Novel Compounds Identified by Structure-Based Prion Disease Drug Discovery Using In Silico Screening Delay the Progression of an Illness in Prion-Infected Mice

The accumulation of abnormal prion protein (PrP^Sc) produced by the structure conversion of PrP (PrP^C) in the brain induces prion disease. Although the conversion process of the protein is still not fully elucidated, it has been known that the intramolecular chemical bridging in the most fragile pocket of PrP, known as the “hot spot,” stabilizes the structure of PrP^C and inhibits the conversion process. Using our original structure-based drug discovery algorithm, we identified the low molecular weight compounds that predicted binding to the hot spot. NPR-130 and NPR-162 strongly bound to recombinant PrP in vitro, and fragment molecular orbital (FMO) analysis indicated that the high affinity of those candidates to the PrP is largely dependent on nonpolar interactions, such as van der Waals interactions. Those NPRs showed not only significant reduction of the PrP^Sc levels but also remarkable decrease of the number of aggresomes in persistently prion-infected cells. Intriguingly, treatment with those candidate compounds significantly prolonged the survival period of prion-infected mice and suppressed prion disease-specific pathological damage, such as vacuole degeneration, PrP^Sc accumulation, microgliosis, and astrogliosis in the brain, suggesting their possible clinical use. Our results indicate that in silico drug discovery using NUDE/DEGIMA may be widely useful to identify candidate compounds that effectively stabilize the protein.Electronic supplementary materialThe online version of this article (10.1007/s13311-020-00903-9) contains supplementary material, which is available to authorized users.     

How effective are lead-rubber aprons in protecting radiosensitive organs from secondary ionizing radiation?

IntroductionThe purpose of this experiment was to explore the direction of scattered secondary ionizing radiation to a patient. A left lateral radiographic examination of the elbow was deemed appropriate due to its close proximity to radiosensitive organs and record dose limiting opportunities upon wearing a lead-rubber apron.MethodsAn anthropomorphic phantom and lead-rubber apron (Pb 0.35 mm) was used with a 15 cc ionization chamber (model 10,100 AT TRIAD) to measure scattered radiation to radiosensitive organs. Dose readings were recorded before and after in order to quantify dose reduction. Pearson's correlation, linear regression, t-test and one way analysis of variance (ANOVA) statistics were used to affirm how likely dose limitation was attributed to chance (p < 0.05).ResultsThe lead-rubber apron offered dose reduction to most radiosensitive organs. Notably, ionizing radiation was significantly reduced to the left breast 0.0083 μGy (98%), right breast 0.0000 μGy (99.9%) and spleen 0.0262 μGy (99.9%). No empirical benefit was recorded for testes and ovaries. Interestingly, the thyroid recorded an increase in dose (0.1733 μGy; p = 0.01). This was later mitigated using a thyroid collar but identifies increased stochastic risks if lead-aprons are worn alone. Scattered radiation was also reduced to both eyes, which were not directly covered.ConclusionLead-rubber aprons are generally utilized to limit ionizing radiation, yet this article offers insight whereby increases to ionizing radiation to the thyroid are plausible when wearing a lead-rubber apron alone. Whilst these findings cannot be generalized to other radiographic examinations it provides insight into a potential increase risk of scatter to a radiosensitive organ.Implications for practiceThis paper has implications because it identifies that lead-rubber has an impact on scattered ionizing radiation to radiosensitive organs for a lateral elbow examination. Further, it identifies the potential for ionizing radiation to be increased to the thyroid upon wearing a lead-rubber apron alone.     

Customized three-dimensionally printed mandibular external fixator

The advent of customized three-dimensional (3D) printing allows the affordable manufacturing of sophisticated medical devices, thereby providing swift and simple solutions to specific needs in modern healthcare. Meanwhile, certain devices such as industrial mandibular external fixators (EFs) have become less and less available from medical device companies because of decreased indications. What is more, their handling is often complex. The authors report, step by step, the original design and uneventful clinical use of a 3D-printed, customized mandibular EF. This device was designed together with a positioning and drilling guide for the fixation of a septic mandibular pseudarthrosis. It provided an adequate and satisfactory balance between lightness and rigidity. A simple, accurate and safe placement of the EF was achieved thanks to the skin-supported positioner and drilling guide, thereby making the procedure minimally invasive and time-efficient. To our knowledge, this is the first reported clinical use of a 3D-printed, customized mandibular EF to date. Because such 3D technology is becoming increasingly available to a large number of surgeons, the authors believe that the present innovation could become an alternative to reusable standard EFs.     

Melatonin prevents cell death and mitochondrial dysfunction via a SIRT1‐dependent mechanism during ischemic‐stroke in mice

Silent information regulator 1 (SIRT1), a type of histone deacetylase, is a highly effective therapeutic target for protection against ischemia reperfusion (IR) injury (IRI). Previous studies showed that melatonin preserves SIRT1 expression in neuronal cells of newborn rats after hypoxia–ischemia. However, the definite role of SIRT1 in the protective effect of melatonin against cerebral IRI in adult has not been explored. In this study, the brain of adult mice was subjected to IRI. Prior to this procedure, the mice were given intraperitoneal with or without the SIRT1 inhibitor, EX527. Melatonin conferred a cerebral‐protective effect, as shown by reduced infarct volume, lowered brain edema, and increased neurological scores. The melatonin‐induced upregulation of SIRT1 was also associated with an increase in the anti‐apoptotic factor, Bcl2, and a reduction in the pro‐apoptotic factor Bax. Moreover, melatonin resulted in a well‐preserved mitochondrial membrane potential, mitochondrial Complex I activity, and mitochondrial cytochrome c level while it reduced cytosolic cytochrome c level. However, the melatonin‐elevated mitochondrial function was reversed by EX527 treatment. In summary, our results demonstrate that melatonin treatment attenuates cerebral IRI by reducing IR‐induced mitochondrial dysfunction through the activation of SIRT1 signaling.     

Corrective Taxes and Cigarette Characteristics

If cigarette design was exogenous, inefficiencies arising from smoking could be addressed either with a tax per packet or with an ad valorem tax. However, it is well known that the consequences of these two instruments differ when product characteristics are endogenous. We consider three such characteristics: nicotine, tar, and flavor. Implementation of the first‐best social optimum typically requires the capacity to tax or regulate harmful ingredients. Without such a capacity, the next‐best policy often combines a per‐unit tax on cigarettes with an ad valorem subsidy. Copyright © 2015 John Wiley & Sons, Ltd.