.org/ 

      ●● Cita: J. Clinical Microbiology: <> 2001 Jun;39(6):2371-2.

AUTORES / AUTHORS:  - Sing A; Tybus K; Heesemann J; Mathis A  N. Ref:: 5

 

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[95]

TÍTULO / TITLE:  - Eradication of parvovirus B19 infection after renal transplantation requires reduction of immunosuppression and high-dose immunoglobulin therapy.

REVISTA / JOURNAL:  - Nephrol Dial Transplant. Acceso gratuito al texto completo a partir de los 2 años de la fecha de publicación.

      ●● Enlace a la Editora de la Revista http://ndt.oupjournals.org/ 

      ●● Cita: Nephrology Dialysis Transplantation: <> 2002 Oct;17(10):1840-2.

AUTORES / AUTHORS:  - Liefeldt L; Buhl M; Schweickert B; Engelmann E; Sezer O; Laschinski P; Preuschof L; Neumayer HH

INSTITUCIÓN / INSTITUTION:  - Department of Nephrology, Charite, Humboldt-University Berlin, Germany. lutz.liefeldt@charite.de  N. Ref:: 17

 

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[96]

- Castellano -

TÍTULO / TITLE:Presentacion de canceres en receptores trasplantados con organo solido. Presentation of cancers in recipients of a solid-organ transplant.

REVISTA / JOURNAL:  - Nefrologia. Acceso gratuito al texto completo.

      ●● Enlace a la Editora de la Revista http://www.aulamedica.es/nefrologia/ 

      ●● Cita: Nefrologia: <> 2001;21(6):528-37.

AUTORES / AUTHORS:  - Lampreabe I; Gomez-Ullate P; Amenabar JJ; Zarraga S; Gainza FJ; Urbizu JM

INSTITUCIÓN / INSTITUTION:  - Servicio de Nefrologia, Hospital de Cruces, Facultad de Medicina, Universidad del Pais Vasco. ilampreave@hcru.osakidetza.net  N. Ref:: 35

 

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[97]

TÍTULO / TITLE:  - Limited dose monoclonal IL-2R antibody induction protocol after primary kidney transplantation.

REVISTA / JOURNAL:  - Am J Transplant 2002 Jul;2(6):568-73.

AUTORES / AUTHORS:  - Ahsan N; Holman MJ; Jarowenko MV; Razzaque MS; Yang HC

INSTITUCIÓN / INSTITUTION:  - Nephrology and Transplant Division, University of Medicine and Dentistry of New Jersey, New Brunswick 08904, USA. ahsanna@umdnj.edu

RESUMEN / SUMMARY:  - This study prospectively compared immunoprophylaxis with a single intraoperative dose (2 mg/kg) of monoclonal interleukin-2 receptor (IL-2R) antibody vs. noninduction in kidney transplant recipients treated with tacrolimus (FK 506), mycophenolate mofetil (MMF) and a prednisone-based immunosuppression regimen. One hundred recipients of first-kidney transplant were enrolled into the study to receive either anti-IL-2R monoclonal antibody, daclizumab (2 mg/kg intraoperatively, limited anti-IL-2R) or no induction (control). Each patient also received oral tacrolimus (dosed to target trough level 10-15 ng/mL), MMF (500 mg bid) and prednisone. The primary efficacy end-point was the incidence of biopsy proven acute rejection during the first 6 months post-transplant. The patients were also followed for 12-month graft function, and graft and patient survival rates. Other than the donor’s age being significantly lower in the control group, both groups were comparable with respect to age, weight, gender, race, human leukocyte antigen (HLA)-DR mismatch, panel reactive antibody (%PRA), cold ischemic time, cytomegalovirus (CMV) status, causes of renal failure, and duration and modes of renal replacement therapy (RRT). During the first 6 months, episodes of first biopsy confirmed acute rejection was 3/50 (6%) in the limited anti-IL-2R group and 8/50 (16%) in the controls (p < 0.05). Twelve-month patient 100/98 (%) and graft survival 100/96 (%) were not statistically different. The group receiving limited anti-IL-2R did not have any adverse reactions. Our study demonstrates that a limited (single) 2 mg/kg immunoprophylaxis dose with monoclonal IL-2R antibody (daclizumab) when combined with tacrolimus/MMF/steroid allows significant reduction in early renal allograft rejection to the single digit level. The therapy with anti-IL-2R antibody is simple and is well tolerated.

 

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[98]

TÍTULO / TITLE:  - The utility of monoclonal antibody therapy in renal transplantation.

REVISTA / JOURNAL:  - Transplant Proc 2002 May;34(3):797-800.

AUTORES / AUTHORS:  - Loertscher R

INSTITUCIÓN / INSTITUTION:  - Division of Transplantation, McGill University Health Centre, Montreal, Quebec, Canada. rolf.loertscher@mcgill.ca  N. Ref:: 37

 

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[99]

TÍTULO / TITLE:  - Low-intensity hematopoietic stem-cell transplantation across human leucocyte antigen barriers in dyskeratosis congenita.

REVISTA / JOURNAL:  - Bone Marrow Transplant 2003 May;31(10):847-50.

      ●● Enlace al texto completo (gratuito o de pago) 1038/sj.bmt.1703931

AUTORES / AUTHORS:  - Dror Y; Freedman MH; Leaker M; Verbeek J; Armstrong CA; Saunders FE; Doyle JJ

INSTITUCIÓN / INSTITUTION:  - Marrow Failure and Myelodysplasia Programme, Division of Haematology and Oncology, Department of Paediatrics, The Hospital for Sick Children and the University of Toronto, Toronto, Ontario, Canada.

RESUMEN / SUMMARY:  - Since the results of conventional hematopoietic stem-cell transplantation (HSCT) for patients with dyskeratosis congenita (DC) are poor owing to the high incidence of transplant-related complications, we explored the use of a low-intensity HSCT regimen. We report two children with DC with severe cytopenia, who underwent successful HSCT from a matched unrelated donor after conditioning with fludarabine, cyclophosphamide, and antithymocyte globulin. Graft-versus-host-disease (GVHD) prophylaxis consisted of corticosteroids and cyclosporin A. The regimen was well tolerated, no significant transplant-related complications were observed, and engraftment was rapid and complete. At 15 and 16 months after HSCT, the children were fully engrafted, in excellent clinical condition, full-donor chimerism, and no signs of GVHD. We conclude that a low-intensity regimen is sufficient to induce durable engraftment using matched unrelated donor HSCT in DC patients, with minimal 1-year transplant-related toxicity. Longer follow-up will determine whether this regimen also reduces long-term toxicity.  N. Ref:: 35

 

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[100]

TÍTULO / TITLE:  - Role of prostanoids and endothelins in the prevention of cyclosporine-induced nephrotoxicity.

REVISTA / JOURNAL:  - Prostaglandins Leukot Essent Fatty Acids 2001 Apr-May;64(4-5):231-9.

      ●● Enlace al texto completo (gratuito o de pago) 1054/plef.2001.0265

AUTORES / AUTHORS:  - Darlametsos IE; Varonos DD

INSTITUCIÓN / INSTITUTION:  - Centre Franco-Hellenique de Recherches Biomedicales, Nikolaos Papanikolaou, Corporation of the Municipality Agrinion, Agrinion, 30100, Greece. darlamet@otenet.gr

RESUMEN / SUMMARY:  - Cyclosporine A nephrotoxicity includes both functional toxicity and histological changes, whose seriousness is dependent upon the dose and the duration of the drug administration. Several vasoactive agents have been found to be implicated in cyclosporine induced nephrotoxicity, among which prostanoids and endothelins are the most important. In previous studies we were able to prevent the early stage (7 days) of cyclosporine (37.4 micromol [45 mg]/kg/day) induced nephrotoxicity in rats either by the administration, i) of OKY-046, a thromboxane A(2)synthase inhibitor, ii) of ketanserine, an antagonist of S(2)serotonergic, a(1)adrenergic, and H(1)histaminergic receptors and iii) of nifedipine, a calcium channel blocker, or by diet supplementation either with evening primrose oil or fish oil. All these protective agents elevated ratios of excreted renal prostanoid vasodilators (prostaglandins E(2), 6ketoF(1 alpha)) to vasoconstrictor (thromboxane B(2)), a ratio which was decreased by the administration of cyclosporine alone. Nifedipine averted the cyclosporine induced increase of urinary endothelin-1 release. All protections were associated with the reinstatement of glomerular filtration rate forwards normal levels whereas renal damage defence, consisting of a decrease of the cyclosporine induced vacuolizations, was variable. Ketanserine and evening primrose oil were the only agents which prevented the animal body weight loss. These data suggest that prostanoids and endothelin-1 may mediate functional toxicity while thromboxane A(2)is involved the morphological changes too, provoked in the early stage of cyclosporine treatment. However, other nephrotoxic factors and additional mechanisms could also be implicated in the cyclosporine induced nephrotoxicity.  N. Ref:: 91

 

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[101]

TÍTULO / TITLE:  - Role of chiral chromatography in therapeutic drug monitoring and in clinical and forensic toxicology.

REVISTA / JOURNAL:  - Ther Drug Monit 2002 Apr;24(2):290-6.

AUTORES / AUTHORS:  - Williams ML; Wainer IW

INSTITUCIÓN / INSTITUTION:  - Department of Oncology, Leicester University, Leicester, United Kingdom.

RESUMEN / SUMMARY:  - Advances in chiral chromatographic separations have given pharmacologists and toxicologists the tools to examine unexpected clinical results involving chiral drugs. The ability to unravel complex phenomena associated with drug transport and drug metabolism is presented in this manuscript. The relation between the chirality of the drug mefloquine and the intracellular concentrations of the drug cyclosporine is illustrated by examining the effect of the enantiomers of mefloquine on the transport activity of P-glycoprotein (Pgp). These studies were conducted using a liquid chromatographic column containing immobilized Pgp. The results demonstrated that (+)-mefloquine competitively displaced the Pgp substrate cyclosporine whereas (-)-mefloquine had no effect on cyclosporine-Pgp binding. The data suggest that cyclosporine cellular and CNS concentrations can be increased through the concomitant administration of (+)-mefloquine. The use of chirality in clinical and forensic situations is also illustrated by the metabolism of the enantiomers of ketamine (KET). The plasma concentrations of (+)-KET and (-)-KET and the norketamine metabolites (+)-NK and (-)-NK were measured in rat plasma using enantioselective gas chromatography. The separations were accomplished using a gas chromatography chiral stationary phase based on beta-cyclodextrin. The pharmacokinetic profiles of (+)-, (-)-KET and (+)-, (-)-NK were determined in control and protein-calorie malnourished (PCM) rats to determine the effect of PCM on ketamine metabolism and clearance. The results indicate that PCM produced a significant and stereoselective decrease in KET and NK metabolism. The data suggest that the effects of environmental factors (smoking, alcohol use, diet) and drug interactions (coadministered agents) can be measured using the changes in stereochemical metabolic and pharmacokinetic patterns of KET and similar drugs.  N. Ref:: 33

 

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[102]

TÍTULO / TITLE:  - Molecular actions of sirolimus: sirolimus and mTor.

REVISTA / JOURNAL:  - Transplant Proc 2003 May;35(3 Suppl):227S-230S.

AUTORES / AUTHORS:  - Kirken RA; Wang YL

INSTITUCIÓN / INSTITUTION:  - Department of Integrative Biology and Pharmacology, The University of Texas Health Science Center at Houston, Houston, Texas 77030, USA. robert.a.kirken@uth.tmc.edu

RESUMEN / SUMMARY:  - Recent therapeutic strategies to combat organ allograft rejection have focused on T-cell signaling pathways and the molecules that comprise them. The macrolide antibiotic produced by the bacterium Streptomyces hygroscopicus, known as sirolimus or rapamycin, has shown great therapeutic potential in the transplant setting. Sirolimus alone or in combination with other immunosuppressive agents can block acute rejection, chronic graft destruction, and promote permanent allograft acceptance. Sirolimus targets a unique serine-threonine kinase, mammalian target of rapamycin (mTor), which plays a key role in mitogenic and nutritional cells signals. Within T cells, mTor regulates a number of proteins likely dependent on T cell growth factors such as interleukin 2. This review is focused on the molecular mechanisms by which mTor may regulate T-cell signaling cascades and affect T-cell responsiveness, and how sirolimus likely uncouples this activity.  N. Ref:: 32

 

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[103]

TÍTULO / TITLE:  - The treatment of atopic dermatitis with systemic immunosuppressive agents.

REVISTA / JOURNAL:  - Clin Dermatol 2003 May-Jun;21(3):225-40.

AUTORES / AUTHORS:  - Akhavan A; Rudikoff D

INSTITUCIÓN / INSTITUTION:  - Department of Dermatology, Mount Sinai School of Medicine, New York, New York 10029, USA.  N. Ref:: 165

 

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[104]

TÍTULO / TITLE:  - Retroviral oncogenes and TOR.

REVISTA / JOURNAL:  - Curr Top Microbiol Immunol 2004;279:321-38.

AUTORES / AUTHORS:  - Aoki M; Vogt PK

INSTITUCIÓN / INSTITUTION:  - Department of Molecular and Experimental Medicine, The Scripps Research Institute, 10550 North Torrey Pines Road, BCC-239, La Jolla, CA 92037, USA.

RESUMEN / SUMMARY:  - Retroviruses have recruited the catalytic subunit of PI 3-kinase and its downstream target, Akt, as oncogenes. These viruses cause tumors in animals and induce oncogenic transformation in cell culture. The oncogenicity of these viruses is specifically inhibited by rapamycin; retroviruses carrying other oncogenes are insensitive to this macrolide antibiotic. Rapamycin is an inhibitor of the TOR (target of rapamycin) kinase whose downstream targets include p70 S6 kinase and the negative regulator of translation initiation 4E-BP. Emerging evidence suggests that the TOR signals transmitted to the translational machinery are essential for oncogenic transformation by the PI 3-kinase pathway.  N. Ref:: 93

 

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[105]

TÍTULO / TITLE:  - Regulation of MAPK signaling pathways through immunophilin-ligand complex.

REVISTA / JOURNAL:  - Curr Top Med Chem 2003;3(12):1358-67.

AUTORES / AUTHORS:  - Matsuda S; Koyasu S

INSTITUCIÓN / INSTITUTION:  - Department of Microbiology and Immunology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.

RESUMEN / SUMMARY:  - It is well established that the immunosuppressive effects of cyclosporin A (CsA) and FK506 (also known as tacrolimus) are mediated through binding to their cognate cellular proteins cyclophilin and FKBP (collectively termed immunophilins), respectively. Biochemical analysis had revealed that cyclophilin-CsA and FKBP-FK506 complexes bind to and inactivate Ca(2+)-dependent serine/threonine phosphatase calcineurin. Since calcineurin regulates nuclear translocation and subsequent activation of nuclear factor of activated T cells (NFAT) transcription factors that is one of essential steps for cytokine gene expression in activated T cells, it is believed that inhibition of calcineurin is a molecular basis of the immunosuppressive properties of CsA and FK506. However, recent studies indicate that both CsA and FK506 can block activation of JNK and p38 signaling pathways during T cell activation. CsA and FK506, thus, have two distinct mechanisms of action; one is the inhibition of the protein phosphatase activity of calcineurin, leading to the blockade of the nuclear translocation of NFAT transcription factors, and the other is the suppression of JNK and p38 activation pathways. It is likely that the presence of two distinct targets in T cell activation makes CsA and FK506 highly potent immunosuppressive drugs. Here we discuss the action of immunophilin-ligand complexes on JNK and p38 activation pathways. We also argue the possibility of immunotherapeutic application targeting at JNK and p38 signaling pathways.  N. Ref:: 121

 

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[106]

TÍTULO / TITLE:  - Cytokine and immunosuppressive therapies of type 1 diabetes mellitus.

REVISTA / JOURNAL:  - Endocrinol Metab Clin North Am 2002 Jun;31(2):477-95.

AUTORES / AUTHORS:  - Gottlieb PA; Hayward AR

INSTITUCIÓN / INSTITUTION:  - Barbara Davis Center for Childhood Diabetes, Department of Pediatrics, University of Colorado Health Sciences Center, Box B140, 4200 East 9th Ave., Denver, CO 80262, USA.

RESUMEN / SUMMARY:  - In this article, the authors covered a number of issues that affect how researchers approach prevention of diabetes. The focus has been the use of cytokines and immunosuppressive therapies. The historical understanding of cytokine and immunosuppressive approaches, new developments in using these agents in humans, and the issues involved in designing diabetes prevention trials were reviewed. Although progress at times appears slow, the current research activities predict new developments in the next few years that may improve the understanding of the progression of diabetes and possible ways to intervene.  N. Ref:: 79

 

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[107]

TÍTULO / TITLE:  - Regulation of endothelial-type NO synthase expression in pathophysiology and in response to drugs.

REVISTA / JOURNAL:  - Nitric Oxide 2002 Nov;7(3):149-64.

AUTORES / AUTHORS:  - Li H; Wallerath T; Munzel T; Forstermann U

INSTITUCIÓN / INSTITUTION:  - Department of Pharmacology, Johannes Gutenberg University, Obere Zahlbacher Strasse 67, D-55101, Mainz, Germany.

RESUMEN / SUMMARY:  - In many types of cardiovascular pathophysiology such as hypercholesterolemia and atherosclerosis, diabetes, cigarette smoking, or hypertension (with its sequelae stroke and heart failure) the expression of endothelial NO synthase (eNOS) is altered. Both up- and downregulation of eNOS have been observed, depending on the underlying disease. When eNOS is upregulated, the upregulation is often futile and goes along with a reduction in bioactive NO. This is due to an increased production of superoxide generated by NAD(P)H oxidase and by an uncoupled eNOS. A number of drugs with favorable effects on cardiovascular disease upregulate eNOS expression. The resulting increase in vascular NO production may contribute to their beneficial effects. These compounds include statins, angiotensin-converting enzyme inhibitors, AT1 receptor antagonists, calcium channel blockers, and some antioxidants. Other drugs such as glucocorticoids, whose administration is associated with cardiovascular side effects, downregulate eNOS expression. Stills others such as the immunosuppressants cyclosporine A and FK506/tacrolimus or erythropoietin have inconsistent effects on eNOS. Thus regulation of eNOS expression and activity contributes to the overall action of several classes of drugs, and the development of compounds that specifically upregulate this protective enzyme appears as a desirable target for drug development.  N. Ref:: 201

 

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[108]

TÍTULO / TITLE:  - What’s in the pipeline? New immunosuppressive drugs in transplantation.

REVISTA / JOURNAL:  - Am J Transplant 2002 Nov;2(10):898-903.

AUTORES / AUTHORS:  - Vincenti F

INSTITUCIÓN / INSTITUTION:  - University of California, San Francisco, Kidney Transplant Service, 505 Parnassus Avenue, Room 884M, San Francisco, CA 94143-0116, USA. vincentif@surgery.ucsf.edu

RESUMEN / SUMMARY:  - In the pipeline, there are a number of novel immunosuppressive drugs in preclinical development or in early clinical trials. The major target of new agents are cell-surface molecules important in immune cell interactions (especially the costimulatory pathway), signaling pathways that activate T cells, T-cell proliferation and trafficking and recruitment of immune cells responsible for rejection. The most promising biologic agents include a humanized anti-CD11a (anti-LFA1), humanized anti-B7.1/B7.2, a second-generation CTLA4Ig (LEA29Y) and a humanized antibody to anti-CD45 RB. Inhibitors of T-cell activation and signaling are still in preclinical development. The most interesting inhibitors of T-cell proliferation include inhibitors of the Janus protein tyrosine kinase, JAK3, and FK778, a leflunomide analog. Chemokines play an important role in rejection by virtue of their critical role as regulator of trafficking and activation of lymphocytes. Early trials of FTY720, a synthetic small molecule with functional homology to sphingosine-1 phosphate leading to lymphocyte sequestration, appear very promising; however, enthusiasm for this drug is mitigated by its potential cardiac side-effects. Antagonists to several chemokine receptors, including CCR1, CXCR3 and CCR5, have been shown to be effective in experimental transplantation and are likely to be considered for clinical development.  N. Ref:: 46

 

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[109]

TÍTULO / TITLE:  - Current and potential agents for the treatment of alopecia areata.

REVISTA / JOURNAL:  - Curr Pharm Des 2001 Feb;7(3):213-30.

AUTORES / AUTHORS:  - Freyschmidt-Paul P; Hoffmann R; Levine E; Sundberg JP; Happle R; McElwee KJ

INSTITUCIÓN / INSTITUTION:  - Department of Dermatology, Philipp University, Marburg, Germany. freyschm@mailer.uni-marburg.de

RESUMEN / SUMMARY:  - Alopecia areata is considered to be a T-cell mediated autoimmune disease of the hair follicle. Current immunosuppressive approaches and immunomodulatory treatment with contact sensitizers such as diphenylcyclopropenone and squaric acid dibutylester are dealt with in this review article. The efficacy of the various modes of treatment is evaluated by a review of literature and their mode of action is discussed. In accordance with the mechanism of autoimmune pathogenesis of AA, improved future treatments may be immunosuppressive or immunomodulatory, or they should otherwise protect the hair follicle from the injurious effects of the inflammation. Such possible future therapeutic approaches include the use of liposomes as an improved vehicle, application of immunosuppressive cytokines like TGF-beta and IL-10, inhibition of apoptosis mediated by the Fas-FasL system, inhibition of the lymphocyte homing receptor CD44v10, induction of tolerance as well as principles of gene therapy.  N. Ref:: 141

 

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[110]

TÍTULO / TITLE:  - Tolerance to islet autoantigens in type 1 diabetes.

REVISTA / JOURNAL:  - Annu Rev Immunol 2001;19:131-61.

      ●● Enlace al texto completo (gratuito o de pago) 1146/annurev.immunol.19.1.131

AUTORES / AUTHORS:  - Bach JF; Chatenoud L

INSTITUCIÓN / INSTITUTION:  - INSERM U 25, Hopital Necker, 161 rue de Sevres, Paris Cedex 15, 75743 France. bach@necker.fr

RESUMEN / SUMMARY:  - Tolerance to beta cell autoantigens represents a fragile equilibrium. Autoreactive T cells specific to these autoantigens are present in most normal individuals but are kept under control by a number of peripheral tolerance mechanisms, among which CD4(+) CD25(+) CD62L(+) T cell-mediated regulation probably plays a central role. The equilibrium may be disrupted by inappropriate activation of autoantigen-specific T cells, notably following to local inflammation that enhances the expression of the various molecules contributing to antigen recognition by T cells. Even when T cell activation finally overrides regulation, stimulation of regulatory cells by CD3 antibodies may reset the control of autoimmunity. Other procedures may also lead to disease prevention. These procedures are essentially focused on Th2 cytokines, whether used systemically or produced by Th2 cells after specific stimulation by autoantigens. Protection can also be obtained by NK T cell stimulation. Administration of beta cell antigens or CD3 antibodies is now being tested in clinical trials in prediabetics and/or recently diagnosed diabetes.  N. Ref:: 153

 

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[111]

TÍTULO / TITLE:  - The role of newer monoclonal antibodies in renal transplantation.

REVISTA / JOURNAL:  - Transplant Proc 2001 Feb-Mar;33(1-2):1000-1.

AUTORES / AUTHORS:  - Vincenti F

INSTITUCIÓN / INSTITUTION:  - University of California, San Francisco, California, USA.  N. Ref:: 5

 

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[112]

TÍTULO / TITLE:  - Advances in the management of psoriasis: monoclonal antibody therapies.

REVISTA / JOURNAL:  - Int J Dermatol 2002 Dec;41(12):827-35.

AUTORES / AUTHORS:  - Mehrabi D; DiCarlo JB; Soon SL; McCall CO

INSTITUCIÓN / INSTITUTION:  - Department of Dermatology, Emory University School of Medicine, Atlanta, GA 30322, USA.

RESUMEN / SUMMARY:  - Psoriasis is a common skin disorder characterized by erythematous, scaling plaques. Until recently, therapies for this disease have been aimed at reducing keratinocyte proliferation. We have learned that psoriasis is not primarily a disorder of keratinocyte hyperproliferation, but is an inflammatory disease. This knowledge, especially our current understanding of the role of activated T cells in psoriasis, has led to new therapeutic options and new areas of research. Immunosuppressive agents such as cyclosporine have proven very useful in the treatment of psoriasis, but their use is limited by toxicity. Monoclonal antibodies directed against key components of the inflammatory process have been studied in an attempt to produce safer, more selective immunosuppressive agents. This review summarizes much of the available literature describing the use of monoclonal antibodies in the treatment of psoriasis.  N. Ref:: 59

 

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[113]

TÍTULO / TITLE:  - Molecular mechanisms of renal allograft fibrosis.

REVISTA / JOURNAL:  - Br J Surg 2001 Nov;88(11):1429-41.

      ●● Enlace al texto completo (gratuito o de pago) 1046/j.0007-1323.2001.01867.x

AUTORES / AUTHORS:  - Waller JR; Nicholson ML

INSTITUCIÓN / INSTITUTION:  - Division of Transplant Surgery, University of Leicester, Leicester, UK. julian@waller79.fsnet.co.uk

RESUMEN / SUMMARY:  - BACKGROUND: Chronic graft nephropathy (CGN) remains the leading cause of renal allograft loss after the first year following transplantation. Histologically it is characterized by glomerulosclerosis, intimal hyperplasia and interstitial fibrosis. The pathogenesis is unclear, but is likely to involve both immunological and non-immunological factors. Despite improvements in short-term graft survival rates, new immunosuppressive regimens have made no impact on CGN. METHODS: A review of the current literature on renal transplantation, novel immunosuppression regimens and advances in the molecular pathogenesis of renal allograft fibrosis was performed. RESULTS AND CONCLUSION: Recent advances in understanding of the underlying molecular mechanisms involved suggest autocrine secretion of cytokines and growth factors, especially transforming growth factor beta, are associated with a change in fibroblast phenotype leading to the deposition of extracellular matrix. Repeated insults trigger upregulation of the tissue inhibitors of matrix metalloproteinases, favouring accumulation of extracellular matrix. To date, no drug has proved effective in inhibiting or reducing allograft fibrosis. The deleterious consequences of chronic immunosuppression on the development of such fibrosis are now recognized; newer immunosuppressive drugs, including rapamycin and mycophenolate mofetil, reduce profibrotic gene expression in both experimental and clinical settings, and offer potential strategies for prolonging allograft survival.  N. Ref:: 155

 

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[114]

TÍTULO / TITLE:  - Daclizumab: a review of its use in the management of organ transplantation.

REVISTA / JOURNAL:  - BioDrugs 2001;15(11):745-73.

AUTORES / AUTHORS:  - Carswell CI; Plosker GL; Wagstaff AJ

INSTITUCIÓN / INSTITUTION:  - Adis International Limited, Auckland, New Zealand. demail@adis.co.nz

RESUMEN / SUMMARY:  - The humanised monoclonal antibody daclizumab is an immunosuppressive agent that reduces acute rejection in solid organ transplantation. It is specific for the alpha subunit (Tac/CD25) of the interleukin (IL)-2 receptor on activated T cells and achieves immunosuppression by competitive antagonism of IL-2-induced T cell proliferation. When added to standard triple immunosuppression regimens, daclizumab significantly reduces the rate of acute rejection at 1 year in renal transplantation by 36% and there are indications that it may be effective in other solid organ transplantations. Three-year outcomes of two phase III clinical trials in renal transplantation indicate similar values for graft and patient survival between daclizumab and placebo when given in addition to triple immunosuppression; however, these pivotal trials were not designed with sufficient power to demonstrate any statistical significance. The addition of daclizumab induction shows potential in allowing calcineurin inhibitor- and corticosteroid-sparing regimens without increasing the rate of acute graft rejection or adverse effects in renal and liver transplantation. Preliminary reports indicate that daclizumab may also be a useful agent in delayed graft function and graft versus host disease (GVHD). Further investigation of its efficacy in these groups and in children is needed. Data from clinical trials show daclizumab to be well tolerated in solid organ transplantation. It does not increase the incidence of infection, including cytomegalovirus infection, when compared with placebo or no induction groups. Preliminary comparative data with muromonab CD3 indicate that daclizumab may be associated with a lower rate of infectious complications and similar or better efficacy. CONCLUSIONS: In conclusion, daclizumab has been proven to reduce acute rejection in renal transplant recipients when given in addition to traditional baseline immunosuppression. It has shown potential to reduce acute rejection in other solid organ transplants; however, well designed, randomised studies are required to confirm this. Clinical experience from trials to date indicate that daclizumab has a tolerability profile similar to placebo with no significant effect on the incidence of infection. The relative efficacy and tolerability of daclizumab compared with other induction agents has yet to be defined. Available data suggest that daclizumab may allow the use of calcineurin inhibitor-sparing and corticosteroid-sparing regimens and may have potential in the treatment of GVHD.  N. Ref:: 80

 

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[115]

TÍTULO / TITLE:  - Neuroimmunophilin ligands: the development of novel neuroregenerative/ neuroprotective compounds.

REVISTA / JOURNAL:  - Curr Top Med Chem 2003;3(12):1368-75.

AUTORES / AUTHORS:  - Gold BG; Villafranca JE

INSTITUCIÓN / INSTITUTION:  - Center for Research on Occupational and Environmental Toxicology, Developmental Biology, Oregon Health & Science University, 3181 S.W. Sam Jackson Park Road, Portland, OR 97201-3098, USA. gold@ohsu.edu

RESUMEN / SUMMARY:  - FK506 (tacrolimus), initially developed as an immunosuppressant drug, represents a class of compounds with potential high impact for the treatment of human neurological disorders. While immunosuppression is mediated by the 12-kD FK506-binding-protein (FKBP-12), the neurite elongation activity of FK506 involves FKBP-52 (also known as FKBP-59 or Hsp-56), a component of mature steroid receptor complexes: FKBP-52 binds to Hsp-90, which bind to p23 and the steroid receptor protein to form the complex. The brief review focuses on how three classes of compounds (FK506 derivatives, steroid hormones, and ansamycin anti-cancer drugs, e.g., geldanamycin) increase neurite elongation/nerve regeneration (axonal elongation). A model is presented whereby neurite elongation is elicited by compounds that bind to steroid receptor chaperone proteins (e.g., FKBP-52 and Hsp-90) and thereby disrupt mature steroid receptor complexes (comprising FKBP-52, Hsp-90 and p23 in addition to the steroid receptor binding protein). Disruption of the complex leads to a “gain-of-function” whereby one or more of these steroid receptor chaperone proteins (i.e, FKBP-52, Hsp-90 or p23) activates mitogen-associated protein (MAP) kinase/extracellular signal-regulated kinase (ERK) pathway. Thus, the neurotrophic actions of these distinct classes of compounds can be understood from their ability to bind steroid receptor chaperones, thereby providing a unique receptor-mediated means to activate the ERK pathway. These studies thereby shed new light on the intrinsic mechanism regulating axonal elongation. Furthermore, this mechanism may also underlie calcineurin-independent neuroprotective actions of FK506. We suggest that components of steroid receptor complexes are novel targets for the design of neuroregenerative/neuroprotective drugs.  N. Ref:: 98

 

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[116]

TÍTULO / TITLE:  - Sequential protocol biopsies from renal transplant recipients show an increasing expression of active TGF beta.

REVISTA / JOURNAL:  - Transpl Int 2002 Dec;15(12):630-4. Epub 2002 Oct 19.

      ●● Enlace al texto completo (gratuito o de pago) 1007/s00147-002-0472-3

AUTORES / AUTHORS:  - Jain S; Mohamed MA; Sandford R; Furness PN; Nicholson ML; Talbot D

INSTITUCIÓN / INSTITUTION:  - University Department of Surgery, Leicester General Hospital, Gwendolen Road, Leicester, LE5 4PW, UK. sj34@le.ac.uk

RESUMEN / SUMMARY:  - Chronic allograft nephropathy (CAN) is a major cause of graft loss after renal transplantation. Implicated in the pathogenesis of this complication is overproduction of the cytokine transforming growth factor beta (TGF beta). In this study we measured changes in CAN’s expression in stable patients early after transplantation, and studied links with established risk factors for CAN, such as delayed graft function, acute rejection, and cyclosporine exposure. We took biopsies from 40 renal allografts at time of transplantation (pre-perfusion), and then, using ultrasound guidance, at 1 week and 6 months after transplantation. An immunofluorescence technique was used to stain sections for active TGF beta. These were then assessed by semi-quantitative scanning laser confocal microscopy. There was very little variation in active TGF-beta expression among patients in their pre-perfusion biopsies. Expression had increased by 1 week and then very significantly by 6 months ( P<0.0001). Patients who suffered delayed graft function had increased TGF-beta expression at both time points. There was no difference regarding donor type, acute rejection, and immunosuppressive drug (cyclosporine or tacrolimus). There was no correlation between the amount of TGF-beta expression at any time-point and isotope glomerular filtration rate (GFR) at 12 months. This study demonstrated that in a group of stable renal allograft recipients, TGF-beta expression in the kidney increased after transplantation. As the study used protocol biopsies, this increase is unlikely to be due to acute events, and probably represents a genuine increase.

 

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[117]

TÍTULO / TITLE:  - The macrolide immunosuppressants in dermatology: mechanisms of action.

REVISTA / JOURNAL:  - Eur J Dermatol 2002 Nov-Dec;12(6):618-22.

AUTORES / AUTHORS:  - Marsland AM; Griffiths CE

INSTITUCIÓN / INSTITUTION:  - Dermatology Centre, University of Manchester School of Medicine, Hope Hospital, United Kingdom. sacha.marsland@virgin.net

RESUMEN / SUMMARY:  - Macrolides are xenobiotics, produced by soil fungi, which have immunosuppressant properties. They will probably revolutionise the treatment of inflammatory dermatoses. This article outlines the context and putative mechanisms of action of this novel class of drugs. Cyclosporin, and the structurally distinct macrolides tacrolimus and pimecrolimus (an ascomycin derivative), modulate immune-cell function by inhibiting calcineurin-dependent dephosphorylation-activation of specific nuclear factors, thus preventing transcription of pro-inflammatory cytokines. The macrolide rapamycin (sirolimus) acts by abrogating Target of Rapamycin, a key signalling protein that controls activation of a number of proteins which direct progression of the cell cycle in response to pro-inflammatory cytokines. Tacrolimus and pimecrolimus are small enough molecules to penetrate skin and are available in topical formulations. “Skin-specific” pimecrolimus seems not to cause systemic immunosuppression when given orally. Neither topical tacrolimus nor pimecrolimus are capable of producing skin atrophy. Sirolimus has anti-angiogenic properties that may be beneficial to the treatment of psoriasis and perhaps skin cancer.  N. Ref:: 27

 

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[118]

TÍTULO / TITLE:  - Pharmacokinetic aspects of treating infections in the intensive care unit: focus on drug interactions.

REVISTA / JOURNAL:  - Clin Pharmacokinet 2001;40(11):833-68.

AUTORES / AUTHORS:  - Pea F; Furlanut M

INSTITUCIÓN / INSTITUTION:  - Institute of Clinical Pharmacology and Toxicology, Department of Experimental and Clinical Pathology and Medicine, Medical School, University of Udine, Italy. federico.pea@med.uniud.it

RESUMEN / SUMMARY:  - Pharmacokinetic interactions involving anti-infective drugs may be important in the intensive care unit (ICU). Although some interactions involve absorption or distribution, the most clinically relevant interactions during anti-infective treatment involve the elimination phase. Cytochrome P450 (CYP) 1A2, 2C9, 2C19, 2D6 and 3A4 are the major isoforms responsible for oxidative metabolism of drugs. Macrolides (especially troleandomycin and erythromycin versus CYP3A4), fluoroquinolones (especially enoxacin, ciprofloxacin and norfloxacin versus CYP1A2) and azole antifungals (especially fluconazole versus CYP2C9 and CYP2C19, and ketoconazole and itraconazole versus CYP3A4) are all inhibitors of CYP-mediated metabolism and may therefore be responsible for toxicity of other coadministered drugs by decreasing their clearance. On the other hand, rifampicin is a nonspecific inducer of CYP-mediated metabolism (especially of CYP2C9, CYP2C19 and CYP3A4) and may therefore cause therapeutic failure of other coadministered drugs by increasing their clearance. Drugs frequently used in the ICU that are at risk of clinically relevant pharrmacokinetic interactions with anti-infective agents include some benzodiazepines (especially midazolam and triazolam), immunosuppressive agents (cyclosporin, tacrolimus), antiasthmatic agents (theophylline), opioid analgesics (alfentanil), anticonvulsants (phenytoin, carbamazepine), calcium antagonists (verapamil, nifedipine, felodipine) and anticoagulants (warfarin). Some lipophilic anti-infective agents inhibit (clarithromycin, itraconazole) or induce (rifampicin) the transmembrane transporter P-glycoprotein, which promotes excretion from renal tubular and intestinal cells. This results in a decrease or increase, respectively, in the clearance of P-glycoprotein substrates at the renal level and an increase or decrease, respectively, of their oral bioavailability at the intestinal level. Hydrophilic anti-infective agents are often eliminated unchanged by renal glomerular filtration and tubular secretion, and are therefore involved in competition for excretion. Beta-lactams are known to compete with other drugs for renal tubular secretion mediated by the organic anion transport system, but this is frequently not of major concern, given their wide therapeutic index. However, there is a risk of nephrotoxicity and neurotoxicity with some cephalosporins and carbapenems. Therapeutic failure with these hydrophilic compounds may be due to haemodynamically active coadministered drugs, such as dopamine, dobutamine and furosemide, which increase their renal clearance by means of enhanced cardiac output and/or renal blood flow. Therefore, coadministration of some drugs should be avoided, or at least careful therapeutic drug monitoring should be performed when available. Monitoring may be especially helpful when there is some coexisting pathophysiological condition affecting drug disposition, for example malabsorption or marked instability of the systemic circulation or of renal or hepatic function.  N. Ref:: 397

 

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[119]

TÍTULO / TITLE:  - Plant growth and the TOR pathway.

REVISTA / JOURNAL:  - Curr Top Microbiol Immunol 2004;279:97-113.

AUTORES / AUTHORS:  - Menand B; Meyer C; Robaglia C

INSTITUCIÓN / INSTITUTION:  - CEA Cadarache DSV DEVM, Laboratoire du Metabolisme Carbone, UMR 163 CNRS CEA, Univ-Mediterranee UMR 163, Saint-Paul-lez-Durance, France.

RESUMEN / SUMMARY:  - In mammalian, insect, and yeast cells, TOR proteins are essential regulators of cell growth in response to environmental signals including nutrients, mitogens, and stresses. Although many aspects of the TOR-dependent signalling pathway are conserved between animals and fungi, important differences have also been found and are likely to be related to the ecophysiological adaptations of these organisms. The TOR protein also exists in plants. This review will first discuss specific aspects of plants concerning the contribution of cell growth to overall growth, as well as their responses to nutrient starvation, with emphasis on recent results obtained through genetic analysis in the model plant Arabidopsis thaliana. This is followed by the current status of the genetic analysis of the TOR gene in this plant and the search for potential members of a TOR pathway in the Arabidopsis genome.  N. Ref:: 51

 

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[120]

TÍTULO / TITLE:  - Cyclophilin D as a drug target.

REVISTA / JOURNAL:  - Curr Med Chem 2003 Aug;10(16):1485-506.

AUTORES / AUTHORS:  - Waldmeier PC; Zimmermann K; Qian T; Tintelnot-Blomley M; Lemasters JJ

INSTITUCIÓN / INSTITUTION:  - Nervous System Research, Novartis Pharma Ltd., CH-4002 Basel, Switzerland. peter.waldmeier@pharma.novartis.com

RESUMEN / SUMMARY:  - The mitochondrial permeability transition (MPT) plays an important role in damage-induced cell death, and agents inhibiting the MPT may have a therapeutic potential for treating human conditions such as ischemia/reperfusion injury, trauma, and neurodegenerative diseases. The mitochondrial matrix protein, cyclophilin D (CYP D), a member of a family of highly homologous peptidylprolyl cis-trans isomerases (PPIases), plays a decisive role in MPT, being an integral constituent of the MPT pore. Other putative MPT pore proteins include the adenine nucleotide translocator (ANT) and the voltage-dependent anion channel (VDAC). In an alternative model, the MPT pore is formed by clusters of misfolded membrane proteins outlining aqueous channels that are regulated by CYP D and other chaperone-like proteins. Like cyclophilin A (CYP A) and other cyclophilin family members, CYP D is targeted by the immunosuppressant cyclosporin A (CsA). CsA is cytoprotective in many cellular and animal models, but protection may result from either inhibition of the MPT through an interaction with CYP D or inhibition of calcineurin-mediated dephosphorylation of BAD through an interaction with CYP A. The relevance of MPT inhibition by CsA for its cytoprotective effects is well documented in many cellular models. Mechanisms of action in vivo are more difficult to define, and accordingly the evidence is as yet less compelling in in vivo animal models of ischemia/reperfusion injury, trauma and neurodegenerative diseases. Notwithstanding, CYP D is a drug target of high interest. Structural considerations suggest feasibility of designing CYP D ligands without immunosuppressant properties. This is highly desirable, since they have the potential of being useful therapeutic agents in a variety of disease states. It might be a tougher challenge to obtain compounds specific for CYP D vs. other cyclophilins, and/or of small molecular weight, allowing brain penetration to make them suitable for treating neurodegenerative diseases.  N. Ref:: 204

 

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[121]

TÍTULO / TITLE:  - T-cell depleting antibodies: new hope for induction of allograft tolerance in bone marrow transplantation?

REVISTA / JOURNAL:  - BioDrugs 2003;17(3):147-54.

AUTORES / AUTHORS:  - Simpson D

INSTITUCIÓN / INSTITUTION:  - North Shore Hospital, PB 93-503, Takapuna, Auckland 1309, New Zealand. david.simpson@whl.co.nz

RESUMEN / SUMMARY:  - Graft versus host disease (GVHD) remains the main barrier to successful allogeneic bone marrow transplant outcomes. Depletion of graft T cells is an effective way of reducing the incidence of acute and chronic GVHD, and a variety of methods have been used to achieve this depletion. Donor CD8+ T cells seem to be the critical effector cells; GVHD is reduced when the depletion process eliminates these cells, but not when CD4 cells are targeted alone. However, despite the successful reduction in GVHD, transplant outcomes are usually inferior with T-cell depleted transplants, because of increased graft failure, infections and relapse. Alternative approaches are needed. In vivo T-cell depletion, using antithymocyte globulin (ATG) as part of the conditioning regimen, seems an attractive option. Pre-transplant ATG lingers in the bone marrow to deplete engrafting donor T cells, but also depletes host T cells to prevent graft rejection and allow de-escalation of the conditioning regimen. It also avoids the need for graft manipulation with its associated costs, need for expertise and CD34+ cell loss. The efficacy of pre-transplant horse ATG remains anecdotal but it has been reported to modestly lower GVHD in single arm studies. Rabbit ATG has been studied in prospective randomised trials. There is evidence of a dose-response effect in reducing GVHD; however, there was no improvement in outcome, because of increased mortality associated with infection. In contrast, pre-transplant alemtuzumab (campath-1H) or an earlier version of this molecule (campath-1G), which target CD52+ cells, do appear to be effective in reducing both acute and chronic GVHD. There is speculation that this is not solely due to the effect of campath on T cells but that it may also be due to the elimination of host antigen-presenting cells (APC), which seem to be important in GVHD pathogenesis. Host APC are more efficient at expressing endogenous and exogenous host antigens on class I MHC to donor CD8+ cells than donor APC, which need to cross-prime exogenous antigen. Campath-1G eliminates host dendritic cells by the time of graft infusion, supporting this as a possible mechanism of action. Pre-transplant alemtuzumab has not yet been studied in a prospective randomised study, and this is required to quantify any benefit on outcome; despite this, published studies do show cause for optimism.  N. Ref:: 42

 

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[122]

TÍTULO / TITLE:  - Subcutaneous infection with Mycobacterium fortuitum after allogeneic bone marrow transplantation.

REVISTA / JOURNAL:  - Bone Marrow Transplant 2001 Oct;28(7):709-11.

      ●● Enlace al texto completo (gratuito o de pago) 1038/sj/bmt/1703211

AUTORES / AUTHORS:  - Okano A; Shimazaki C; Ochiai N; Hatsuse M; Takahashi R; Ashihara E; Inaba T; Fujita N; Noda Y; Nakagawa M

INSTITUCIÓN / INSTITUTION:  - Second Department of Medicine, Kyoto Prefectural University of Medicine, 465 Kawaramachi-Hirokoji, Kami-gyoku, Kyoto, 602-8566, Japan.

RESUMEN / SUMMARY:  - Reports of cases of mycobacterial infections after SCT are rare. We report a 30-year-old female with a cutaneous infection of Mycobacterium fortuitum 30 months after allogeneic bone marrow transplantation for acute lymphoblastic leukemia. The patient was successfully treated with surgical debridement followed by oral minocycline and clarithromycin. Mycobacterial infections should be considered in SCT patients with undiagnosed refractory chronic cutaneous infection, and surgical debridement is useful for the diagnosis and treatment of such infections.  N. Ref:: 7

 

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[123]

TÍTULO / TITLE:  - mTOR signaling to translation.

REVISTA / JOURNAL:  - Curr Top Microbiol Immunol 2004;279:169-97.

AUTORES / AUTHORS:  - Gingras AC; Raught B; Sonenberg N

INSTITUCIÓN / INSTITUTION:  - Department of Biochemistry, McGill Cancer Centre, McGill University, 3655 Promenade Sir-William-Osler, Montreal, Quebec, H3G 1Y6, Canada.

RESUMEN / SUMMARY:  - Over the past few years, the target of rapamycin (TOR) pathway has been implicated in the control of translation, both in yeast and in higher eukaryotes. In this review, we provide an overview of translation in eukaryotes, and discuss the mechanisms and advantages of the regulation of translation. We then describe how the TOR pathway can modulate translation in yeast and in mammals, through the modulation of the phosphorylation of key translation components, and the regulation of the abundance of ribosomes and translation factors.  N. Ref:: 117

 

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[124]

TÍTULO / TITLE:  - The involvement of mammalian and plant FK506-binding proteins (FKBPs) in development.

REVISTA / JOURNAL:  - Transgenic Res 2002 Aug;11(4):321-35.

AUTORES / AUTHORS:  - Breiman A; Camus I

INSTITUCIÓN / INSTITUTION:  - Department of Plant Science, Tel Aviv University, Israel. adina@post.tau.ac.il

RESUMEN / SUMMARY:  - The FK506-binding proteins (FKBPs) are peptidyl prolyl cis/trans isomerases and the information gathered in the last 10 years reveals their involvement in diverse biological systems affecting the function and structure of target proteins. Members of the FKBP family were shown to be growth-regulated and participate in signal transduction. In this review we have chosen to focus on a few examples of the mammalian and plant systems in which members of the FKBP family have been demonstrated to affect the function of proteins or development. The technologies that enable production of knockout mice, Arabidopsis mutants and overexpression in transgenic organisms have revealed the contribution of FKBP to development in higher eukaryotes. It appears that members of the FKBP family have conserved some of their basic functions in the animal and plant kingdom, whereas other functions became unique. Studies that will take advantage of the full genome sequence available for Arabidopsis and the human genome, DNA chip technologies and the use of transgenic complementation system will contribute to the elucidation of the molecular mechanism and biological function of FKBPs.  N. Ref:: 120

 

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[125]

TÍTULO / TITLE:  - Treatment with immunotoxin.

REVISTA / JOURNAL:  - Philos Trans R Soc Lond B Biol Sci. Acceso gratuito al texto completo a partir de los 2 años de la fecha de publicación.

      ●● Enlace a la Editora de la Revista http://www.pubs.royalsoc.ac.uk/ 

      ●● Cita: Philos Trans R Soc Lond B Biol Sci: <> 2001 May 29;356(1409):681-9.

AUTORES / AUTHORS:  - Knechtle SJ

INSTITUCIÓN / INSTITUTION:  - Department of Surgery, Division of Organ Transplantation, 600 Highland Avenue, University of Wisconsin Medical School, Madison,WI 53792-7375, USA. stuart@tx.surgery.wisc.edu

RESUMEN / SUMMARY:  - T-cell depletion prior to or beginning at the time of transplantation has been shown to be a valuable adjunct to the induction of immunological unresponsiveness. Both total lymphoid irradiation and anti-lymphocyte globulin have been used for this purpose in experimental models of transplantation as well as in human organ transplant recipients. However, these methods of T-cell depletion are limited in their ability to deplete T cells selectively due to non-specific targeting and limited efficacy. A new anti-CD3 immunotoxin has been developed with a far more potent ability to deplete T cells selectively as measured by flow cytometry analysis of peripheral blood T lymphocytes as well as lymph node lymphocytes. This immunotoxin is well tolerated by rhesus monkeys when administered in vivo. When administered as a single immunosuppressive agent pretransplant, it substantially promotes allograft survival, inducing tolerance in at least one-third of recipients as measured by subsequent acceptance of donor skin grafts and rejection of third-party skin grafts. When administered on the day of transplant in combination with steroid pretreatment and a brief course of deoxyspergualin or mycophenolate mofetil (4 to 14 days), long-term unresponsiveness is also produced and in a more reliable manner than using immunotoxin alone. A new immunotoxin directed at the human CD3epsilon has been developed with excellent potency in T-cell killing and lacking the Fc portion of the CD3 antibody. This construct may be useful for T-cell depletion in humans and has a potential application in tolerance induction in human organ transplantation. Lessons learned from anti-CD3 immunotoxin in the non-human primate model to date include (i) profound (2-3 log) depletion of T-cells can be accomplished safely without inducing lymphoma or infection, (ii) such depletion is a useful adjunct for tolerance induction to allogeneic organ transplants, and (iii) tolerance to both allogeneic renal transplants and xenogeneic islet transplants has been accomplished using such strategies to date in non-human primates and in pigs. Immunotoxin may be useful for the induction of chimerism using strategies that include donor bone marrow infusion. Successful strategies for tolerance induction have also been developed using immunotoxin without the adjunct of donor bone marrow or stem cell infusion. Clinical application of immunotoxin will use a newly engineered construct with the potential for causing cytokine release, less susceptibility to neutralization by anti-diphtheria antibody and not dependent on chemical conjugation of an antibody and toxin. The usefulness of immunotoxin is directly related to its tremendous potency for depleting T cells. Based on results in nonhuman primates, it is anticipated that it will become a useful agent in tolerance induction in humans.  N. Ref:: 63

 

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[126]

TÍTULO / TITLE:  - Insights into pharmacogenomics and its impact upon immunosuppressive therapy.

REVISTA / JOURNAL:  - Transpl Immunol 2002 May;9(2-4):203-9.

AUTORES / AUTHORS:  - Yagil Y; Yagil C

INSTITUCIÓN / INSTITUTION:  - Department of Nephrology and Hypertension, Faculty of Health Sciences, Ben-Gurion University, Barzilai Medical Center, Ashkelon, Israel. labmomed@bgumail.bgu.ac.il

RESUMEN / SUMMARY:  - The advent of the genomic era has brought about several new fields of study, one of them being pharmacogenomics, which seeks to link drug treatment (pharmaco-) with the individual’s genetic make-up (genomics). Pharmacogenomics holds many promises for improved treatment of a large variety of medical conditions, including immunosuppression for organ transplantation and autoimmune disease. Many of these promises have, however, not yet been fulfilled. In this brief overview of the subject, we attempt to provide insights into the evolving field of pharmacogenomics and discuss some of its potential benefits and promises, technological tools used by pharmacogenomics, the reasons for delays in breakthroughs in the field, and the relevance of pharmacogenornics to immunosuppression.  N. Ref:: 65

 

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[127]

TÍTULO / TITLE:  - Clinically significant drug interactions with agents specific for migraine attacks.

REVISTA / JOURNAL:  - CNS Drugs 2001;15(2):105-18.

AUTORES / AUTHORS:  - Eadie MJ

INSTITUCIÓN / INSTITUTION:  - Department of Medicine, University of Queensland, Royal Brisbane Hospital, Australia. M.Eadie@mailbox.uq.edu.au

RESUMEN / SUMMARY:  - The drugs which provide specific relief from migraine attacks, the ergopeptides (ergotamine and dihydroergotamine) and the various ‘triptans’ (notably sumatriptan), are often prescribed for persons already taking various migraine preventative agents, and sometimes drugs for other indications. As a result, migraine-specific drugs may become involved in drug-drug interactions. The migraine-specific drugs all act as agonists at certain subclasses of serotonin (5-hydroxytryptamine; 5-HT) receptor, particularly those of the 5-HT1D subtype, and produce vasoconstriction through these receptor-mediated mechanisms. The oral bioavailabilities of these drugs, particularly those of the ergopeptides, are often incomplete, due to extensive presystemic metabolism. As a result, if migraine-specific agents are coadministered with drugs with vasoconstrictive properties, or with drugs which inhibit the metabolism of the migraine-specific agents, there is a risk of interactions occurring which produce manifestations of excessive vasoconstriction. This can also occur through pharmacodynamic mechanisms, as when ergopeptides or triptans are coadministered with methysergide or propranolol (although a pharmacokinetic element may apply in relation to the latter interaction), or if one migraine-specific agent is used shortly after another. When ergopeptide metabolism is inhibited by the presence of macrolide antibacterials, particularly troleandomycin and erythromycin, the resultant interaction can produce ergotism, sometimes leading to gangrene. Similar pharmacokinetic mechanisms, with their vasoconstrictive consequences, probably apply to combination of the ergopeptides with HIV protease inhibitors (indinavir and ritonavir), heparin, cyclosporin or tacrolimus. Inhibition of triptan metabolism by monoamine oxidase A inhibitors, e.g. moclobemide, may raise circulating triptan concentrations, although this does not yet seem to have led to reported clinical problems. Caffeine may cause increased plasma ergotamine concentrations through an as yet inadequately defined pharmacokinetic interaction. However, a direct antimigraine effect of caffeine may contribute to the claimed increased efficacy of ergotamine-caffeine combinations in relieving migraine attacks. Serotonin syndromes have been reported as probable pharmacodynamic consequences of the use of ergots or triptans in persons taking serotonin reuptake inhibitors. There have been two reports of involuntary movement disorders when sumatriptan has been used by patients already taking loxapine. Nearly all the clinically important interactions between the ergopeptide antimigraine agents and currently marketed drugs are likely to have already come to notice. In contrast, new interactions involving the triptans are likely to be recognised as additional members of this family of drugs, with their different patterns of metabolism and pharmacokinetics, are marketed.  N. Ref:: 101

 

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[128]

TÍTULO / TITLE:  - Methods and assays to investigate nuclear export.

REVISTA / JOURNAL:  - Curr Top Microbiol Immunol 2001;259:119-28.

AUTORES / AUTHORS:  - Stauber RH

INSTITUCIÓN / INSTITUTION:  - Institute for Clinical and Molecular Virology, University of Erlangen-Nurnberg, Schlossgarten 4, 91054 Erlangen, Germany.  N. Ref:: 34

 

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[129]

TÍTULO / TITLE:  - Structures of immunophilins and their ligand complexes.

REVISTA / JOURNAL:  - Curr Top Med Chem 2003;3(12):1392-409.

AUTORES / AUTHORS:  - Dornan J; Taylor P; Walkinshaw MD

INSTITUCIÓN / INSTITUTION:  - Structural Biochemistry, The University of Edinburgh, Michael Swann Building, King’s Buildings, Edinburgh EH9 3JR, Scotland, UK. M.WALKINSHAW@ed.ac.uk

RESUMEN / SUMMARY:  - This review includes an analysis of available X-ray and NMR structures of both members of the immunophilin family; cyclophilins and the FK-506 binding proteins (FKBPs). Available structures are compared and contrasted to highlight different structural features seen both within and between species. Each immunophilin family has been structurally characterised with a variety of small molecule ligands, principally immunosuppressive drugs and their analogues and an overview of these complexes is also presented. Currently the Protein Data Base contains over 60 entries for cyclophilins and over 40 entries for FKBPs. A number of FKBP related structures are also available including structures of MIP (Macrophage Infectivity Potentiator protein) from Legionella pneumophila and Trypanosoma cruzi and Trigger Factor from Mycoplasma genitalium. For all structures discussed in the review a summary of the available biological data is also presented.  N. Ref:: 106

 

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[130]

TÍTULO / TITLE:  - Novel therapies for anti-neutrophil cytoplasmic antibody-associated vasculitis.

REVISTA / JOURNAL:  - Curr Opin Nephrol Hypertens 2001 Mar;10(2):211-7.

AUTORES / AUTHORS:  - Tervaert JW; Stegeman CA; Kallenberg CG

INSTITUCIÓN / INSTITUTION:  - University Hospital Maastricht, Department of Clinical and Experimental Immunology, Maastricht, the Netherlands. jw.cohentervaert@immuno.unimaas.nl

RESUMEN / SUMMARY:  - High-dose corticosteroids in combination with cytotoxic drugs are universally accepted as the initial approach in vasculitides that are associated with anti-neutrophil cytoplasmic antibodies. Cyclophosphamide is the most effective cytotoxic drug and is used in more severe cases. Because cyclophosphamide has more severe short- and long-term side-effects than methotrexate, methotrexate is used in less severe cases. New prospects for the treatment of vasculitis include novel immunosuppressive agents (e.g. mycophenolate, 15-deoxyspergualin, and leflunomide), sequential chemotherapy (e.g. cyclophosphamide followed by azathioprine or cyclophosphamide followed by methotrexate), intravenous immunoglobulin, tumour necrosis factor-alpha directed therapy, anti-lymphocyte directed therapy (e.g. antithymocyte globulin or anti CD52/anti CD4 antibodies), anti-adhesion molecule directed therapy (e.g. anti-CD18 or intercellular adhesion molecule-1 antisense) or immunoablation using high-dose cytotoxic medication with or without stem cell rescue.  N. Ref:: 60

 

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[131]

TÍTULO / TITLE:  - Role of anti-interleukin-2 receptor antibodies in kidney transplantation.

REVISTA / JOURNAL:  - BioDrugs 2001;15(10):655-66.

AUTORES / AUTHORS:  - Cibrik DM; Kaplan B; Meier-Kriesche HU

INSTITUCIÓN / INSTITUTION:  - University of Michigan, Ann Arbor, Michigan 48109-0704, USA. dcibrik@umich.edu

RESUMEN / SUMMARY:  - From the early 1960s, the mainstay of immunosuppression for kidney transplantation has been corticosteroids. Since then, many new drugs have been developed to maintain the renal allograft. Current maintenance immunosuppression commonly consists of corticosteroids, antiproliferative agents and calcineurin inhibitors (e.g. cyclosporin). More recently, antihuman antibodies, either monoclonal or polyclonal, have been developed to use for induction at the time of transplantation or to treat rejection. With the advances in molecular technology, a new class of antihuman antibodies [the anti-interleukin-2 receptor (IL-2R) antibodies] has emerged that incorporate a murine antigen-binding site on to a human immunoglobulin backbone. Such methodology creates antihuman antibodies with high affinity for the epitope and with prolonged serum antibody half-lives. Interleukin-2 and its receptor are central to lymphocyte activation and are the main targets of calcineurin inhibitors. In addition, the anti-IL-2R antibodies inhibit a key target in immune activation. Daclizumab and basiliximab have been shown to significantly reduce the incidence of acute rejection in kidney transplantation. Since these anti-IL-2R antibodies are well tolerated and since calcineurin inhibitors are intrinsically nephrotoxic, anti-IL-2R antibodies have been used in an attempt to avoid cyclosporin after transplantation. Data from clinical trials seem to indicate that the addition of an anti-IL-2R antibody is not sufficient to warrant complete withdrawal of calcineurin inhibitors for more than a very short period after transplantation. A more promising role for anti-IL-2R antibodies may be in renal transplant recipients with delayed graft function (DGF). Recent data on the use of either low-dose calcineurin inhibitors or sirolimus (rapamycin) in conjunction with the anti-IL-2R antibodies for patients with DGF showed no increased risk of acute rejection. Long-term graft survival with use of these low-dose calcineurin inhibitor protocols has yet to be established.  N. Ref:: 41

 

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[132]

TÍTULO / TITLE:  - Chromomycosis due to Exophiala jeanselmei in a renal transplant recipient.

REVISTA / JOURNAL:  - Eur J Dermatol 2003 May-Jun;13(3):305-7.

AUTORES / AUTHORS:  - Pena-Penabad C; Duran MT; Yebra MT; Rodriguez-Lozano J; Vieira V; Fonseca E

INSTITUCIÓN / INSTITUTION:  - Department of Dermatology, Complejo Hospitalario Juan Canalejo, Servicio de Dermatologia, Xubias de Arriba, 84, 15006. a Coruna, España.

RESUMEN / SUMMARY:  - Chromomycosis is a rare mycotic infection that is more frequent in tropical and subtropical regions. Dematiaceous fungi are the causal agents of this mycosis. Several cases of chromomycosis in organ transplant recipients have been reported. We present a case of chromomycosis by Exophiala jeanselmei in a Spanish male who had received a renal transplant several months previously, and was receiving treatment with tacrolimus, prednisone and mycophenolate mofetil. Very few cases of chromomycosis due to Exophiala have been reported, and this is, to our knowledge, the first European case.  N. Ref:: 16

 

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[133]

TÍTULO / TITLE:  - Transcriptional reprogramming during T helper cell differentiation.

REVISTA / JOURNAL:  - Immunol Res 2001;23(2-3):193-204.

AUTORES / AUTHORS:  - Aune TM

INSTITUCIÓN / INSTITUTION:  - Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN 37232, USA. thomas.aune@mcmail.vanderbilt.edu

RESUMEN / SUMMARY:  - Our laboratory employs reporter transgenic mice as model systems to study the transcriptional reprogramming that accompanies T helper cell differentiation. These studies demonstrate that changes in the activity of simple transcriptional elements associated with the IFN-gamma gene can recapitulate alterations in gene expression. In addition, our studies have revealed a key role for the transcription factor, CAMP response element binding protein (CREB), in the protection of differentiating T cells from apoptosis. Together, these findings further our understanding of the logic employed by T cells to alter gene expression profiles in response to differentiation signals.  N. Ref:: 49

 

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[134]

TÍTULO / TITLE:  - Good fungi gone bad: the corruption of calcineurin.

REVISTA / JOURNAL:  - Bioessays 2002 Oct;24(10):894-903.

      ●● Enlace al texto completo (gratuito o de pago) 1002/bies.10157

AUTORES / AUTHORS:  - Fox DS; Heitman J

INSTITUCIÓN / INSTITUTION:  - Department of Molecular Genetics and Microbiology, Duke University Medical Center, Durham, NC 27710, USA.

RESUMEN / SUMMARY:  - Calcineurin is a Ca(2+)/calmodulin-activated protein phosphatase that is conserved in eukaryotes, from yeast to humans, and is the conserved target of the immunosuppressive drugs cyclosporin A (CsA) and FK506. Genetic studies in yeast and fungi established the molecular basis of calcineurin inhibition by the cyclophilin A-CsA and FKBP12-FK506 complexes. Calcineurin also functions in fungi to control a myriad of physiological processes including cell cycle progression, cation homeostasis, and morphogenesis. Recent investigations into the molecular mechanisms of pathogenesis in Candida albicans and Cryptococcus neoformans, two fungi that cause life-threatening infections in humans, have revealed an essential role for calcineurin in morphogenesis, virulence, and antifungal drug action. Novel non-immunosuppressive analogs of the calcineurin inhibitors CsA and FK506 that retain antifungal activity have been identified and hold promise as candidate antifungal drugs. In addition, comparisons of calcineurin function in both fungi and humans may identify fungal-specific components of calcineurin-signaling pathways that could be targeted for therapy, as well as conserved elements of calcium signaling events.  N. Ref:: 88

 

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[135]

TÍTULO / TITLE:  - The limitations of calcineurin and mTOR inhibitors: new directions for immunosuppressive strategies.

REVISTA / JOURNAL:  - Transplant Proc 2002 Feb;34(1):130-3.

AUTORES / AUTHORS:  - Kahan BD

INSTITUCIÓN / INSTITUTION:  - Division of Organ Transplantation, Department of Surgery, The University of Texas Medical School, Houston, Texas 77030, USA.  N. Ref:: 76

 

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[136]

TÍTULO / TITLE:  - Acquired anti-FVIII inhibitors in children.

REVISTA / JOURNAL:  - Haemophilia 2002 Jan;8(1):28-32.

AUTORES / AUTHORS:  - Moraca RJ; Ragni MV

INSTITUCIÓN / INSTITUTION:  - The Department of Medicine, Division of Hematology/Oncology, University of Pittsburgh Medical Center, PA, USA.

RESUMEN / SUMMARY:  - Acquired inhibitors to FVIII (anti-FVIII) are uncommon in children. An acquired anti-FVIII developed in a previously healthy 4-year-old boy treated with penicillin for streptococcal pharyngitis. Aspirin prophylaxis begun for suspected rheumatic fever led to compartment syndromes of all four extremities, which resolved with high-dose FVIII and surgical decompression. Anti-FVIII in this patient, and the five additional cases identified in a survey of 160 haemophilia treatment centres, occurred at a median age of 8 years, with median initial and peak titres of 4.6 and 6.9 Bethesda Units (BU), respectively. All six presented with bleeding, including haematomas (three intramuscular, one intracranial), and ecchymoses in three. The median baseline FVIII was 0.05 U mL(-1), and the median baseline activated partial thromboplastin time (APTT) was 79.8 s. The inhibitor resolved completely in five patients (83%) within a median 5 months, after treatment with FVIII concentrate, steroids, cytoxan, methotrexate, and no treatment. The inhibitor persisted in the patient with Goodpasture’s disease, despite steroids, cytoxan, cyclosporin, and intravenous gamma globulin. Aspirin therapy, in two, worsened ongoing bleeding. The association of penicillin-like drugs in this and three other cases in the literature suggest that to avoid potential catastrophic bleeding, it is prudent to obtain an APTT prior to initiating aspirin for suspected rheumatic fever. In conclusion, acquired anti-FVIII inhibitors in children may cause severe bleeding, and remit in the majority after FVIII and/or immunosuppressive therapy.  N. Ref:: 21

 

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[137]

TÍTULO / TITLE:  - Safety of the new macrolide immunomodulators.

REVISTA / JOURNAL:  - Semin Cutan Med Surg 2001 Dec;20(4):242-9.

AUTORES / AUTHORS:  - Robinson N; Singri P; Gordon KB

INSTITUCIÓN / INSTITUTION:  - Department of Dermatology, Northwestern University, Chicago, IL 60611, USA.

RESUMEN / SUMMARY:  - With the wide acceptance of cyclosporine in the treatment of skin disease, there has been an effort to find new immunomodulating agents with superior safety profiles for use in dermatology. Among the most promising of the classes are the new macrolide immunomodulators, including tacrolimus and pimecrolimus. Of these, only tocrolimus has had widespread use for nondermatologic indications, primarily solid organ transplantation. Both of these agents have been studied for inflammatory diseases of the skin. In this article, we review the systemic and topical toxicities of these macrolide immunomodulators.  N. Ref:: 68

 

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[138]

TÍTULO / TITLE:  - Signalling pathways in cardiac myocyte hypertrophy.

REVISTA / JOURNAL:  - Ann Med 2001 Dec;33(9):611-22.

AUTORES / AUTHORS:  - Sugden PH

INSTITUCIÓN / INSTITUTION:  - National Heart and Lung Institute Division, Faculty of Medicine, Imperial College of Science, Technology and Medicine, London, UK. p.sugden@ic.ac.uk

RESUMEN / SUMMARY:  - In response to a requirement for increased contractile power in vivo, mammalian cardiac myocytes adapt through a hypertrophic response (cell enlargement in the absence of cell division). This response can be simulated by exposing isolated myocytes in primary culture to alpha-adrenergic agonists or the vasoactive peptide, endothelin-1. The signalling pathways responsible for hypertrophic growth have been actively studied, and it is likely that reversible protein phosphorylation and dephosphorylation are involved. Three signalling pathways show particular potential as regulators of the response, ie protein kinase C (PKC), mitogen-activated protein kinase (MAPK) cascades, and calcineurin. These species are thought to regulate the rate and specificity of gene transcription ultimately through modifying the transactivating activity of nuclear transcription factors. There are three pertinent MAPK cascades, the extracellular signal-regulated kinase (ERK) cascade, the c-Jun N-terminal kinase (JNK or SAPK1) cascade, and the p38-MAPK (SAPK2-5) cascade. PKC participates in the activation of the ERK cascade but does not contribute significantly to the activation of the two remaining cascades. Calcineurin (or protein phosphatase 2B) is activated by increases in [Ca2+i] through the [Ca2+]-sensing protein, calmodulin. In this review, I discuss the evidence for and against the involvement of these signalling proteins in the induction of myocyte hypertrophy and emphasize that the ERK cascade should perhaps feature more widely in the collective consciousness.  N. Ref:: 136

 

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[139]

TÍTULO / TITLE:  - Cyclosporin A as a model antigen: immunochemical and structural studies.

REVISTA / JOURNAL:  - J Mol Recognit 2002 Sep-Oct;15(5):277-85.

      ●● Enlace al texto completo (gratuito o de pago) 1002/jmr.588

AUTORES / AUTHORS:  - Altschuh D

INSTITUCIÓN / INSTITUTION:  - UMR 7100 - CNRS/ULP ‘Biotechnologie des Interactions Moleculaires’, Ecole Superieure de Biotechnologie de Strasbourg, Pole API, Bld Sebastien Brandt, 67400 Illkirch, France. daniele.altschuh@esbs.u-strasbg.fr

RESUMEN / SUMMARY:  - The immunosuppressant drug cyclosporin (Cs) A is a cyclic undecapeptide which has been used as a model antigen because structural information and a large number of analogs, modified at each of its 11 positions, were available. This review summarizes immunochemical and crystallographic studies of the interaction between the Fab of monoclonal antibody R45-45-11 and Cs. Three points are discussed: (1) the different conformations of CsA and the question of its biologically active form; (2) the Fab-CsA recognition mechanism; and (3) the relationship between structure and binding properties of CsA analogs.  N. Ref:: 50

 

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[140]

TÍTULO / TITLE:  - Homocysteine levels among transplant recipients: effect of immunosuppressive protocols.

REVISTA / JOURNAL:  - Transplant Proc 2001 Sep;33(6):2945-6.

AUTORES / AUTHORS:  - Mor E; Helfmann L; Lustig S; Bar-Nathan N; Yussim A; Sela BA

INSTITUCIÓN / INSTITUTION:  - Department of Transplantation, Rabin Medical Center, Petach-Tikva, Israel.

 

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[141]

TÍTULO / TITLE:  - Advances in the treatment of lupus nephritis.

REVISTA / JOURNAL:  - Annu Rev Med 2001;52:63-78.

      ●● Enlace al texto completo (gratuito o de pago) 1146/annurev.med.52.1.63

AUTORES / AUTHORS:  - Zimmerman R; Radhakrishnan J; Valeri A; Appel G

INSTITUCIÓN / INSTITUTION:  - Columbia University College of Physicians and Surgeons, New York, New York 10032, USA.

RESUMEN / SUMMARY:  - Systemic lupus erythematosus (SLE) is an autoimmune disease that leads to the formation and deposition of immune complexes throughout the body, which are pathogenic for the disease. Different forms of glomerulonephritis can occur in patients with SLE and can contribute significantly to the associated morbidity and, ultimately, mortality from the disease. Over the past two decades, there have been significant strides in our understanding of the disease and in treatments that attempt to control the formation and deposition of anti-DNA auto-antibodies and immune complexes, as well as the subsequent inflammatory cascade mediated through various cellular and humoral pathways leading to progressive renal damage and end-stage renal disease. In this chapter, we review the current understanding of the pathogenesis and treatment of lupus nephritis in its various stages and discuss the experimental and human data regarding some of the potential newer forms of therapy. We discuss data regarding the use of steroids, azathioprine, cyclophosphamide, cyclosporine A, mycophenolate mofetil, gammaglobulin, plasmapheresis, LJP 394, flaxseed oil, bindarit, anti-CD40 ligand, and CTLA4Ig.  N. Ref:: 89

 

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[142]

TÍTULO / TITLE:  - Molecular and cellular mechanisms of donor cell-induced tolerance.

REVISTA / JOURNAL:  - Immunol Res 2002;26(1-3):119-29.

AUTORES / AUTHORS:  - George JF; Ahumada L; Lu A

INSTITUCIÓN / INSTITUTION:  - Department of Surgery, University of Alabama at Birmingham, 35294-0007, USA. jgeorge@uab.edu

RESUMEN / SUMMARY:  - The induction of immunologic tolerance to solid organ allografts is a subject of intense investigation because of the morbidity and mortality associated with standard immunosuppressive therapy. One method that is currently in clinical and preclinical testing involves the transient ablation of recipient T cells using polyclonal antithymocyte sera or monoclonal anti-CD4/CD8 antibody treatment, followed by the posttransplant administration of donor bone marrow cells or of donor peripheral lymphoid populations. Recent studies in our laboratory have shown that the molecular and cellular basis of the prolongation of graft survival by donor cell administration depends on the cellular compartment from which the donor cells were derived. We provide here a brief review of these data followed by new data suggesting that the mode of peripheral and central selection is also dependent on the source from which the donor cells were derived.  N. Ref:: 38

 

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[143]

TÍTULO / TITLE:  - mTOR inhibitors: an overview.

REVISTA / JOURNAL:  - Liver Transpl 2001 Jun;7(6):473-84.

      ●● Enlace al texto completo (gratuito o de pago) 1053/jlts.2001.24645

AUTORES / AUTHORS:  - Neuhaus P; Klupp J; Langrehr JM

INSTITUCIÓN / INSTITUTION:  - Department of Surgery, Charite Virchow, Berlin, Germany. chirurgie@charite.de

RESUMEN / SUMMARY:  - Inhibitors of the mammalian target of rapamycin are a new class of immunosuppressants. In contrast to other macrolides, such as tacrolimus and cyclosporine A, they do not inhibit calcineurin and thus signal I of T-cell activation. By inhibiting signal III, the mechanism of action and side effects of sirolimus (rapamycin) and its derivative RAD are distinct from other immunosuppressants. Reports of synergism with cyclosporine A and tacrolimus in preclinical and clinical studies, avoidance of nephrotoxicity, and possible treatment or prevention of chronic allograft rejection are leading to high expectations for this new class of immunosuppressants. Furthermore, studies evaluating tolerance induction are being conducted. This review summarizes preclinical and clinical results published to date and exploits the future value of sirolimus and RAD for clinical transplantation.  N. Ref:: 119

 

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[144]

TÍTULO / TITLE:  - IL-17 as a potential target for modulating airway neutrophilia.

REVISTA / JOURNAL:  - Curr Pharm Des 2002;8(20):1855-61.

AUTORES / AUTHORS:  - Laan M; Linden

INSTITUCIÓN / INSTITUTION:  - Lung Pharmacology Group, Department of Respiratory Medicine Allergology, Guldhedsgatan 10A, Gothenburg, SE-413 46, Sweden. martti.laan@hjl.gu.se

RESUMEN / SUMMARY:  - Several chronic inflammatory airway diseases are characterized by an increased number of neutrophils in the airways. There is evidence that the recruitment of these neutrophils can be controlled by certain T-lymphocytes. However, the mechanisms behind this T-cell control of airway neutrophilia are poorly understood. In this review, we summarize the evidence that interleukin (IL)-17 released from T-lymphocytes of the CD45RO+ subset can link the activation of these T-cells to the recruitment and activation of neutrophils. This evidence suggests that pharmacotherapeutical modulation of neutrophilic airway inflammation can be achieved using several different strategies, including inhibition of IL-17 production by cAMP elevating agents or certain nuclear factor inhibitors, neutralization of released IL-17 protein by specific anti-IL-17-antibodies, blockade of the IL-17 receptor as well as inhibition of certain MAP kinases mediating the post receptor effects of IL-17 in airway cells. Additional studies on animals in vivo and patients, respectively, are needed to further evaluate the pharmacotherapeutical potential of these strategies.  N. Ref:: 57

 

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[145]

TÍTULO / TITLE:  - n-3 Fatty acids and their role in nephrologic practice.

REVISTA / JOURNAL:  - Curr Opin Nephrol Hypertens 2001 Sep;10(5):639-42.

AUTORES / AUTHORS:  - Donadio JV

INSTITUCIÓN / INSTITUTION:  - Mayo Clinic and Foundation, Rochester, Minnesota 55905, USA. donadio.james@mayo.edu

RESUMEN / SUMMARY:  - During the past year, a newly reported clinical trial has strengthened the argument for recommending daily treatment with n-3 polyunsaturated fatty acids in patients with immunoglobulin A nephropathy (the most common form of primary glomerulonephritis in the world) who are at high risk for progression of renal disease. Studies are underway that involve a combination of cyclosporine A, a commonly prescribed immunosuppressive agent in solid-organ transplantation, with a high-potency n-3 polyunsaturated fatty acid to reduce cyclosporine toxicity. Two studies reported during the past year show promise that dietary supplementation with n-3 polyunsaturated fatty acids will substantially decrease vascular access graft thrombosis in patients receiving maintenance hemodialysis, and may reduce hypercalciuria in patients who suffer from kidney stones.  N. Ref:: 26

 

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[146]

TÍTULO / TITLE:  - Solid-state fermentation: a promising microbial technology for secondary metabolite production.

REVISTA / JOURNAL:  - Appl Microbiol Biotechnol 2001 Apr;55(3):284-9.

AUTORES / AUTHORS:  - Robinson T; Singh D; Nigam P

INSTITUCIÓN / INSTITUTION:  - Biotechnology Research Group, University of Ulster, Coleraine, UK.

RESUMEN / SUMMARY:  - Solid state (substrate) fermentation (SSF) has been used successfully for the production of enzymes and secondary metabolites. These products are associated with the stationary phase of microbial growth and are produced on an industrial scale for use in agriculture and the treatment of disease. Many of these secondary metabolites are still produced by submerged liquid fermentations (SmF) even though production by this method has been shown to be less efficient than SSF. As large-scale production increases further, so do the costs and energy demands. SSF has been shown to produce a more stable product, requiring less energy, in smaller fermenters, with easier downstream processing measures. In this article we review an important area of biotechnology, since the recent evidence indicates that bacteria and fungi, growing under SSF conditions, are more than capable of supplying the growing global demand for secondary metabolites.  N. Ref:: 53

 

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[147]

TÍTULO / TITLE:  - Multimodular biocatalysts for natural product assembly.

REVISTA / JOURNAL:  - Naturwissenschaften 2001 Mar;88(3):93-101.

AUTORES / AUTHORS:  - Schwarzer D; Marahiel MA

INSTITUCIÓN / INSTITUTION:  - Fachbereich Chemie/Biochemie, Philipps-Universitat Marburg, Hans-Meerwein-Strasse, 35032 Marburg, Germany.

RESUMEN / SUMMARY:  - Nonribosomal peptides and polyketides represent a large class of natural products that show an extreme structural diversity and broad pharmacological relevance. They are synthesized from simple building blocks such as amino or carboxy acids and malonate derivatives on multimodular enzymes called nonribosomal peptide synthetases (NRPSs) and polyketide synthases (PKSs), respectively. Although utilizing different substrates, NRPSs and PKSs show striking similarities in the modular architecture of their catalytic domains and product assembly-line mechanism. Among these compounds are well known antibiotics (penicillin, vancomycin and erythromycin) as well as potent immunosuppressive agents (cyclosporin, rapamycin and FK 506). This review focuses on the modular organization of NRPSs, PKSs and mixed NRPS/PKS systems and how modules and domains that build up the biosynthetic templates can be exploited for the rational design of recombinant enzymes capable of synthesizing novel compounds.  N. Ref:: 50

 

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[148]

TÍTULO / TITLE:  - Management of fistulas in patients with Crohn’s disease: antibiotic to antibody.

REVISTA / JOURNAL:  - Can J Gastroenterol 2001 Nov;15(11):751-6.

AUTORES / AUTHORS:  - Pare P

INSTITUCIÓN / INSTITUTION:  - Universitaire de Quebec, Hopital St-Sacrement, Laval University, Quebec, Canada. pierre.pare@cha.quebec.qc.ca

RESUMEN / SUMMARY:  - Fistulas are common in patients with Crohn’s disease and, when associated with inflammatory disease and established for several weeks, tend to be chronic. Perianal fistulas are the most frequent complication of, and are most often associated with, colonic disease. Perianal fistulas commonly require surgical resection and permanent ileostomy. Antibiotics, cyclosporine, methotrexate and thalidomide have been used in uncontrolled trials; only azathioprine, 6-mercaptopurine and infliximab have been assessed in double-blind, placebo controlled studies. Relapse of the fistula occurs with all drugs, unless treatment is continued long term. Each drug differs in its onset of action and long term tolerability. An approach to fistulizing disease in Crohn’s disease is suggested.  N. Ref:: 44

 

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[149]

TÍTULO / TITLE:  - New aspects of cyclosporin a mode of action: from gene silencing to gene up-regulation.

REVISTA / JOURNAL:  - Mini Rev Med Chem 2003 May;3(3):205-14.

AUTORES / AUTHORS:  - Mascarell L; Truffa-Bachi P

INSTITUCIÓN / INSTITUTION:  - Unite Biologie des Populations Lymphocytaires, CNRS URA 1961, Institut Pasteur, Paris, France.

RESUMEN / SUMMARY:  - Cyclosporin A (CSA) has transformed clinical transplantation, both in term of success and of quality-of-life of the patient. Studies aimed to unfold the site of CSA action have shown that this molecule binds to cytosolic proteins of the cyclophilin family. CSA:cyclophilin complexes have a high affinity for calcineurin, a key enzyme in T-cell activation. By blocking the calcineurin activity, CSA prevents the induction of genes encoding for cytokines and their receptors. Thus, humoral and cellular immune responses are abolished, this resulting in the successful graft acceptance. Disappointingly, CSA and the other molecules as FK506, sharing the capacity to inhibit calcineurin, should be administered for all patient life, as tolerance to alloantigens is not achieved by these molecules. The long term utilization of this class of immunosuppressors increases the incidence of different tumors. The finding that CSA does not interfere with various biochemical pathways has prompted different groups to analyze a possible effect of CSA on molecules that might be involved in different functions of the immune response and/or in tumorogenesis. A new picture of CSA mode of action is emerging in which the immunosuppressor prevents the transcription of a group of genes, concomitantly inducing the transcription of another set. Here, we review the data and discuss the consequences of these new findings in term of T-cell activation mechanisms.  N. Ref:: 80

 

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[150]

TÍTULO / TITLE:  - Cap-dependent translation and control of the cell cycle.

REVISTA / JOURNAL:  - Prog Cell Cycle Res 2003;5:469-75.

AUTORES / AUTHORS:  - Cormier P; Pyronnet S; Salaun P; Mulner-Lorillon O; Sonenberg N

INSTITUCIÓN / INSTITUTION:  - Station Biologique de Roscoff, Universite Pierre et Marie Curie (EI 37), CNRS-UMR 7127, (INSU), BP 74, 29682 Roscoff, France.

RESUMEN / SUMMARY:  - The control of gene expression at the translational level has emerged in the past decade as an important aspect of cell growth, proliferation and malignant transformation. Translation is primarily regulated at the initiation step, and mitogen-dependent signaling pathways converge to modulate the activity of translation initiation factors. In most tumors tested, at least one translation initiation factor is overexpressed and overexpression of translation initiation factors often provokes transformation. Malignant transformation could be caused by the increased translation of a subset of mRNAs encoding important proteins which are required for cell growth and proliferation. These mRNAs usually possess regulatory sequences that render their translation more sensitive to changes in the activity of translation initiation factors. In this chapter, we describe recent advances illustrating the importance of translation in cell cycle progression and cell transformation. Control of translation initiation may represent an excellent target for antitumor drugs.  N. Ref:: 96

 

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[151]

TÍTULO / TITLE:  - Lichen planus esophagitis: report of three patients treated with oral tacrolimus or intraesophageal corticosteroid injections or both.

REVISTA / JOURNAL:  - Dis Esophagus 2003;16(1):47-53.

AUTORES / AUTHORS:  - Keate RF; Williams JW; Connolly SM

INSTITUCIÓN / INSTITUTION:  - Division of Gastroenterology and Hepatology, Mayo Clinic, Scottsdale, AZ 85259, USA. keate.ray@mayo.edu

RESUMEN / SUMMARY:  - Clinically significant involvement of the esophagus is uncommon in patients who have lichen planus, a common disorder of squamous epithelium. In three patients who had oral, cutaneous, and esophageal lichen planus, endoscopic intralesional esophageal injection of corticosteroids (in all three patients) and oral tacrolimus (FH506) (in two patients) resulted in improvement in dysphagia, a less frequent need for dilation, and improvement in esophageal inflammation.  N. Ref:: 36

 

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[152]

TÍTULO / TITLE:  - Therapeutic implications for immunophilin ligands in the treatment of neurodegenerative diseases.

REVISTA / JOURNAL:  - Curr Drug Target CNS Neurol Disord 2003 Dec;2(6):349-56.

AUTORES / AUTHORS:  - Pong K; Zaleska MM

INSTITUCIÓN / INSTITUTION:  - Department of Neuroscience, Wyeth Research, Princeton, NJ 08543, USA. pongk@wyeth.com

RESUMEN / SUMMARY:  - There is a significant unmet need for therapeutic agents in the treatment of neurodegenerative diseases. Given their clinical importance, prototypical molecules that clearly exhibit both neuroprotective and neuroregenerative activities have been highly sought after. The journey led to the exploitation of neurotrophins, a family of proteins that had extraordinary therapeutic properties in pre-clinical models of neurodegeneration. Although experimentally promising, clinical development of neurotrophins for various neurological indications, such as Alzheimer’s Disease, Amyotrophic Lateral Sclerosis, and Parkinson’s Disease was met with severe obstacles and setbacks, such as the inability to deliver these large proteins to target population of neurons, instability of the proteins, and non-specific activity. Immunophilins are proteins that act as receptors for immunosuppresant drugs, i.e. FK506 (tacrolimus), cyclosporin A, and rapamycin (sirolimus, Rapamune). Studies indicate immunophilins are expressed 10-100 fold higher in CNS and PNS tissue than in immune tissue. Subsequent studies revealed potent neuroprotective and neuroregenerative properties of immunophilin ligands in both culture and animal models. In contrast to neurotrophins, most immunophilin ligands are highly stable, small molecules that can readily cross the blood-brain barrier and are orally bioavailable. Taken together, these data prompted the development of nonimmunosuppressive immunophilin ligands with potent therapeutic activities, although the potency of select compounds has come into question in more recent studies. This review will examine the experimental evidence supporting the use of immunophilin ligands for the treatment of neurodegenerative diseases and the current progression of these molecules in clinical trials.  N. Ref:: 91

 

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[153]

TÍTULO / TITLE:  - The state of the art in the management of inflammatory bowel disease.

REVISTA / JOURNAL:  - Rev Gastroenterol Disord 2003 Spring;3(2):81-92.

AUTORES / AUTHORS:  - Hanauer SB; Present DH

INSTITUCIÓN / INSTITUTION:  - Section of Gastroenterology and Nutrition, University of Chicago, Pritzker School of Medicine, Chicago, IL, USA.

RESUMEN / SUMMARY:  - Ulcerative colitis (UC) and Crohn’s disease (CD), collectively known as inflammatory bowel disease (IBD), afflict an estimated one million Americans and produce symptoms that impair quality of life and ability to function. Progress in IBD management strategies has led to optimized approaches for achieving the two primary clinical goals of therapy: induction and maintenance of remission. Although surgery is indicated to treat refractory disease or specific complications, pharmacotherapy is the cornerstone of IBD management. The efficacy of aminosalicylates for induction of remission in mild to moderate UC and CD is well established, as is their role for maintenance of remission in UC. The sulfa-free mesalamine formulation offers an adverse effect profile similar to that of placebo, enabling the administration of higher, more effective doses. Although corticosteroids provide potent anti-inflammatory effects, their benefits are countermanded by the risk of intolerable and serious adverse effects, and they are ineffective for maintenance therapy. Other agents effective in inducing or maintaining remission are azathioprine, 6-mercaptopurine, infliximab, cyclosporine, methotrexate, and antibiotics. Ongoing clinical trials of experimental therapies will generate new tools for IBD treatment. Currently, a broad range of options allows physicians to tailor treatment to each patient’s needs and preferences. Such considerations are essential for maximizing adherence to therapy.  N. Ref:: 62

 

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[154]

TÍTULO / TITLE:  - The immunosuppressive activity of proinflammatory cytokines in experimental models: potential for therapeutic intervention in autoimmunity.

REVISTA / JOURNAL:  - Curr Drug Targets Inflamm Allergy 2002 Mar;1(1):77-87.

AUTORES / AUTHORS:  - Grohmann U; Puccetti P

INSTITUCIÓN / INSTITUTION:  - Department of Experimental Medicine, University of Perugia, Perugia, Italy. ugrohmann@tin.it

RESUMEN / SUMMARY:  - The role of cytokines in the pathogenesis of T cell-mediated diseases, and in particular autoimmune responses, has been the subject of intense investigation in the past few years. Transgenic strains of mice have been generated, each expressing individual cytokines in organs targeted by autoimmunity. These animal models provide the most advanced tool available for analyzing the relationship between cytokines and T-dependent autoimmune responses. On the one hand, these experiments confirm that the local expression of proinflammatory cytokines is pivotal in initiating and maintaining pathogenic responses to self. On the other hand, and somewhat unexpectedly, these models have also revealed that cytokine factors controlling autoimmunity can act both as potentiating and inhibitory agents, depending upon the site and timing of exposure. As a result, one major concept emerging from different experimental models, including those originally established in our laboratory, is that proinflammatory cytokines may ameliorate autoimmunity. In this review, we analyze the mechanisms whereby cytokines that are considered as proinflammatory may in contrast suppress immune responses to self antigens. Besides emphasizing that the proinflammatory/immunogenic properties of a given cytokine may not be an intrinsic property, we review evidence that the regulation imposed by the cytokine network on autoimmunity is a finely tuned balance between activation and downmodulation of an individual autoreactive T cell repertoire. By emphasizing that factors such as the duration of cytokine exposure and the type of cell population involved strongly influence that balance, we underline the potential therapeutic implications of cytokine-mediated modulation of autoimmunity.  N. Ref:: 92

 

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[155]

TÍTULO / TITLE:  - Pharmacotherapeutic management of pulmonary sarcoidosis.

REVISTA / JOURNAL:  - Am J Respir Med 2003;2(4):311-20.

AUTORES / AUTHORS:  - Fazzi P

INSTITUCIÓN / INSTITUTION:  - Cardiac and Thoracic Department, Respiratory Pathophysiology Section, University of Pisa, Pisa, Italy. pfazzi@dcap.med.unipi.it

RESUMEN / SUMMARY:  - Corticosteroids are the mainstay of treatment for sarcoidosis. Although the indications for medical therapy of sarcoidosis are controversial, standard therapy for symptomatic, progressive disease consists of corticosteroids. The British Thoracic Society concluded, with respect to systemic corticosteroids for the treatment of sarcoidosis, that some patients required no treatment, some required prednisone for control of symptoms, and others, with persistent disease, appeared to benefit from long-term corticosteroid therapy. Inhaled budesonide can be an effective treatment for lung sarcoidosis, with few adverse effects, when used in combination with oral systemic corticosteroids such as deflazacort administered in a tapered regimen for 6 months. A randomized controlled trial has also demonstrated the efficacy of 3 months of treatment with oral prednisolone in a tapered regimen followed by inhaled budesonide for 15 months in patients with early stage pulmonary sarcoidosis.Alternative drugs are required in chronic resistant sarcoidosis and/or in conditions where systemic corticosteroids are contraindicated. Immunosuppressive agents (chlorambucil, cyclophosphamide, methotrexate, cyclosporine, azathioprine), anticytokine agents (thalidomide, pentoxifylline), antimalarials (chloroquine, hydroxychloroquine), melatonin and monoclonal antibody (infliximab) have been used in such situations.Chlorambucil and cyclophosphamide have been used in anecdotal cases of pulmonary sarcoidosis as corticosteroid-sparing agents. However, their toxicity and neoplastic potential recommend prudence in patient selection. A comparison between combination therapy with cyclosporine and prednisone and prednisone alone has shown an increased prevalence of serious adverse effects with combined therapy with no between-group differences in treatment efficacy. The cost and toxicity of cyclosporine limit its use to patients in whom its efficacy has been proven.In patients with chronic or refractory disease, methotrexate, usually administered once a week as a single oral dose for at least 2 years, has resulted in a significant improvement in respiratory function, chest radiographs and extrapulmonary manifestations. In most patients, this treatment enabled discontinuation of corticosteroids.Azathioprine may be effective as a corticosteroid-sparing agent in the long-term treatment of sarcoidosis. The combination of prednisolone and azathioprine over a period of 2 years has induced long-lasting remission in patients with resistant sarcoidosis. Thalidomide at low doses is effective in selected cases of sarcoidosis with cutaneous and mild pulmonary involvement. Pentoxifylline alone or combined with low doses of corticosteroids has achieved significant improvement in respiratory function in patients with pulmonary sarcoidosis. Chloroquine and hydroxychloroquine have been shown to have a specific effect in cutaneous manifestations, neurological involvement and hypercalcemia associated with sarcoidosis. Infliximab has yielded good results in patients with chronic resistant pulmonary and extrapulmonary sarcoidosis resistant to corticosteroid and cytotoxic therapy. The effectiveness of melatonin in cutaneous and pulmonary sarcoidosis has also been confirmed in a single center.  N. Ref:: 52

 

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[156]

TÍTULO / TITLE:  - Polymorphisms in immunoregulatory genes: towards individualized immunosuppressive therapy?

REVISTA / JOURNAL:  - Am J Pharmacogenomics 2002;2(1):13-23.

AUTORES / AUTHORS:  - Daly AK; Day CP; Donaldson PT

INSTITUCIÓN / INSTITUTION:  - Centre for Liver Research, University of Newcastle upon Tyne, Framlington Place, Newcastle upon Tyne NE2 4HH, UK. A.K.Daly@ncl.ac.uk

RESUMEN / SUMMARY:  - In organ transplantation, successful immunosuppression requires that both rejection and infection episodes be minimized. Unfortunately it is currently impossible to predict individual dose requirement for immunosuppressive drugs, but a number of studies of various immune response genes are now being performed with a view to identifying genotypes associated with rejection and/or infection. The key role of cytokines in the immune response and other processes, including fibrosis, has concentrated most of this attention on polymorphisms in cytokine genes. Data on polymorphisms in genes encoding tumor necrosis factor-alpha, transforming growth factor-beta, interferon-gamma and interleukin (IL)-1, 4, 6 and 10 together with the IL-4 receptor have been analyzed but so far there is currently no indication of any consistently positive associations between graft rejection and any of these polymorphisms. Studies of other immunomodulatory genes including the CTLA4 gene and the chemokine receptor CCR-5 have proved more positive though the data, so far, are only preliminary. In conclusion, additional large series studies of these and other cytokine genes, as well as other immunoregulatory gene polymorphisms of proven functional significance are needed to achieve major progress in this area.  N. Ref:: 112

 

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[157]

TÍTULO / TITLE:  - Small molecule immunosuppressive agents in experimental and clinical transplantation.

REVISTA / JOURNAL:  - Curr Drug Targets Cardiovasc Haematol Disord 2002 Dec;2(2):57-71.

AUTORES / AUTHORS:  - Ma A; Chen H

INSTITUCIÓN / INSTITUTION:  - Laboratory of Experimental Surgery, Research Center of CHUM, Notre-Dame Hospital, University of Montreal, 1560 Sherbrooke Street East, Montreal, Quebec, Canada.

RESUMEN / SUMMARY:  - Immunosuppression is currently the major approach used for the prevention and management of transplant rejection. In this overview, preclinical and clinical studies of the small molecule immunosuppressive agents are reviewed from the discovery of cyclosporine. More recently it was demonstrated that certain agents, namely tacrolimus (FK506), sirolimus (rapamycin), and mycophenolate mofetil (CellCept, MMF), act selectively on adaptive host responses at different stages of T- and B-cell cycles and spare nonspecific host resistance. Because each agent has its specific and significant toxic effects, it has been difficult to optimize the use of individual agents in monotherapy. Therefore, drug combination therapy has been of great interest in addition to the introduction of new small molecule agents, such as malononitrilamides [MNAs (leflunomide, FK778, FK779)], 15-deoxyspergualin (DSG) and its analogues, FTY720 and inhibitors of signal transduction, which offer promising modes of immunosuppression.  N. Ref:: 129

 

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[158]

TÍTULO / TITLE:  - The molecular target of rapamycin (mTOR) as a therapeutic target against cancer.

REVISTA / JOURNAL:  - Cancer Biol Ther 2003 Jul-Aug;2(4 Suppl 1):S169-77.

AUTORES / AUTHORS:  - Mita MM; Mita A; Rowinsky EK

INSTITUCIÓN / INSTITUTION:  - Institute for Drug Development; Cancer Therapy and Research Center; San Antonio, Texas 78229, USA. mmita@saci.org

RESUMEN / SUMMARY:  - The molecular target of rapamycin (mTOR), which is a member of the phosphoinositide 3-kinase related kinase (PIKK) family and a central modulator of cell growth, is a prime strategic target for anti-cancer therapeutic development. mTOR plays a critical role in transducing proliferative signals mediated through the phosphatidylinositol 3 kinase (PI3K)/protein kinase B (Akt) signaling pathway, principally by activating downstream protein kinases that are required for both ribosomal biosynthesis and translation of key mRNAs of proteins required for G(1) to S phase traverse. By targeting mTOR, the immunsuppressant and antiproliferative agent rapamycin (RAP) inhibits signals required for cell cycle progression, cell growth, and proliferation. RAP, a complex macrolide and highly potent fungicide, immunosuppressant, and anti-cancer agent, is a highly specific inhibitor of mTOR. In essence, RAP gains function by binding to the immunophilin FK506 binding protein 12 (FKBP12) and the resultant complex inhibits the activity of mTOR. Since mTOR activates both the 40S ribosomal protein S6 kinase ((p)70(s6k)) and the eukaryotic initiation factor 4E-binding protein-1 (4E-BP1), RAP blocks activation of these downstream signaling elements, which results in cell cycle arrest in the G1 arrest. RAP also prevents cyclin-dependent kinase (cdk) activation, inhibits retinoblastoma protein ((p)Rb) phosphorylation, and accelerates the turnover of cyclin D1 that leads to a deficienciy of active cdk4/cyclin D1 complexes, all of which potentially contribute to the prominent inhibitory effects of RAP at the G(1)/S phase transition. Both RAP and several RAP analogs with more favorable pharmaceutical properties have demonstrated prominent growth inhibitory effects against a broad range of human cancers in both preclinical and early clinical evaluations. This review will summarize the principal mechanisms of action of RAP and RAP derivatives and their potential utility of these agents as anti-cancer therapeutics. The preliminary results of early clinical evaluations with RAP analogs and the unique developmental challenges that lie ahead will also be discussed.  N. Ref:: 112

 

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[159]

TÍTULO / TITLE:  - Combination treatment in autoimmune diseases: systemic lupus erythematosus.

REVISTA / JOURNAL:  - Springer Semin Immunopathol 2001;23(1-2):75-89.

AUTORES / AUTHORS:  - Moroni G; Della Casa Alberighi O; Ponticelli C

INSTITUCIÓN / INSTITUTION:  - Divisione di Nefrologia e Dialisi, Ospedale Maggiore IRCCS, Via della Commenda 15, 20122 Milan, Italy.  N. Ref:: 84

 

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[160]

TÍTULO / TITLE:  - New developments in the prophylaxis and treatment of graft versus host disease.

REVISTA / JOURNAL:  - Expert Opin Pharmacother 2001 Jul;2(7):1109-17.

AUTORES / AUTHORS:  - Simpson D

INSTITUCIÓN / INSTITUTION:  - North Shore Hospital, Auckland, New Zealand. david.simpson@whl.co.nz

RESUMEN / SUMMARY:  - Graft versus host disease (GVHD) remains the major obstacle to successful allogeneic bone marrow transplantation. Cyclosporin with methotrexate is the most common prophylactic regimen. Tacrolimus is associated with less GVHD and is gaining ground especially in unrelated donor transplants where current regimens are unsatisfactory. Mycophenolate mofetil (MMF) and rapamycin have not yet shown benefit in acute GVHD prophylaxis. In vivo T-cell depletion with Campath 1H or thymoglobulin used during transplant conditioning are increasingly used in place of ex vivo T-cell depletion, where results remain disappointing. Steroids remain first choice for therapy of GVHD but anti-CD25 antibodies, daclizumab or basiliximab are gaining popularity as second-line therapy ahead of ATG. Chronic GVHD is increasing with greater use of peripheral blood stem cell grafts and older patients. The combination of tacrolimus and MMF is promising for patients with extensive disease. Tolerance induction using CTLA-4-Ig, anti-CD40L, tresperimus and/or rapamycin may revolutionise GVHD therapy. However, due to the desirability of tumour intolerance, tolerance is likely to be developed in organ transplantation before bone marrow transplantation for traditional indications. Bone marrow transplants performed to induce organ tolerance may see increasing use of these agents. TNF blockade using infliximab or etanercept (Enbrel) is promising but the role of these agents is not yet defined.  N. Ref:: 68

 

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[161]

TÍTULO / TITLE:  - Influence of one human leukocyte antigen mismatch on outcome of allogeneic bone marrow transplantation from related donors.

REVISTA / JOURNAL:  - Hematology 2003 Feb;8(1):27-33.

      ●● Enlace al texto completo (gratuito o de pago) 1080/1024533031000072054

AUTORES / AUTHORS:  - Hasegawa W; Lipton JH; Messner HA; Jamal H; Yi QL; Daly AS; Kotchetkova N; Kiss TL

INSTITUCIÓN / INSTITUTION:  - Bone Marrow Transplant Service, Princess Margaret Hospital/University Health Network, Toronto, Ont, M5G 2M9, Canada.

RESUMEN / SUMMARY:  - This study compares the clinical outcomes of 60 consecutive patients who received an allogeneic blood or marrow stem cell transplant (BMT) from one Human Leukocyte Antigen (HLA) mismatched related donors with those of 120 matched patients who had HLA identical sibling donors. The control patients were matched for diagnosis, disease status, conditioning regimen, and age at BMT. All patients received standard CYA and MTX for GVHD prophylaxis. The probability of overall survival (OS) at 5 years was 35% in the study group compared to 56% in the control group. The relapse rates and acute GVHD rates did not differ between the two groups. Graft failure was a significant problem in the study group compared to the control group (13 vs. 0%, p < 0.0001). All cases of graft failure occurred in patients with a mismatch in the host-versus-graft direction. BMT-related deaths were also increased in the study group. Forty percent of deaths were caused by infection in the study group vs. 19% in the control group (p < 0.01). In conclusion, the OS of patients receiving marrow/stem cells from one antigen mismatched related donors was inferior to that of controls with HLA-identical related donors. There was an increase in mortality related to infections occurring in the setting of an increased frequency of graft failure in these patients.  N. Ref:: 21

 

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[162]

TÍTULO / TITLE:  - Heat shock proteins: novel therapeutic tools for HIV-infection?

REVISTA / JOURNAL:  - Expert Opin Biol Ther 2001 Jan;1(1):67-77.

AUTORES / AUTHORS:  - Brenner BG; Wainberg Z

INSTITUCIÓN / INSTITUTION:  - McGill University, Montreal, Quebec, Canada. bbrenn1@po-box.mcgill.ca

RESUMEN / SUMMARY:  - Heat shock proteins (Hsps), cyclophilins (Cyps) and FK binding proteins (FKBPs) form a family of intracellular chaperone molecules that facilitate protein folding and assembly. These stress proteins are selectively expressed in cells in response to a range of stimuli, including heat, lymphokine and microbial/viral infections. This review discusses the role of stress proteins in the HIV-1 viral life cycle, with regard to the development of specific Hsp-based therapeutic strategies against HIV-1 infection. Cumulative findings are cited implicating CypA, Hsp27, Hsp70 and FKBPs in host cell and viral activation, viral entry, assembly or formation of infectious virions. Biological response modifiers that show specific high-affinity interactions with Cyp, FKBPs and Hsps, including cyclosporins, FK-506 and cyclopentenone prostaglandins respectively, may block HIV-1 replication and infection, providing novel HIV-1 therapeutic strategies. Moreover, Hsp binding to viral complexes can enhance antiviral immunity, including natural killer (NK), antibody-dependent (ADCC), gamma delta T-cell and cytotoxic T-lymphocyte (CTL) activities against HIV-1 infected cells. The ability of Hsps to interact with HIV-1 viral proteins, combined with their inherent adjuvant and immunogenic properties indicates that Hsps may also serve as vehicles for antigen delivery and the design of AIDS vaccines.  N. Ref:: 94

 

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[163]

TÍTULO / TITLE:  - Transporter-enzyme interactions: implications for predicting drug-drug interactions from in vitro data.

REVISTA / JOURNAL:  - Curr Drug Metab 2003 Oct;4(5):393-8.

AUTORES / AUTHORS:  - Benet LZ; Cummins CL; Wu CY

INSTITUCIÓN / INSTITUTION:  - University of California, Department of Biopharmaceutical Sciences Box 0446, San Francisco, CA 94143-0446, USA. benet@itsa.ucsf.edu

RESUMEN / SUMMARY:  - As discussed in earlier articles, predictions of in vivo drug-drug interactions from in vitro studies is a subject of high interest with obvious therapeutic as well as economic benefits. Up until now little attention has been given to the potential interplay between metabolic enzymes and transporters that could confound the in vivo-in vitro relationships. Drug efflux by intestinal P-glycoprotein (P-gp) is known to decrease the bioavailability of many CYP3A4 substrates. We have demonstrated that the interplay between P-gp and CYP3A4 at the apical intestinal membrane can increase the opportunity for drug metabolism by determining bidirectional extraction ratios across CYP3A4 transfected Caco-2 cells for two dual P-gp/CYP3A4 substrates, K77 (an experimental cysteine protease inhibitor) and sirolimus, as well as two negative control, CYP3A4 only substrates, midazolam and felodipine. Studies were carried out under control conditions, with a P-gp inhibitor (GG918) and with a dual inhibitor (cyclosporine). Measurement of intracellular concentration changes is an important component in calculating the extraction ratios. We hypothesize that the inverse orientation of P-gp and CYP3A4 in the liver will result in an opposite interactive effect in that organ. In vivo rat intestinal perfusion studies with K77 and rat liver perfusion studies with tacrolimus under control conditions and with inhibitors of CYP3A4 (troleandomycin), P-gp (GG918) and both CYP3A4/P-gp (cyclosporine) lend support to our hypotheses. These results serve as a template for predicting enzyme- transporter (both absorptive and efflux) interactions in the intestine and the liver.  N. Ref:: 24

 

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[164]

TÍTULO / TITLE:  - Apoptosis, TGF beta and transfusion-related immunosuppression: Biologic versus clinical effects.

REVISTA / JOURNAL:  - Transfus Apheresis Sci 2003 Oct;29(2):127-9.

AUTORES / AUTHORS:  - Dzik WH

INSTITUCIÓN / INSTITUTION:  - Blood Transfusion Service, J-224, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA. sdzik@partners.org

RESUMEN / SUMMARY:  - Whether or not blood transfusion exerts an immunosuppressive effect on the recipient remains an area of controversy. The mechanism to clearly explain the effect has been elusive. We have previously suggested that there may be two categories of immunosuppressive transfusion effect: one which is HLA-dependent and directed against adaptive immunity and a second category which is mild, non-specific, and directed against innate immunity. This non-specific effect might result from the infusion of apoptotic blood cells. There is solid evidence that blood cells undergo apoptotic changes during refrigerated storage. The infusion of apoptotic cells has recently been shown in animal models to be immunosuppressive. Immunosuppression resulting from the infusion of apoptotic cells may be linked to transforming growth factor beta (TGF-beta).  N. Ref:: 10

 

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[165]

TÍTULO / TITLE:  - Treatment of the extraintestinal manifestations of inflammatory bowel disease.

REVISTA / JOURNAL:  - Curr Gastroenterol Rep 2002 Dec;4(6):513-6.

AUTORES / AUTHORS:  - Bernstein CN

INSTITUCIÓN / INSTITUTION:  - Inflammatory Bowel Disease Clinical and Research Centre, University of Manitoba, John Buhler Research Centre, 804F-715 McDermot Avenue, Winnipeg, Manitoba, Canada R3E 3P4. cbernst@cc.umanitoba.ca

RESUMEN / SUMMARY:  - There is a paucity of randomized, controlled therapy studies of the extraintestinal manifestations of inflammatory bowel disease (IBD). Most current therapeutic approaches are empiric or based on approaches to therapy in other settings. In the past year anecdotal evidence has emerged for the use of therapies that neutralize tumor necrosis factor-a in both ankylosing spondylitis and the dermatologic extraintestinal manifestations. Topical tacrolimus has also emerged as a potentially useful therapy for dermatologic manifestations. Finally, patients with IBD occasionally become transplant recipients. One study reported worsening IBD after orthotopic liver transplantation for primary sclerosing cholangitis, and another reported the benefit of renal transplantation in amyloidosis-induced renal failure.  N. Ref:: 28

 

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[166]

TÍTULO / TITLE:  - A new class of cyclosporin analogues for the treatment of asthma.

REVISTA / JOURNAL:  - Expert Opin Investig Drugs 2003 Apr;12(4):647-53.

AUTORES / AUTHORS:  - Eckstein JW; Fung J

INSTITUCIÓN / INSTITUTION:  - Enanta Pharmaceuticals,500 Arsenal Street, Watertown, MA 02472, USA. eckstein@enanta.com

RESUMEN / SUMMARY:  - The disease management of asthma - in particular severe and steroid-resistant asthma - remains a real and daily challenge in the clinic. Cyclosporin A has been a mainstay of immunosuppression therapy in organ transplantation for many years. While its application clearly is efficacious in the inhibition of T-cell proliferation and results in the decrease of inflammatory processes, its side effects in long-term use manifested most prominently through nephrotoxicity have been the main concern against broader use of the drug in inflammatory and immune diseases other than organ transplantation. Several new strategies are currently being pursued to address cyclosporin A toxicity, as summarised in this review. The improved safety profile of novel cyclosporin analogues appear to promise potential new treatments of asthma.  N. Ref:: 48

 

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[167]

TÍTULO / TITLE:  - Use of basiliximab in pediatric liver transplantation for Langerhans cell histiocytosis.

REVISTA / JOURNAL:  - Pediatr Transplant 2003 Jun;7(3):247-51.

AUTORES / AUTHORS:  - Rajwal SR; Stringer MD; Davison SM; Gerrard M; Glaser A; Tanner MS; McClean P

INSTITUCIÓN / INSTITUTION:  - Children’s Liver and G.I. Unit, St James’s University Hospital, Leeds, UK.

RESUMEN / SUMMARY:  - This report describes a 16-month-old girl with multi-system Langerhans cell histiocytosis (LCH), who developed end-stage liver disease despite intensive chemotherapy. She underwent a liver transplant at 28 months of age while receiving maintenance chemotherapy for bony lesions. In view of previous reports of a high incidence of acute cellular rejection and post-transplant lymphoproliferative disease (PTLD) in children transplanted for LCH, basiliximab was added to the post-transplant immunosuppression regime of tacrolimus and prednisolone. Sixteen months post-transplant, she has had no episodes of acute rejection or PTLD and her LCH has remained in remission. Current literature regarding liver transplantation (LTx) for LCH and the use of basiliximab in pediatric LTx is reviewed.  N. Ref:: 17

 

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[168]

TÍTULO / TITLE:  - Oral lichen planus: clinical presentation and management.

REVISTA / JOURNAL:  - J Can Dent Assoc 2002 Sep;68(8):494-9.

AUTORES / AUTHORS:  - Edwards PC; Kelsch R

INSTITUCIÓN / INSTITUTION:  - Department of Dental Medicine, Long Island Jewish Medical Center, New Hyde Park, New York 11040, USA. dental919@hotmail.com

RESUMEN / SUMMARY:  - Oral lichen planus (OLP) is a chronic mucosal condition commonly encountered in clinical dental practice. Lichen planus is believed to represent an abnormal immune response in which epithelial cells are recognized as foreign, secondary to changes in the antigenicity of the cell surface. It has various oral manifestations, the reticular form being the most common. The erosive and atrophic forms of OLP are less common, yet are most likely to cause symptoms. Topical corticosteroids constitute the mainstay of treatment for symptomatic lesions of OLP. Recalcitrant lesions can be treated with systemic steroids or other systemic medications. However, there is only weak evidence that these treatments are superior to placebo. Given reports of a slightly greater risk of squamous cell carcinoma developing in areas of erosive OLP, it is important for clinicians to maintain a high index of suspicion for all intraoral lichenoid lesions. Periodic follow-up of all patients with OLP is recommended.  N. Ref:: 36

 

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[169]

TÍTULO / TITLE:  - Immunosuppression with limited toxicity: the characteristics of nucleoside analogs and anti-lymphocyte antibodies used in non-myeloablative hematopoietic cell transplantation.

REVISTA / JOURNAL:  - Cancer Treat Res 2002;110:39-49.

AUTORES / AUTHORS:  - Bashey A

INSTITUCIÓN / INSTITUTION:  - Blood and Marrow Transplantation Division, University of California San Diego, Department of Medicine, UCSD Cancer Center, La Jolla, CA 92093-0960, USA.

RESUMEN / SUMMARY:  - The availability of two groups of pharmacologic agents, the nucleoside analogs and anti-lymphocyte antibody preparations of various specificities has enabled the development of NST. Although these agents are significantly less cytotoxic than high-dose alkylating agents and total-body irradiation (TBI), they are profoundly immunosuppressive. Opportunistic infections such as the reactivation of cytomegalovirus remain clinical obstacles when NST are performed using these agents, especially in elderly and previously immunosuppressed patients. For anti-lymphocyte antibody preparations, the degree of immunosuppression produced and hence the risk of opportunistic infection varies depending upon specificity of the antibody (broad versus narrow). Allergic reactions and infusion related toxicity can occur with any antibody preparation, but the infusion of muromonab-CD3 is sometimes associated with a particularly potent cytokine-release syndrome. Although fludarabine has been the mainstay of nucleoside analog usage for NST, the other nucleoside analogs-cladribine and pentostatin are beginning to be investigated in this context.  N. Ref:: 12

 

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[170]

TÍTULO / TITLE:  - Pharmacogenomic considerations for immunosuppressive therapy.

REVISTA / JOURNAL:  - Pharmacogenomics 2003 May;4(3):309-19.

AUTORES / AUTHORS:  - Yagil Y; Yagil C

INSTITUCIÓN / INSTITUTION:  - Department of Nephrology and Hypertension, Faculty of Health Sciences, Ben-Gurion University Barzilai Medical Center Campus, Ashkelon 78306, Israel. labmomed@bgumail.bgu.ac.il

RESUMEN / SUMMARY:  - Immunosuppression, the art of suppressing the endogenous immune system to allow organ transplantation or treatment of autoimmune disease, is a clinico-pharmacological field that has markedly developed over the past three decades with the advent of highly potent and rationally targeted immunosuppressive agents. Pharmacogenomics, the art of providing tailored pharmacological therapy with the highest therapeutic index based on the genomic composition of the individual, is a science that has rapidly developed over the past decade, along with the advances in the human genome project and in biotechnology. Pharmacogenomics of immunosuppression is the combined art of tailoring specific immunosuppressive drug therapy to specific immune-mediated clinical entities which require immunosuppression, with optimum matching of the drug to the individual’s genomic makeup. Timely and judicious application of pharmacogenomics to clinical immunosuppression should direct the clinician to the best immunosuppressive drug for any given clinical condition, and markedly increase its efficacy as well as decreasing the incidence of side effects and toxicity, thereby decreasing morbidity and prolonging survival. Is this a description of an ongoing clinical evolution in immunosuppression or a prediction of future events? The promises of pharmacogenomics of immunosuppression are high, yet the availability and/or application and/or realization of the promises of this highly specialized clinical science are very slow to come.  N. Ref:: 20

 

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[171]

TÍTULO / TITLE:  - Control of translation by the target of rapamycin proteins.

REVISTA / JOURNAL:  - Prog Mol Subcell Biol 2001;27:143-74.

AUTORES / AUTHORS:  - Gingras AC; Raught B; Sonenberg N

INSTITUCIÓN / INSTITUTION:  - Department of Biochemistry and McGill Cancer Centre, McGill University, 3655 Dummond Street, Montreal, Quebec, H3G 1Y6, Canada.  N. Ref:: 181

 

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[172]

TÍTULO / TITLE:  - Interaction of cyclosporine A and the renin-angiotensin system; new perspectives.

REVISTA / JOURNAL:  - Curr Drug Metab 2002 Feb;3(1):61-71.

AUTORES / AUTHORS:  - Lassila M

INSTITUCIÓN / INSTITUTION:  - Institute of Biomedicine, Pharmacology, Biomedicum Helsinki, University of Helsinki, Finland. markus.lassila@helsinki.fi

RESUMEN / SUMMARY:  - Despite extensive research, the exact mechanisms of cyclosporine A (CsA)-induced hypertension and nephrotoxicity remain obscure. Several lines of evidence suggest an involvement of the renin-angiotensin system (RAS) in CsA toxicity, but the issue is still controversial in more ways than one. Some interesting data of the interaction of CsA and RAS have been presented by us and others during the last years. In rats, activation of RAS by CsA is a consistent finding while the results from clinical studies show controversial results. The mechanisms of activation of RAS may be multifactorial. CsA increases renin release directly from juxtaglomerular cells. However, RAS activation may at least partly account for glomerular ischemia by vasoconstriction. A totally different view about the interaction of CsA and RAS has recently been presented. CsA antagonised the harmful effects of RAS over-expression on renal damage in double transgenic rats harbouring human renin and angiotensinogen genes. The protection was due to anti-inflammatory properties of CsA by inhibition of interleukin-6 and inducible nitric oxide synthase (iNOS) expression. Other studies have confirmed the inhibitory effect of CsA on iNOS. Calcium antagonists have been proposed to be the antihypertensive drugs of choice in treatment of CsA-induced hypertension because of their favourable haemodynamic effects on the kidneys. However, because angiotensin II plays a major role in the development of CsA-induced structural renal damage, pharmacological inhibition of RAS in CsA-treatment may have some beneficial effects beyond blood pressure control.  N. Ref:: 120

 

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[173]

TÍTULO / TITLE:  - The pharmacogenetics of immunosuppression for organ transplantation: a route to individualization of drug administration.

REVISTA / JOURNAL:  - Am J Pharmacogenomics 2003;3(5):291-301.

AUTORES / AUTHORS:  - Fredericks S; Holt DW; MacPhee IA

INSTITUCIÓN / INSTITUTION:  - Department of Cardiovascular Medicine, Analytical Unit, St George’s Hospital Medical School, Cranmer Terrace, London SW17 0RE, UK.

RESUMEN / SUMMARY:  - Transplantation has transformed the treatment of patients with organ failure in a number of clinical settings, and immunosuppressive drug therapy is fundamental to its success. However, all the drugs in current use have a narrow therapeutic index. Under-dosing can lead to rejection, while over-dosing increases the risks of infection, malignant disease, and serious drug-specific adverse effects, including diabetes mellitus, nephrotoxicity, hypertension, and hyperlipidemia.Heterogeneity in the pharmacokinetics of these drugs makes initial dose determination difficult, as there is a poor correlation between dose and blood concentration. This results in difficulties in achieving target blood concentrations early after transplantation, which are important for reducing the rate of immunological rejection. This problem is compounded by the observation that neither drug dose nor drug blood concentration accurately predict clinical efficacy or toxicity.The main determinant of heterogeneity in dose requirements is intestinal absorption of the active drug. The oxidative enzymes, cytochrome P450 (CYP) 3A4 and CYP3A5, and the drug efflux pump P-glycoprotein (P-gp) in enterocytes regulate this process. Most substrates for the P-gp pump are also substrates for the CYP3A enzymes. An efficient barrier to xenobiotic absorption is formed by the CYP enzymes and P-gp, and by the two systems working synergistically. Genetic polymorphisms have been reported for the genes associated with the expression of the CYP3A enzymes and P-gp. Genotyping patients for CYP3A genes has the potential to aid the establishment of optimal dosage regimens for transplant patients.Genetic polymorphism of the multiple drug resistance gene-1 (MDR1, also known as ABCB1) [3435C/T] and the CYP3A5 genes (CYP3A5*1, CYP3AP1*1) have the greatest potential to influence the pharmacokinetics of immunosuppressants. Homozygosity of the T allele of the MDR1 3435C/T polymorphism has been associated with reduced enterocyte expression of P-gp resulting in increased drug absorption. The presence of the CYP3A5*1 allele is necessary for the production of a fully catalytic CYP3A5 protein, and also influences the ratio of CYP3A4 : CYP3A5 as well as the overall CYP3A catalytic activity. The CYP3A4 : CYP3A5 ratio may, in turn, influence the pattern of drug metabolites formed. Heterogeneity in the production of active and inactive metabolites has implications for both the pharmacokinetics and pharmacodynamics of these drugs.Gene frequencies and drug dose requirements differ between ethnic groups. Ethnic differences in dose requirements for immunosuppressants have been discussed widely. However, ethnicity is a rather crude marker for genotype. Pharmacogenetic typing offers the possibility of significant improvement in the individualization of immunosuppressive drug prescribing with reduced rates of rejection and toxicity.  N. Ref:: 145

 

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[174]

TÍTULO / TITLE:  - Mammalian target of rapamycin: a new molecular target for breast cancer.

REVISTA / JOURNAL:  - Clin Breast Cancer 2003 Jun;4(2):126-37.

AUTORES / AUTHORS:  - Mita MM; Mita A; Rowinsky EK

INSTITUCIÓN / INSTITUTION:  - Institute for Drug Development, Cancer Therapy and Research Center, San Antonio, TX, USA. mmita@idd.org

RESUMEN / SUMMARY:  - The mammalian target of rapamycin (mTOR), a downstream effector of the phosphatidylinositol 3-kinase (PI3K)/Akt (protein kinase B) signaling pathway that mediates cell survival and proliferation, is a prime strategic target for anticancer therapeutic development. By targeting mTOR, the immunosuppressant and antiproliferative agent rapamycin inhibits signals required for cell cycle progression, cell growth, and proliferation. Both rapamycin and novel rapamycin analogues with more favorable pharmaceutical properties, such as CCI-779, RAD 001, and AP23573, are highly specific inhibitors of mTOR. In essence, these agents gain function by binding to the immunophilin FK506 binding protein 12 and the resultant complex inhibits the activity of mTOR. Because mTOR activates both the 40S ribosomal protein S6 kinase (p70s6k) and the eukaryotic initiation factor 4E-binding protein-1, rapamycin-like compounds block the actions of these downstream signaling elements, which results in cell cycle arrest in the G1 phase. Rapamycin and its analogues also prevent cyclin-dependent kinase (CDK) activation, inhibit retinoblastoma protein phosphorylation, and accelerate the turnover of cyclin D1, leading to a deficiency of active CDK4/cyclin D1 complexes, all of which potentially contribute to the prominent inhibitory effects of rapamycin at the G1/S boundary of the cell cycle. Rapamycin and rapamycin analogues have demonstrated impressive growth-inhibitory effects against a broad range of human cancers, including breast cancer, in preclinical and early clinical evaluations. In breast cancer cells, PI3K/Akt and mTOR pathways seem to be critical for the proliferative responses mediated by the epidermal growth factor receptor, the insulin growth factor receptor, and the estrogen receptor. Furthermore, these pathways may be constitutively activated in cancers with many types of aberrations, including those with loss of PTEN suppressor gene function. Therefore, the development of inhibitors of mTOR and related pathways is a rational therapeutic strategy for breast and other malignancies that possess a wide range of aberrant molecular constituents. This review will summarize the principal mechanisms of action of rapamycin and rapamycin derivatives, as well as the potential utility of these agents as anticancer therapeutic agents with an emphasis on breast cancer. The preliminary results of early clinical evaluations with rapamycin analogues and the unique developmental challenges that lie ahead will also be discussed.  N. Ref:: 148

 

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[175]

TÍTULO / TITLE:  - NF-kappaB in transplantation: friend or foe?

REVISTA / JOURNAL:  - Transpl Infect Dis 2001 Dec;3(4):212-9.

AUTORES / AUTHORS:  - Tsoulfas G; Geller DA

INSTITUCIÓN / INSTITUTION:  - Department of Surgery, University of Pittsburgh, Starzl Transplant Institute, Pittsburgh, Pennsylvania 15213, USA.

RESUMEN / SUMMARY:  - NF-kappaB is an inducible nuclear transcription factor regulating the expression of many genes. NF-kappaB activation may function as a master switch in a variety of immune and inflammatory processes, including sepsis and transplant tolerance. In this review, we summarize features of NF-kappaB regulation, as well as describe its role in intracellular signal transduction pathways. Subsequently, we concentrate on the role of NF-kappaB in the field of organ transplantation and the role of NF-kappaB in organ ischemia/reperfusion injury and graft rejection. Finally, potential therapeutic strategies are discussed to modify NF-kappaB activity with certain immunosuppression medications, including cyclosporine, tacrolimus, and glucocorticoids.  N. Ref:: 54

 

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[176]

TÍTULO / TITLE:  - Non-ribosomal peptide synthetases as technological platforms for the synthesis of highly modified peptide bioeffectors—Cyclosporin synthetase as a complex example.

REVISTA / JOURNAL:  - Biotechnol Annu Rev 2003;9:151-97.

AUTORES / AUTHORS:  - Velkov T; Lawen A

INSTITUCIÓN / INSTITUTION:  - Monash University, Department of Biochemistry and Molecular Biology, School of Biomedical Sciences, P.O. Box 13D, Melbourne, Victoria 3800, Australia.

RESUMEN / SUMMARY:  - Many microbial peptide secondary metabolites possess important medicinal properties, of which the immunosuppressant cyclosporin A is an example. The enormous structural and functional diversity of these low-molecular weight peptides is attributable to their mode of biosynthesis. Peptide secondary metabolites are assembled non-ribosomally by multi-functional enzymes, termed non-ribosomal peptide synthetases. These systems consist of a multi-modular arrangement of the functional domains responsible for the catalysis of the partial reactions of peptide assembly. The extensive homology shared among NRPS systems allows for the generalisation of the knowledge garnered from studies of systems of diverse origins. In this review we shall focus the contemporary knowledge of non-ribosomal peptide biosynthesis on the structure and function of the cyclosporin biosynthetic system, with some emphasis on the re-direction of the biosynthetic potential of this system by combinatorial approaches.  N. Ref:: 205

 

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[177]

TÍTULO / TITLE:  - Role of plasma lipoproteins in modifying the toxic effects of water-insoluble drugs: studies with cyclosporine A.

REVISTA / JOURNAL:  - AAPS PharmSci 2002;4(4):E30.

      ●● Enlace al texto completo (gratuito o de pago) 1208/ps040430

AUTORES / AUTHORS:  - Wasan KM; Ramaswamy M; Kwong M; Boulanger KD

INSTITUCIÓN / INSTITUTION:  - Division of Pharmaceutics and Biopharmaceutics, Faculty of Pharmaceutical Sciences, The University of British Columbia, Vancouver, British Columbia, Canada V6T 1Z3. Kwasan@interchange.ubc.ca

RESUMEN / SUMMARY:  - Lipoproteins are a heterogeneous population of macromolecular aggregates of lipids and proteins that are responsible for the transport of lipids through the vascular and extravascular fluids from their site of synthesis or absorption to peripheral tissues. Lipoproteins are involved in other biological processes as well, including coagulation and tissue repair, and serve as carriers of a number of hydrophobic compounds within the systemic circulation. It has been well documented that disease states (eg, AIDS, diabetes, cancer) significantly influence circulating lipoprotein content and composition. Therefore, it appears possible that changes in the lipoprotein profile would affect not only the ability of a compound to associate with lipoproteins but also the distribution of the compound within the lipoprotein subclasses. Such an effect could alter the pharmacokinetics and pharmacological action of the drug. This paper reviews the factors that influence the interaction of one model hydrophobic compound, cyclosporine A, with lipoproteins and the implications of altered plasma lipoprotein concentrations on the pharmacological behavior of this compound.  N. Ref:: 28

 

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[178]

TÍTULO / TITLE:  - Safety and tolerability of caspofungin acetate in the treatment of fungal infections.

REVISTA / JOURNAL:  - Transpl Infect Dis 2002 Mar;4(1):25-30.

AUTORES / AUTHORS:  - Sable CA; Nguyen BY; Chodakewitz JA; DiNubile MJ

INSTITUCIÓN / INSTITUTION:  - Department of Infectious Diseases, Merck Research Laboratories, West Point, Pennsylvania 19486, USA.

RESUMEN / SUMMARY:  - Caspofungin acetate is the first member of the novel echinocandin class of antifungal drugs to be marketed in the United States. It has recently been approved for use in patients with invasive aspergillosis who are refractory to or intolerant of conventional therapy. Accordingly, its safety profile is particularly important to review. The safety and tolerability of caspofungin have been examined in 623 persons, including 295 patients who received >/= 50 mg/day for at least one week in clinical studies. In the 263 patients, given caspofungin in randomized double-blind active-control trials to date, there have been no serious clinical or laboratory drug-related adverse events; caspofungin was discontinued in only 2% of these patients because of drug-related adverse experiences. Caspofungin may have potentially important drug interactions with cyclosporine and tacrolimus.  N. Ref:: 13

 

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[179]

TÍTULO / TITLE:  - Creating polyketide diversity through genetic engineering.

REVISTA / JOURNAL:  - Front Biosci 2003 Jan 1;8:c1-13.

AUTORES / AUTHORS:  - Kealey JT

INSTITUCIÓN / INSTITUTION:  - Kosan Biosciences, 3832 Bay Center Place, Hayward, CA 94545, USA. kealey@kosan.com

RESUMEN / SUMMARY:  - Modular polyketide synthases (PKS) are large multifunctional enzymes that synthesize complex polyketides, a therapeutically important class of natural products. The linear order and composition of catalytic sites that comprise the PKS represent a “code” that determines the identity of the polyketide product. By re-programming the PKS through genetic engineering, it is possible to alter the code in a predictable manner to create specific structural modifications of polyketides and to produce new libraries of these natural products.  N. Ref:: 43

 

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[180]

TÍTULO / TITLE:  - Molecular actions of calcineurin inhibitors.

REVISTA / JOURNAL:  - Drug News Perspect 2003 Jun;16(5):277-82.

AUTORES / AUTHORS:  - Hamawy MM

INSTITUCIÓN / INSTITUTION:  - Department of Surgery, Division of Transplantation, University of Wisconsin, H4/749, CSC 600 Highland Avenue, Madison, WI 53792, USA. hamawy@surgery.wisc.edu

RESUMEN / SUMMARY:  - The immunosuppressive drugs cyclosporin A and FK-506, also called calcineurin inhibitors, have been useful for treating immune system-mediated diseases and have truly revolutionized allograft transplantation. Both drugs block T-cell proliferation by mechanisms that involve the inhibition of the key signaling phosphatase calcineurin, hence, the name calcineurin inhibitors. The inhibition of calcineurin activation by cyclosporin A and FK-506 blocks T-cell receptor-mediated production of interleukin-2 (IL-2), a growth factor critical for T-cell proliferation. Recent studies, however, suggest that the effects of the drugs are not limited to blocking calcineurin activation and IL-2 production. This review discusses the molecular actions of cyclosporin A and FK-506.  N. Ref:: 79

 

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[181]

TÍTULO / TITLE:  - Current thinking in atopic eczema.

REVISTA / JOURNAL:  - Practitioner 2003 Oct;247(1651):806-10.

AUTORES / AUTHORS:  - Katugampola R; Finlay AY

INSTITUCIÓN / INSTITUTION:  - Department of Dermatology, University Hospital of Wales, Cardiff.  N. Ref:: 16

 

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[182]

TÍTULO / TITLE:  - Daclizumab as induction therapy in kidney and simultaneous pancreas-kidney transplantation.

REVISTA / JOURNAL:  - Minerva Urol Nefrol 2003 Mar;55(1):43-56.

AUTORES / AUTHORS:  - Ciancio G; Mattiazzi A; Miller J; Burke GW

INSTITUCIÓN / INSTITUTION:  - Division of Transplantation, Department of Surgery, University of Miami School of Medicine, Miami, FL 33101, USA. gciancio@med.miami.edu

RESUMEN / SUMMARY:  - Acute rejection still remains a major problem in organ transplantation and is a significant risk factor for chronic rejection, and chronic rejection is one of the most important causes of late graft loss. Current new immunosuppressive drugs such as tacrolimus, rapamycin and mycophenolate mofetil have been developed to reduce acute rejection and to improve renal allograft survival. More recently, antihuman antibodies, either monoclonal or polyclonal, have been developed to use for induction therapy at the time of transplantation or to treat rejection. Daclizumab, a new engineered human immunoglobulin monoclonal antibody to the interleukin-2 receptor a-subunit was approved to prevent acute rejection after solid organ transplantation. Data from clinical trials show daclizumab to be well tolerated in solid organ transplantation. It does not increase the incidence of infection, including cytomegalovirus infection.  N. Ref:: 72

 

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[183]

TÍTULO / TITLE:  - Modulation of inducible nitric oxide synthase activation by immunosuppressive drugs.

REVISTA / JOURNAL:  - Curr Drug Metab 2001 Sep;2(3):315-29.

AUTORES / AUTHORS:  - Trajkovic V

INSTITUCIÓN / INSTITUTION:  - Institute of Microbiology and Immunology, Medical School, University of Belgrade, Yugoslavia. vladtr@eunet.yu

RESUMEN / SUMMARY:  - The activation of inducible form of nitric oxide (NO) synthase (iNOS, type II, or macrophage NOS) and subsequent production of free radical gas NO is an important anti-infectious and anti-tumor mechanism of innate immunity. On the other hand, high amounts of iNOS-derived NO have been implicated in self-tissue destruction during autoimmune diseases, allograft rejection, sepsis, and other disorders accompanied by excessive activation of the immune system. It is generally accepted that beneficial effects of some recently designed immunosuppressive agents primarily stem froin their ability to interfere with the function of T and/or B cells, thus preventing deleterious consequences of specific immunity-innate immunity positive feedback, with high NO production being one of them. However, it has been recently observed that drugs like cyclosporin A, FK506, leflunomide, mycophenolate mofetil, pentoxifylline, and linomide can directly modulate cytokine and/or LPS-induced NO production in various cell types in vitro, probably by interfering with iNOS gene transcription or catalytic activity of iNOS enzyme. Interestingly, some of these drugs exhibited cell-specific pattern of iNOS modulation, thus indirectly revealing distinct requirements for iNOS induction in different cell types. Possible impact of this direct and cell-selective interference with iNOS activation on the therapeutic effectiveness of immunosuppressive drugs is discussed.  N. Ref:: 128

 

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[184]

TÍTULO / TITLE:  - Review: metabolism of immunosuppressant drugs.

REVISTA / JOURNAL:  - Curr Drug Metab 2002 Jun;3(3):275-87.

AUTORES / AUTHORS:  - Kelly P; Kahan BD

INSTITUCIÓN / INSTITUTION:  - Novartis Pharmaceuticals Corp., Medical Affairs/Transplantation, Summit, NJ 07901, USA.

RESUMEN / SUMMARY:  - Pharmacokinetic concepts provide a basis for individualization of drug therapy to optimize outcomes of the critical-dose drugs cyclosporine (CsA), tacrolimus (TRL), sirolimus (SRL), and mycophenolate mofetil (MMF). The therapeutic range of a drug-defined as the concentrations at which the desired pharmacologic effect is produced without adverse effects in most patients-is difficult to achieve given the significant inter-and intrapatient variability of the effects of a given concentration of therapeutic agents. Because of the highly variable rates of absorption of immunosuppressive agents and clinical responses to given concentrations in transplant recipients, individualization of drug regimens by using therapeutic drug monitoring (TDM) is essential to optimize pharmacotherapy Assessing proclivity for acute rejection episodes in transplant recipients currently is attempted by estimating drug exposure using the area under the time-concentration curve (AUC) for MMF and the average concentration (Cav, the quotient of the AUC and the dosing interval) for CsA. These studies have revealed that low oral bioavailability was a more important predictor of rejection than was a rapid clearance rate. In addition, the degree of intra-individual variability of AUC values correlated with the development of chronic rejection in renal transplant recipients. Similarly, TDM of MMF requires AUC determinations. Low mycophenolic acid (MPA) exposure, as estimated by the AUC, demonstrates a significant association with an increased risk of an acute renal transplant rejection episode. The AUC0-2 estimate of MPA shows good agreement with the 12-hr AUC estimate from samples obtained during the entire dosing interval. In contrast, trough levels are utilized during treatment with TRL or SRL, potent new immunosuppressive agents that display a pleiotropic array of side effects. Standard body measures, including weight and body mass index, poorly predict the concentration of SRL in whole blood. Large inter- and intra-individual differences displayed in patients also could not be predicted by demographic features or by laboratory parameters. When SRL is given with other immunosuppressive agents such as CsA, which shares with SRL mutual microsomal metabolism by the cytochrome P450 3A system, pharmacokinetic interactions occur, especially when the agents are administered concomitantly. Because of the critical-dose nature of most of the recent generation of immunosuppressive agents, therapeutic drug monitoring is becoming increasingly important in the selection of doses and treatment regimens.  N. Ref:: 155

 

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[185]

TÍTULO / TITLE:  - Initial experience with paclitaxel-coated stents.

REVISTA / JOURNAL:  - J Interv Cardiol 2002 Dec;15(6):471-5.

AUTORES / AUTHORS:  - Grube E; Bullesfeld L

INSTITUCIÓN / INSTITUTION:  - Heart-Center Siegburg, Ringstrasse 49, 53721 Siegburg, Germany. GrubeE@aol.com

RESUMEN / SUMMARY:  - Local delivery of immunosuppressive or antiproliferative agents using a drug-eluting stent is a new technology that is supposed to inhibit in-stent restenosis, thus providing a biological and mechanical solution. This technique is a very promising. To date, several agents have been used, including paclitaxel, QP-2, rapamycin, actinomycin D, dexamethason, tacrolimus, and everolimus. Several studies, published recently or still ongoing, have evaluated these drugs as to their release kinetics, effective dosage, safety in clinical practice, and benefit. These studies include: SCORE (paclitaxel derivative), TAXUS I-VI, ELUTES, ASPECT, DELIVER (paclitaxel), RAVEL, SIRIUS (sirolimus), ACTION (actinomycin), EVIDENT, PRESENT (tacrolimus), EMPEROR (dexamethason), and FUTURE (everolimus). Paclitaxel was one of the first stent-based antiproliferative agents under clinical investigation that provided profound inhibition of neointimal thickening depending on delivery duration and drug dosage. The randomized, multicenter SCORE trail (Quanam stent, paclitaxel-coated) enrolled 266 patients at 17 sites. At 6-month’s follow-up, a drop of 83% in stent restenosis using the drug-eluting stent could be achieved (6.4% drug-eluting stent vs 36.9% control group), which was attributable to a remarkable decrease in intimal proliferation. Unfortunately, due to frequent stent thrombosis and side-branch occlusions, the reported 30-day MACE rate was 10.2%. The randomized TAXUS-I safety trial (BSC, NIRx, paclitaxel-coated) also demonstrated beneficial reduction of restenotic lesions at 6-month’s follow-up (0% vs 10%) but was associated with the absence of thrombotic events presumably due to less drug dosage. The ongoing TAXUS II-VI trials are addressing additional insight regarding the efficacy of the TAXUS paclitaxel-eluting stent. ASPECT and ELUTES evaluated paclitaxel-coated stents (i.e., Cook and Supra G), including subgroups with different drug dosages. With respect to stent restenosis and neointimal proliferation, both studies demonstrated a clear dose response. The RAVEL and the SIRIUS trials evaluated sirolimus-coated stents (i.e., Cordis, Johnson & Johnson, and Bx VELOCITY stents). Results confirmed the beneficial findings regarding reduction of renarrowing using a drug-eluting stent without any major adverse effects. Although parameters such as drug toxicity, optimal drug dosage, or delayed endothelial healing still need to be evaluated, today’s clinical experience indicates that drug-coated stents are extremely beneficial in the interventional treatment of coronary lesions.  N. Ref:: 20

 

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[186]

TÍTULO / TITLE:  - Metabolic aspects of tacrolimus in renal transplantation. Consequences for the choice of an immunosuppressive regimen and for the management of post-transplant diabetes mellitus.

REVISTA / JOURNAL:  - Minerva Urol Nefrol 2003 Mar;55(1):33-42.

AUTORES / AUTHORS:  - van Duijnhoven EM; Boots JM; Christiaans MH; van Hooff JP

INSTITUCIÓN / INSTITUTION:  - Department of Internal Medicine,University Hospital Maastricht, Maastricht, The Netherlands. evd@sint.azm.nl

RESUMEN / SUMMARY:  - The occurrence of post-transplant diabetes mellitus (PTDM) is an important complication after renal transplantation associated with an increased risk of chronic transplant dysfunction and of cardiovascular morbidity and mortality. Both tacrolimus and cyclosporine have been associated with PTDM. In the initial studies, PTDM seemed to occur more often in tacrolimus treated patients than in cyclosporine treated patients. The mechanism by which tacrolimus could cause PTDM was unknown and the relative roles of tacrolimus and corticosteroids, which are often prescribed concomitantly with tacrolimus, were unknown. In several studies we used fasting glucose and insulin levels to assess (peripheral) insulin resistance, and intravenous glucose tolerance tests to assess insulin secretion by the pancreatic b-cells in response to a stimulus (glucose load). Thus, we evaluated the mechanism by which tacrolimus causes glucose metabolic disorders, risk factors for glucose metabolic disorders during tacrolimus treatment, the relative roles of corticosteroids and tacrolimus trough levels in glucose metabolic disorders, and also differences in glucose metabolism between patients using tacrolimus versus patients using cyclosporine. Based on the results of these studies and the available literature, the consequences for the choice of a primary immunosuppressive agent and guidelines for the treatment of PTDM during tacrolimus-based immunosuppression are discussed.  N. Ref:: 40

 

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[187]

TÍTULO / TITLE:  - New monoclonal antibodies in renal transplantation.

REVISTA / JOURNAL:  - Minerva Urol Nefrol 2003 Mar;55(1):57-66.

AUTORES / AUTHORS:  - Vincenti F

INSTITUCIÓN / INSTITUTION:  - Kidney Transplant Service, University of California, San Francisco, CA 94143-0780, USA. vincentif@surgery.ucsf.edu

RESUMEN / SUMMARY:  - A decade of spectacular innovation in maintenance immunosuppression drugs has resulted in dramatic reductions in acute rejection and improvement in short and long term outcome after renal transplantation. However the new drugs continue to lack specificity, many require frequent therapeutic drug monitoring and all are associated with acute and chronic toxicities. The new biologic agents, monoclonal antibodies (chimeric, humanized, and fully human) and receptor-fusion proteins, lack immunogenicity, have long half-life and prolonged biologic effects, require intermittent administration and have minimal toxicity. The specificity and selectively of the targets of the new biologic agents render them less toxic than the oral maintenance drugs and thus could possibly replace the maintenance drugs most associated with long-term toxicity such as the corticosteroids and the calcineurin inhibitors. The recently introduced anti-interleukin 2 receptor (IL-2R) monoclonal antibodies (mAbs) are the prototype of future biologic agents; selective, safe, and inducing prolonged biologic effects. The IL-2R mAbs have been used with a variety of maintenance immunosuppression regimens double therapy with cyclosporine and prednisone, triple therapy with cyclosporine, azathioprine and prednisone and with newer regimens such as cyclosporine or tacrolimus, mycophenolate mofetil (MMF) and prednisone, and most recently with sirolimus, MMF and prednisone. The major thrust of the new biologics in clinical development is to block the co-stimulatory pathway. The first attempt at blockade of the CD40-CD154 with anti-CD154 mAbs was disappointing. Anti-CD 154 therapy was associated with thromboembolic events and acute rejection. Attempts at blocking the CD28-B7s (CD80-CD86) pathway are currently underway with the receptor fusion protein, LEA29Y a second generation CTL4Aig, and humanized mAbs to CD 80 and CD86. LFA1, an adhesion molecule that also participates in the co-stimulatory pathway, has also been targeted with a mAb that binds to the CD11a chain of LFA1. Efalizumab, a humanized anti-CD11a mAb, was shown in a phase I trial to be potentially effective in renal transplantation. A humanized anti-CD45 RB mAb is currently in pre-clinical studies and will likely be tested in a phase I trial of renal transplantation within 1 year. While excellent results with anti-CD45 RB mAbs have been published in experimental transplantation, the mechanism of action of anti-CD45 RB mAbs remains to be determined. Several antibodies that are currently approved for non-transplant indications are currently used in single center clinical trials in renal transplantation including Campath 1 H, a humanized anti-CD52 mAb, Rituxamab, an anti-CD20 chimeric mAb, and Infliximab an anti-TNFa chimeric mAb. In addition, several humanized mutagenized anti-CD3 mAbs, huOKT3g1, aglycosyl CD3 and HuM291 have been used in limited trials in renal transplantation but have yet to have a formal clinical development. Humanized mAbs and receptor fusion proteins offer the potential of providing renal transplant recipients with a novel algorithm for immunosuppression that relies on chronic intermittent intravenous administration of safe, non-toxic agents replacing oral drug therapy maintenance.  N. Ref:: 50

 

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[188]

TÍTULO / TITLE:  - Molecular mechanisms of the immunosuppressive effect of erythroid cells.

REVISTA / JOURNAL:  - Russ J Immunol 2002 Oct;7(3):211-8.

AUTORES / AUTHORS:  - Kozlov VA

INSTITUCIÓN / INSTITUTION:  - Institute of Clinical Immunology, Siberian Branch of RAMS, Yandritsovskaya str. 14, Novosibirsk-99 630099, Russia. v_kozlov@online.nsk.su

RESUMEN / SUMMARY:  - This review presents data suggesting a new immunoregulatory role of the erythroid nucleus-containing cells. The three main mechanisms of the possible immunosuppressive effect of these cells are described. It has been demonstrated that the erythroid nucleus-containing cells produce a variety of both pro- and anti-inflammatory cytokines. The p15 protein (a product of the env gene) is considered to provide a novel immunosuppressive mechanism. Finally, the existing data suggest that the erythroid nucleus-containing cells are able to produce an immunosuppressive factor, which is different from the known cytokines. It has been proposed that the immunosuppressive effect of the erythroid nucleus-containing cells greatly contributes to the regulation of the immune homeostasis in normal and immunopathological conditions.  N. Ref:: 33

 

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[189]

TÍTULO / TITLE:  - Reversal of multidrug resistance: lessons from clinical oncology.

REVISTA / JOURNAL:  - Novartis Found Symp 2002;243:83-96; discussion 96-102, 180-5.

AUTORES / AUTHORS:  - Bates SF; Chen C; Robey R; Kang M; Figg WD; Fojo T

INSTITUCIÓN / INSTITUTION:  - Molecular Therapeutics Section, Medicine Branch, National Cancer Institute, Bethesda, MD 20892, USA.

RESUMEN / SUMMARY:  - Modulation of P glycoprotein (Pgp) in clinical oncology has had limited success. Contributing factors have included the limitation in our understanding of the tumours in which Pgp overexpression is mechanistically important in clinical drug resistance; the failure to prove that concentrations of modulators achieved in patients were sufficient to inhibit Pgp; and the inability to conclusively prove that Pgp modulation was occurring in tumours in patients. New approaches are needed to determine the clinical settings in which Pgp overexpression plays a major role in resistance. (Clinical trials with third generation modulators are ongoing, including trials with the compounds LY335979, R101933 and XR9576. Using the Pgp substrate Tc-99m Sestamibi as an imaging agent, increased uptake has been seen in normal liver and kidney after administration of PSC 833, VX710 and XR9576. These studies confirm that the concentrations of modulator achieved in patients are able to increase uptake of a Pgp substrate. Furthermore, CD56+ cells obtained from patients treated with PSC 833 demonstrate enhanced rhodamine retention in an ex vivo assay after administration of the antagonist. Finally, a subset of patients treated with Pgp antagonists show enhanced Sestamibi retention in imaged tumours. These results suggest that Pgp modulators can increase drug accumulation in Pgp-expressing tumours and normal tissues in patients. Using third generation Pgp antagonists and properly designed clinical trials, it should be possible to determine the contribution of modulators to the reversal of clinical drug resistance.  N. Ref:: 40

 

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[190]

TÍTULO / TITLE:  - Clinical development of P glycoprotein modulators in oncology.

REVISTA / JOURNAL:  - Novartis Found Symp 2002;243:103-15; discussion 115-8, 180-5.

AUTORES / AUTHORS:  - Oza AM

INSTITUCIÓN / INSTITUTION:  - Princess Margaret Hospital, Toronto, Ontario, Canada.

RESUMEN / SUMMARY:  - The last two decades have witnessed dramatic advances into the mechanisms of drug resistance in cancer. The identification of P glycoprotein (Pgp) as a specific mechanism led to the initial hope and expectation that it would be possible to modulate this and increase sensitivity to drug therapy. Clinical trials using first- and second-generation Pgp modulators did establish proof of principle that in some settings, clinical drug resistance could be overcome with the addition of a Pgp modulator-for example, clinical resistance to paclitaxel, a Pgp substrate, in women with ovarian cancer was shown to be overcome in approximately 20% with the addition of PSC 833, a highly effective Pgp modulator. However, evolutionary and adaptive redundancy in resistance mechanisms have tempered clinical results, even with very effective second- and third-generation modulators. The lessons from oncology establish sound methodology for the evaluation of Pgp modulators for safety, tolerability and efficacy in Phase I, II and III clinical trials. This review will focus on some of the early-phase clinical trials with earlier and newer Pgp modulators, either as single agents or in combination with chemotherapy.  N. Ref:: 46

 

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