小胶质细胞极化在出血性脑损伤中的研究进展

出血性脑卒中是脑卒中最致命的类型,目前临床缺乏有效的治疗方法。小胶质细胞是在脑出血后第一个产生免疫应答的中枢神经系统细胞。急性脑损伤后,小胶质细胞可被诱导为经典的M1型(促炎)或补充替代的M2型(抗炎)。但是小胶质细胞极化在脑出血后的病理过程和功能恢复中的机制尚不明确,可能与细胞因子、趋化因子有关。本研究综述了关于脑出血后小胶质细胞极化的关键分子机制,包括M1型和M2型小胶质细胞标记物、调节转录因子和关键分子信号通路。     

小胶质细胞在金花茶多糖保护脑出血中的作用

目的探讨金花茶多糖(camellia nitidissima polysaccharides,CNP)在脑出血中的作用及机制。方法C57 BL/6小鼠随机分为假手术组、脑出血组和金花茶多糖组,脑出血后即刻灌胃金花茶多糖并连续给药3 d。神经功能缺陷评分评价整体功能,旷场与粘附移除实验检测运动与感觉功能。伊文思蓝染色和水肿实验检测血脑屏障损伤程度;免疫荧光检测小胶质细胞激活情况;ELISA检测炎症因子水平;定量PCR及免疫荧光检测小胶质细胞极化水平。结果金花茶多糖可提高小鼠神经功能评分,改善运动功能而对感觉功能无影响;减轻脑水肿与保护血脑屏障;抑制小胶质细胞的激活、抑制炎症因子表达,同时促进小胶质细胞从M1型转化为M2型。结论金花茶多糖促进小胶质细胞M1型转化为M2型减轻炎症、脑水肿与血脑屏障损伤,从而改善脑出血后损伤。     

基于非靶向代谢组学的促乳腺癌曲妥珠单抗耐药 代谢产物分析

摘 要 目的：探究人类表皮生长因子受体2（HER2）阳性乳腺癌曲妥珠单抗（trastuzumab）耐药细胞（HCC1954）和敏感细胞（SK-BR-3）之间的代谢物差异。方法：利用超高效液相色谱-串联质谱（UHPLC-MS/MS）非靶向代谢组学方法进行代谢物的鉴定与定量,结合多元统计方法主成分分析（PCA）和正交偏最小二乘-判别分析（OPLS-DA）以筛选差异代谢物,并对差异代谢物进行KEGG通路富集分析。结果：在正负离子模式下鉴定筛选出15种显著性变化差异代谢物,在曲妥珠单抗耐药细胞中丙酰肉碱和谷胱甘肽等7种代谢物上调,肉豆蔻酸和D-葡萄糖酸等8种代谢物下调。KEGG通路富集分析发现,9条代谢通路具有统计学意义（P<0.05）,其中氮代谢和谷氨酰胺与谷氨酸代谢最为显著,P值为0.001 3,还发现谷氨酸和谷氨酰胺均在这两条通路中发挥作用。结论：本研究初步揭示了HER2阳性乳腺癌曲妥珠单抗耐药和敏感细胞之间的代谢物差异,为HER2阳性乳腺癌细胞曲妥珠单抗诊断标志物进一步研究提供了代谢组学的数据支持。     

灵芝酸对小鼠局灶性脑缺血再灌注损伤的保护作用及机制研究

目的研究灵芝酸对小鼠局灶性脑缺血再灌注损伤的保护作用及对小胶质细胞表型的影响。方法线栓法制备小鼠大脑中动脉栓塞模型,缺血60 min后再灌注。灵芝酸(1.25,5和20 mg·kg-1)再灌同时及再灌后24和48 h腹腔注射给药。再灌后72 h,测定小鼠神经功能缺失评分、脑梗死体积及脑水肿程度,并检测损伤侧脑组织中炎症相关蛋白的表达,同时应用免疫荧光双染对梗死周边区小胶质细胞表型进行测定。体外培养BV-2细胞,通过加入LPS、IFN-γ或IL-4诱导M1或M2极化表型,应用灵芝酸预处理后,观察COX-2,TNF-α,i NOS蛋白表达变化及对小胶质细胞极化表型的影响。结果灵芝酸可改善小鼠神经功能缺失,减少脑梗死体积,减轻脑水肿程度,减少损伤侧脑组织中炎症相关蛋白COX-2,TNF-α和IL-6的表达,并且可减少M1型小胶质细胞数量,增加M2型小胶质细胞数量。在体外模型中同样证实灵芝酸可抑制LPS诱导的BV-2细胞中炎症相关蛋白的表达,减少LPS和IFN-γ共同诱导后M1型小胶质细胞标志物,同时增加IL-4诱导后M2型小胶质细胞标志物。结论灵芝酸可通过抑制脑缺血后小胶质细胞的过度活化,促进M1型小胶质细胞向M2型转化,从而减轻脑缺血后炎症反应,发挥对小鼠急性局灶性脑缺血再灌注损伤的保护作用。     

小胶质细胞极化在帕金森病中的作用

帕金森病(PD)是一种高发于中高年人群的神经退行性疾病。近年来,小胶质细胞介导的神经炎症在PD的发病过程中受到了广泛的关注。越来越多的证据表明,炎症微环境会极大地影响小胶质细胞的表型变化,不同极化类型的小胶质细胞可分泌不同作用的炎症因子,介导神经炎症,与PD的发病过程密切相关,但目前其相关机制尚不明确。目前研究认为,调节具有神经毒性的M1型小胶质细胞和产生神经保护作用的M2型小胶质细胞之间的平衡对PD中多巴胺能神经元的损伤起到重要的神经保护作用。本文就小胶质细胞极化在PD发病过程中的作用及其关机制进行综述,为靶向调控小胶质细胞极化治疗PD提供了新的思路并奠定相关基础。     

黄芪-山药药对治疗2型糖尿病的尿液代谢组学研究

为了探讨黄芪-山药药对治疗2型糖尿病(T2DM)的作用机制,本研究首次应用氢核磁共振(1H NMR)尿液代谢组学方法研究了黄芪-山药药对对T2DM大鼠的代谢保护机制。将37只SD大鼠随机分为4个组:模型组M,对照组C,黄芪山药组HS,阳性对照组Y (二甲双胍)。利用高脂饲料喂养合并链脲佐菌素(STZ)诱导制备T2DM模型。造模后连续给药8周,随后取其血检测相关生化指标;取其肾脏检测肾脏系数。动物实验获得广东药科大学伦理委员会的批准。通过1H NMR代谢组学方法检测各组大鼠尿液中代谢物的变化,筛选出标志性代谢物。实验结果显示,与对照组比较,模型组大鼠总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(L-DLC)、尿素氮(BUN)、糖化血红蛋白(HbA1c)及肾脏系数明显升高,高密度脂蛋白(H-DLC)水平显著降低(P<0.01),在黄芪-山药药对治疗后上述指标均有明显改善。模型组大鼠尿液中共发现20个标志性代谢物,黄芪山药治疗后可不同程度的逆转16个代谢物的变化,其效果与200 mg·kg-1二甲双胍相当。主要涉及丁酸代谢、三羧酸循环(TCA循环)、牛磺酸和亚牛磺酸代谢、酮体的合成与降解、丙酮酸代谢。提示黄芪-山药药对可能主要通过以上5条代谢通路对T2DM起到治疗作用,揭示了黄芪-山药药对对T2DM的治疗机制。     

小胶质细胞极化中的糖代谢重编程研究进展

静息态或M2表型的小胶质细胞主要由葡萄糖通过氧化磷酸化为细胞提供能量,病理条件下的M1促炎型小胶质细胞即使在氧气充足条件下,葡萄糖也会被优先用于糖酵解生成大量乳酸,三羧酸循环受到抑制。蛋白激酶 B（Akt）及AMP依赖的蛋白激酶（AMPK）/哺乳动物雷帕霉素靶蛋白（mTOR）/缺氧诱导因子-1α（HIF-1α）信号通路在调节糖酵解与炎症反应过程中发挥重要作用。小胶质细胞中糖酵解与炎症存在制约关系,抑制糖代谢重编程能够干预小胶质细胞 M1炎症表型极化状态,可以作为抑制神经炎症的药物作用靶点,为退行性疾病、脑血管疾病等相关药物的研发提供新思路。     

基于脂质代谢组学评价五味子素B诱导的急性高甘油三酯血症小鼠模型

目的利用脂质代谢组学技术对五味子素B(schisandrin B,Sch B)诱导的小鼠高甘油三酯血症模型进行评价和提供新的实验依据。方法♂ICR小鼠分为4组:正常饮食(ND)组; ND+Sch B组;高脂高糖饮食(HFFD)组; HFFD+Sch B组。生化法检测血清甘油三酯(TG)和总胆固醇水平;利用超高效液相色谱-四极杆飞行时间质谱联用仪(UPLCQ-TOF/MS)的代谢组学技术方法测定各组小鼠血清中脂类代谢物的变化。结果 ND+Sch B组与ND组比,筛选出27个差异代谢物,分别为TG类18个、磷脂酰胆碱(PC) 7个、磷脂酰乙醇胺(PE) 2个; HFFD组与ND组比,筛选出27个差异代谢物,分别为神经鞘磷脂6个、PC 13个、胆甾醇酯(CE) 2个、TG类5个、磷脂酰肌醇1个; HFFD+Sch B组与HFFD组比,筛选出25个差异代谢物,分别为TG类14个、CE 1个、PC 6个、PE 4个。结论 Sch B诱导的高甘油三酯血症动物模型涉及血清脂质代谢组学的改变。     

应用代谢组学探讨芫花酯甲对人肝细胞L02的毒性作用

目的 采用代谢组学分析芫花酯甲抑制人肝细胞L02增殖的差异代谢物,并揭示其毒性机制。方法 芫花酯甲0, 2.5, 5和10 μmol·L^-1加入L02细胞孵育48 h后,采用超高效液相色谱串联四级杆飞行时间质谱(UPLC-QTOF/MS)分析细胞代谢物;运用偏最小方差判别分析模型区别对照组和芫花酯甲2.5,5和 10 μmol·L^-1作用L02后细胞代谢物的总体差异;计算各组细胞代谢物归一化后的峰面积与细胞毒性强度的相关系数,从而发现并鉴定芫花酯甲损伤L02细胞的差异标志物;采用DAVID数据库分析差异代谢标志物相关基因的信号通路。结果 正常对照组及芫花酯甲2.5,5和 10 μmol·L^-1组间的L02细胞代谢物存在明显差异,共鉴定出5个细胞代谢物峰面积显著下调,与细胞毒性强度的相关系数为-0.53~-0.96;5个代谢物峰面积显著上调,与细胞毒性强度的相关系数为0.72~0.99。代谢物包括磷脂类和脂肪酸类等,主要涉及甘油磷脂代谢、鞘脂代谢、脂肪酸氧化、花生四烯酸代谢和有丝分裂原激活蛋白激酶细胞凋亡等相关信号通路。结论 代谢组学方法能够鉴定芫花酯甲诱导人肝细胞L02损伤的差异标志物及其信号通路。     

天门冬中的两个新呋甾皂苷aspacochinoside L和aspacochinoside M(英文)

从天门冬的根中分离得到两个新呋甾烷型皂苷aspacochinoside L(1)和aspacochinoside M(2),通过化学和波谱学方法确定了化合物1和2的结构。利用脂多糖(LPS)诱导的小胶质细胞(BV-2)炎症模型,测试了化合物的抗炎活性,其中aspacochinoside M的IC50值为32.26μM。     

基于细胞代谢组学的商陆皂苷甲诱导HKC细胞损伤的机制研究

目的 基于细胞代谢组学技术,考察商陆皂苷甲（EsA）诱导人肾小管上皮HKC细胞损伤前后对细胞代谢产物的影响,寻找潜在的生物标志物。方法 MTT法检测EsA 0（对照组）、0.125、0.250、0.500、0.750、1.000 mmol/L对HKC细胞活力的影响;试剂盒法检测EsA 0（对照组）、0.25、0.75 mmol/L对HKC细胞上清LDH含量的影响,明确EsA肾细胞毒性;利用UPLC-Q/TOF-MS分析技术,将EsA 0（对照组）、0.25、0.75 mmol/L作用24 h的HKC细胞进行代谢组学分析,采用Progenesis QI软件进行数据处理,将得到的数据导入SIMCA-P12.0 software进行多元统计分析,利用主成分分析（PCA）剔除离群值,进行正交偏最小二乘分析（OPLS-DA）得到变量权重值（VIP）,选取VIP＞1的差异代谢物,进行检验,获得具有统计学意义的生物标志物。通过HMDB、KEGG、METLIN等代谢物数据库对生物标记物进行鉴定,利用MetPA平台对进行代谢通路分析。结果 与对照组比较,EsA在大于0.25 mmol/L时对HKC细胞活力有显著的抑制作用（P<0.05、0.01）;细胞上清液中LDH含量显著上升（P<0.05）。通过代谢组学技术和相关数据库分析筛选出了15个生物标志物,主要涉及甘油磷脂代谢、嘧啶代谢、鞘脂代谢、氨基酸代谢和能量代谢途径。结论 EsA可诱导肾细胞损伤,可能与氧化应激损伤,氨基酸代谢失调,能量代谢异常以及脂质代谢紊乱相关。     

芪附汤对大鼠抗阿霉素心脏毒性作用的血清气相色谱-质谱代谢组学研究

目的 采用基于气相色谱-质谱（GC-MS）血清代谢组学技术研究芪附汤抗阿霉素心脏毒性的作用,并初步探讨其作用机制。方法 将24只大鼠分为正常组、阿霉素组和芪附汤治疗组,给予4周相应的干预治疗后,采集大鼠血清进行GC-MS分析,结合多变量和单变量统计分析,研究阿霉素诱导的心脏毒性损伤大鼠血清中内源性代谢物的变化,以及芪附汤对其的干预作用,寻找其抗阿霉素心脏毒性潜在的生物标志物,采用代谢通路分析鉴定芪附汤靶向代谢通路。结果 GC-MS血清代谢组学分析鉴定了17种阿霉素心脏毒性潜在生物标志物,芪附汤对其中10种代谢物具有显著的逆转作用,代谢通路分析表明,三羧酸循环、乙醛酸和二羧酸代谢（简称二羧酸代谢）、花生四烯酸代谢是芪附汤主要的靶向代谢通路。结论 芪附汤能够通过调节失衡的三羧酸循环、二羧酸代谢和花生四烯酸代谢而发挥抗阿霉素心脏毒性的作用。     

乌帕替尼对氧糖剥夺/复氧后BV2细胞极化的影响

目的研究乌帕替尼对氧糖剥夺再复氧(OGD/R)后BV2小胶质细胞极化及炎症的影响,并探讨其作用机制。方法实验分对照组、OGD组和乌帕替尼组3组。BV2细胞经OGD/R处理后,噻唑蓝试剂(MTT)检测细胞生存率,划痕实验观察细胞迁移能力,实时荧光定量多聚核苷酸链式反应(qPCR)检测BV2细胞M1型极化标志物(CD11b、CD32、iNOS)和M2型极化标志物(Arg-1、IL-10、CD206)的mRNA水平,酶联免疫吸附测定(ELISA)检测培养基中IL-1β、IL-6、TNF-α含量,蛋白质印迹法(Western Blot)检测JAK1/STAT6通路相关蛋白表达水平。结果乌帕替尼能增加OGD/R后BV2细胞的生存率(P<0.05),能减少BV2细胞向M1型极化(P<0.05)。乌帕替尼可明显降低OGD/R诱导的BV2细胞的迁移能力(P<0.05),减少OGD/R诱导BV2细胞分泌的炎症因子:IL-1β、IL-6、TNF-α(P<0.05)。乌帕替尼提高共培养PC12细胞的生存率(P<0.05)。乌帕替尼可显著抑制由OGD/R诱导激活BV2细胞p-JAK1和p-STAT6蛋白的表达水平(P<0.05)。结论乌帕替尼可减少OGD/R诱导BV2细胞向M1型极化和减少炎症反应,与JAK1/STAT6通路有关。     

Elevated internalization and cytotoxicity of polydispersed single-walled carbon nanotubes in activated B cells can be basis for preferential depletion of activated B cells in vivo

Abstract

Uptake of polydispersed acid-functionalized single-walled carbon nanotubes (AF-SWCNTs) in resting and LPS-activated B cells was studied using fluorescence-tagged AF-SWCNTs (FAF-SWCNTs). Activated B cells internalized substantially higher amounts of FAF-SWCNTs [76.5% AF-SWCNT⁺ B cells, mean fluorescence intensity (MFI) 720.6] as compared to the resting B cells [39.5% AF-SWCNT⁺ B cells, MFI 198.5]. B cells in S and G2/M phases were found to have significantly higher uptake of FAF-SWCNTs as compared to cells in G0/G1 phase. Confocal microscopy indicated that AF-SWCNTs were essentially localized on cell membrane in resting B cells, whereas in activated B cells, AF-SWCNTs were distributed throughout the cytoplasm. Targeting of AF-SWCNTs specifically to activated B cells in vivo was examined by first administering intravenously LPS-activated B cells tagged with fluorescence tracer (CFSE) in mice, followed by FAF-SWCNTs through the same route. It was found that FAF-SWCNTs were specifically taken up by CFSE+CD19+-activated B cells (95% FAF-SWCNT⁺ B cells, MFI 3725) as compared to CFSE^? CD19⁺ resting B cells (31.1% FAF-SWCNT⁺ B cells, MFI 428). Administration (i.v.) of LPS resulted in a significant increase in the proportion of B cell in mouse spleen that was reduced by 68% by administering AF-SWCNTs. In control mice, the corresponding decrease in B cell proportion was 49%, which was significantly lower (p?<?0.005) than the decline in LPS-treated mice. These results indicate that AF-SWCNTs may have the potential as an agent for depleting activated B cells in vivo.     

Inhibition of LOX-1 prevents inflammation and photoreceptor cell death in retinal degeneration

PurposeTo explore the expression and role of lectin-like oxidized low-density lipoprotein receptor 1 (LOX-1) in retinal degeneration.MethodsThe retinal degeneration of BALB/c mice was induced by light exposure. BV2 cells were activated by LPS stimulation. Retinas or BV2 cells were pretreated with LOX-1 neutralizing antibody or Polyinosinic acid (PolyI) (the inhibitor of LOX-1) before light damage (LD) or LPS stimulation. LOX-1, TNF-α, IL-1β, CCL2 and NF-κB expression were detected in retinas or BV2 cells by real-time RT-PCR, western blot or ELISA. Histological analyses of retinas were performed. Photoreceptor cell death was assessed by TUNEL assay in retinas or by flow cytometry in 661W cells cultured in microglia-conditioned medium.ResultsPhotoreceptor cell death and elevated expression of LOX-1 were induced by LD in retinas of BALB/c mice. LOX-1 neutralizing antibody or PolyI pretreatment significantly reduced the elevated expression of LOX-1, TNF-α, IL-1β, CCL2 and p-NF-κB caused by LD in retinas. Inhibition of LOX-1 by LOX-1 neutralizing antibody or PolyI significantly reduced photoreceptor cell death induced by LD in retinas. Elevated levels of TNF-α, IL-1β and CCL2 caused by LPS were down-regulated by inhibition of LOX-1 in BV2 cells. Inhibition of LOX-1 reduces microglial neurotoxicity on photoreceptors.ConclusionsLOX-1 expression is increased in light induced retinal degeneration, what’s more, inhibition of LOX-1 prevents inflammation and photoreceptor cell death in retinal degeneration and reduces microglial neurotoxicity on photoreceptors. Therefore, LOX-1 can be used as a potential therapeutic target for such retinal degeneration diseases.     

BICC1 as a novel prognostic biomarker in gastric cancer correlating with immune infiltrates

AimBicC family RNA-binding protein 1 (BICC1) codes an RNA-binding protein that regulates gene expression and modulates cell proliferation and apoptosis. We aim at investigating the role of BICC1 in gastric carcinogenesis.MethodsBICC1 mRNA expression in gastric cancer (GC) was examined using the Tumor Immune Estimation Resource (TIMER), The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) databases. Correlations between BICC1 expression and clinicopathological parameters were analyzed. The Gene Expression Profiling Interactive Analysis (GEPIA) and Kaplan–Meier plotter databases were used to examine the clinical prognostic significance of BICC1 in GC. Signaling pathways related to BICC1 expression were identified by gene set enrichment analysis (GSEA).TIMER and CIBERSORT were used to analyze the correlations among BICC1, BICC1-coexpressed genes and tumor-infiltrating immune cells.ResultsBICC1 was highly expressed in GC and significantly correlated with grade (P = 0.002), TNM stage (P = 0.033), invasion depth (P = 0.001) and vital status (P = 0.009) of GC patients. High BICC1 expression correlated with poor overall survival. The GSEA results showed that cell adhesion-, tumor- and immune- related pathways were significantly enriched in samples with high BICC1 expression. BICC1 and its coexpressed genes were positively related to tumor-infiltrating immune cells and were strongly correlated with tumor-infiltrating macrophages (all r ≥ 0.582, P < 0.0001). The CIBERSORT database revealed that BICC1 correlated with M2 macrophages (P < 0.0001), regulatory T cells (P < 0.0001), resting mast cells (P < 0.0001), activated memory CD4+ T cells (P = 0.002), resting NK cells (P = 0.002), activated dendritic cells (P = 0.002), and follicular helper T cells (P = 0.016). The results from TIMER database confirmed that BICC1 is closely associated with the markers of M2 macrophages and tumor-associated macrophages (all r ≥ 0.5, P < 0.0001).ConclusionBICC1 may be a potential prognostic biomarker in GC and correlates with immune infiltrates.     

Development of an immune gene prognostic classifier for survival prediction and respond to immunocheckpoint inhibitor therapy/chemotherapy in endometrial cancer

Immunotherapy has provided a promising therapeutic strategy for endometrial cancer (EC). The present study aims to develop a prognostic classifier based on immune-related genes (IRGs) to stratify EC patients. A total of 15 prognosis-related IRGs were further filtrated by multivariate Cox regression: LTA, TMSB15A, S100A14, PLA2G2A, PDGFRA, CLDN4, CTF1, PRLH, PTN, SST, HTR3E, NRP1, RORA, THRA and CBLC. A prognostic signature was constructed to split EC patients into the high-risk and low-risk group with statistically different survival outcomes, indicating good potential for the prognostic signature in survival surveillance. Furthermore, five compounds with potential anti-tumor effects were selected, including ciclopirox, ikarugamycin, vincamine, mevalolactone, and thiamazole. The abundance of follicular helper T cells, regulatory T cells and M0 macrophages were significantly enhanced in the high-risk group while resting memory CD4+ T cells, gamma delta T cells, M2 macrophages and resting mast cells were markedly elevated in the low-risk group. Memory activated CD4+ T cells, CD8+ T cells and activated mast cells were three most correlative with riskscore. An immunophenoscore (IPS) analysis revealed that patients of the low-risk group had a higher IPS and more inclined to respond to immune checkpoint inhibitors. Mutation analysis showed that patients of the low-risk group represented more tumor mutation burden but low riskscore, thus getting better prognosis. Patients of the low-risk group were more sensitive for gemcitabine, bleomycin, vinblastine, vinorelbine and methotrexate by prediction. We constructed a potential prognostic model and might offer new insight on the identification of new immune-related biomarkers and target therapy in EC.     

Anti-neuroinflammatory effects of cudraflavanone A isolated from the chloroform fraction of Cudrania tricuspidata root bark

Context: Cudrania tricuspidata Bureau (Moraceae) is an important source of traditional Korean and Chinese medicines used to treat neuritis and inflammation.

Objective: The anti-neuroinflammatory effects of cudraflavanone A isolated from a chloroform fraction of C. tricuspidata were investigated in LPS-induced BV2 cells.

Materials and methods: Cudraflavanone A was isolated from the root of C. tricuspidata, and its structure was determined by MS and NMR data. Cytotoxicity of the compound was examined by MTT assay, indicating no cytotoxicity at 5–40?μM of cudraflavanone A. NO concentration was measured by the Griess reaction, and the levels of PGE₂, cytokines and COX-2 enzyme activity were measured by each ELISA kit. The mRNA levels of cytokines were analysed by quantitative-PCR. The expression of iNOS, COX-2, HO-1, NF-κB, MAPKs and Nrf2 was detected by Western blot.

Results: Cudraflavanone A had no major effect on cell viability at 40?μM indicating 91.5% viability. It reduced the production of NO (IC₅₀?=?22.2?μM), PGE₂ (IC₅₀?=?20.6?μM), IL-1β (IC₅₀?=?24.7?μM) and TNF-α (IC₅₀?=?33.0?μM) in LPS-stimulated BV2 cells. It also suppressed iNOS protein, IL-1β and TNF-α mRNA expression. These effects were associated with the inactivation of NF-κB, JNK and p38 MAPK pathways. This compound mediated its anti-neuroinflammatory effects by inducing HO-1 protein expression via increased nuclear translocation of Nrf2.

Discussion and conclusions: The present study suggests a potent effect of cudraflavanone A to prevent neuroinflammatory diseases. Further investigation is necessary to elucidate specific molecular mechanism of cudraflavanone A.     

Efficacy and tolerability of a new chlorhexidine-based vaginal gel in vaginal infections

SUMMARY

Objective: We evaluated the efficacy and tolerability of a new chlorhexidine-based bioadhesive vaginal gel (Clomirex*) in women with vaginal infections.

Study design and subjects: A total of 90 non-pregnant women with vaginal infections of both bacterial (bacterial vaginosis: BV) or fungal (vaginal candidiasis VC) origin, were enrolled in the study: a randomised, controlled, 4-week, multicentre trial. Patients were randomly treated with either chlorhexidine 0.5% vaginal gel (CHX-VG), 2.5?g or with metronidazole vaginal tablets 500?mg (M) or clotrimazole (CL) vaginal cream, depending on aetiology of the infection, daily for 7?days (treatment phase) in a 2:1 ratio. A total of 45 women had a diagnosis of BV and 45 a diagnosis of VC. Sixty women were treated with CHX-VG, 15 with M and 15 with CL. All patients were followed for an additional 3?weeks without treatments (follow-up phase). For women with BV, clinical cure rate was defined as the disappearance of the following signs and symptoms: homogenous vaginal discharge; presence of ≥ 2 or more clue cells at the wet mount microscopy; a vaginal pH > 4.7 and a positive whiff test. For women with VC, clinical cure rate was defined as a resolution of signs and symptoms plus absence of hyphae, pseudohyphae and blastospores on 10% KOH wet mount microscopy. Clinical cure rate was assessed at the end of the study (week 4) by an investigator unaware of the patient's treatment allocation.

Results: At week 4, in women with BV, 28 out of 30 (93%) women in the CHX-VG group were clinically cured in comparison with 11 out of 15 (74%) in the M group (?p = 0.3). In women with VC, 26 out of 30 (86.6%) women in the CHX-VG group were clinically cured in comparison with 13 out of 15 (86%) in the CL group (?p = 0.5). Tolerability was good and very good in 90% of the CHX-VG patients. Six women (10%) complained of a mild transient burning sensation after CHX-VG vaginal application. No serious adverse events were observed during the trial in all treated groups. No women presented with vaginal discharge after treatment.

Conclusion: These results demonstrate that in the short term, this CHX-VG is an effective treatment for both bacterial and mycotic vaginal infections. Further clinical trials are warranted to evaluate the efficacy and tolerability profile of this new chlorhexidine vaginal gel on a long-term basis and in reducing recurrency rate of vaginal infections.