Mania: differential effects of previous depressive and manic episodes on response to treatment

OBJECTIVE: We compared effects of previous depressive or manic episodes on antimanic response. METHOD: In-patients in a parallel-groups, double-blind comparison of lithium, divalproex or placebo for manic episodes had comprehensive evaluations of illness history. We used non-linear curve fitting of change in Manic Syndrome Score (MSS) of the Schedule for Affective Disorders and Schizophrenia (SADS) versus previous depressive or manic episodes to investigate their relationships to MSS improvement. RESULTS: Response to lithium, but not to divalproex or placebo, worsened with increased depressive or manic episodes. More than 11 manic, or four depressive, episodes was associated with response to lithium that did not differ from placebo. Effects of previous depressive and manic episodes appeared independent, and could not be accounted for by increased rapid cycling or mixed states. CONCLUSION: At least four previous depressive or 12 previous manic episodes are associated with reduced antimanic response to lithium.     

Interleukin-6 alters the cellular responsiveness to clopidogrel, irinotecan, and Oseltamivir by suppressing the expression of Carboxylesterases HCE1 and HCE2

Carboxylesterases constitute a class of enzymes that play important roles in the hydrolytic metabolism of drugs and other xenobiotics, patients with liver conditions such as cirrhosis show increased secretion of proinflammatory cytokines [e. g., interleukin-6 （IL- 6）] and decreased capacity of hydrolysis. In this sfudy, we provide a molecular explanation linking cytokine secretion directly to the decreased capacity of hydrolytic biotransformation. In both primary hepatocytes and HepG2 cells, treatment with IL-6 decreased the expression of human carboxylesterases HCE1 and HCE2 by as much as 60%. The decreased expression occurred at both mRNA and protein levels, and it was confirmed .by enzymatic assay. In cotransfection experiments, both HCE1 and HCE2 promoters were significantly repressed, and the repression was comparable with the decrease in HCE1 and HCE2 mRNA, suggesting that transrepression is responsible for the suppressed expression. In addition, pretreatment with IL-6 altered the cellular responsiveness in an opposite manner of overexpression of HCE1 and HCE2 toward various ester therapeutic agents （ e. g., clopidogrel）. Transfection of HCE1, for example, decreased the cytotoxicity induced by antithrombogenic agent clopidogrel, whereas pretreatment with IL-6 increased the cytotoxicity. Such a reversal was observed with other ester drugs, including anticancer agent irinotecan and anti-influenza agent oseltamivir. The altered cellular responsiveness was observed when drugs were assayed at sub-and low-micromolar concentrations, suggesting that suppressed expression of carboxylesterases by IL-6 has profound pharmacological consequences, particularly with those that are hvdrolvzed in an isoform-specific manner.     

A sensitivity analysis framework for the treatment effect measure used in the meta‐analysis of comparative binary data from randomised controlled trials

The process of undertaking a meta‐analysis involves a sequence of decisions, one of which is deciding which measure of treatment effect to use. In particular, for comparative binary data from randomised controlled trials, a wide variety of measures are available such as the odds ratio and the risk difference. It is often of interest to know whether important conclusions would have been substantively different if an alternative measure had been used. Here we develop a new type of sensitivity analysis that incorporates standard measures of treatment effect. Thus, rather than examining the implications of a variety of measures in an ad hoc manner, we can simultaneously examine an entire family of possibilities, including the odds ratio, the arcsine difference and the risk difference. Copyright © 2012 John Wiley & Sons, Ltd.     

Genome‐wide linkage scans for renal function and albuminuria in Type 2 diabetes mellitus: the Diabetes Heart Study

Aims/hypothesis Glomerular filtration rate (GFR), end‐stage renal disease and albuminuria are highly heritable. We performed a genome‐wide linkage scan in 416 Diabetes Heart Study (DHS) families to detect loci that contributed to renal function and albuminuria. Materials and methods A total of 1067 individuals (900 with Type 2 diabetes mellitus) from 348 European American and 68 African American DHS families had measures of urine albumin : creatinine ratio (ACR), serum creatinine concentration and Modification of Diet in Renal Disease estimated GFR (eGFR). Variance components quantitative trait linkage analysis (using SOLAR) was computed. Results Participants had mean ± sd age 61.4 ± 9.4 years; diabetes duration 10.5 ± 7.4 years; eGFR 1.15 ± 0.32 ml/sec; and urine ACR 15.8 ± 67.2 mmol/l (median 1.4). In all families, significant evidence for linkage of GFR was observed on chromosome 2p16 (log of the odds; LOD = 4.31 at 72.0 cM, ATA47C04P/D2S1352) and 1p36 (LOD = 3.81 at 45.0 cM, D1S3669/D1S3720), with suggestive evidence on 7q21 (LOD = 2.42 at 99.0 cM, D7S820/D7S821) and 13q13 (LOD = 2.28 at 28.0 cM, D13S1493/D13S894). The evidence for linkage to ACR was far weaker, on 13q21‐q22 (LOD = 1.84 at 50 cM, D13S1807/D13S800), 3p24‐p23 (LOD = 1.81 at 58 cM, D3S3038/D3S2432) and 10p11 (LOD = 1.78 at 71.0 cM, D10S1208/D10S1221). Conclusions/interpretations The eGFR linkage peaks on 2p16, 7q21 and 13q13 closely overlap with nephropathy peaks identified in family studies enriched for severe kidney disease. These diabetes‐enriched families provide an opportunity to map genes regulating renal function, potentially leading to the identification of genes producing nephropathy susceptibility in subjects with Type 2 diabetes.     

Ovarian cyclicity, hormones, and behavior as markers of aging in female pigtailed macaques (Macaca nemestrina)

Age-related differences in reproductive function were studied to identify variables suitable for a battery of noninvasive tests used to measure aging rate. Twenty-seven adult female pigtailed macaques, ranging in age from 8 to 31 years, were studied in a cross-sectional design. Perineal tumescence, menses, and activity in the home environment were recorded daily. Sexual behavior, when paired with unfamiliar males of three age groups, was observed six times in the early follicular phase of two ovarian cycles. Estradiol, LH, and FSH were measured twice during the same time period. Of the behavioral measures, mount, present, and activity were found to be lower in old than in young females. Of the physiological measures, ovarian cyclicity was less regular, estradiol was lower, and FSH and LH were higher in old compared to young females. Correlations between measures suggested two dimensions of reproductive function, a behavioral dimension and a physiological dimension.     

Carbohydrate biguanides as potential hypoglycemic agents

A series of monosaccharides containing a biguanide functionality was prepared and evaluated for hypoglycemic activity. Among the analogues prepared were those involving D-glucose substituted on the 6- or 1-position (19 and 24), D-galactose substituted on the 6-position (7), and D-arabinose (31). The target compounds were evaluated in a modified rat glucose-tolerance test (oral glucose load/oral drug, 100 mg/kg). Compounds 8 [6-biguanidino-1,2:3,5-bis-O-(1-methylethylidene)-6-deoxy-al pha-D- glucofuranose] and 23 [methyl 6-biguanidino-6-deoxy-2,3,4-O-tribenzyl-alpha-D-glucopyra nos ide] were the most active, exhibiting nearly equivalent hypoglycemic activity to that of phenformin (1) and metformin (2), as measured by the inhibition of the rise of blood glucose. Compound 31 was somewhat less active with 26% inhibition, as compared to 64% inhibition with 1 and 41% inhibition with 2.