St John's wort greatly reduces the concentrations of oral oxycodone

Background: Chronic pain is associated with depression. Self‐treatment of depression with herbal over‐the‐counter medicine St John's wort makes pain patients prone to drug interactions. Aims: The aim of this study was to assess the potential of St John's wort to alter the CYP3A‐mediated metabolism of a μ‐opioid receptor agonist, oxycodone. Methods: The study design was placebo‐controlled, randomized, cross‐over with two phases at intervals of 4 weeks and was conducted with 12 healthy participants. St John's wort (Jarsin®) or placebo was administered t.i.d. for 15 days and oral oxycodone hydrochloride 15 mg on day 14. Oxycodone pharmacokinetics and pharmacodynamics were compared after St John's wort or placebo. Behavioural and analgesic effects were assessed with subjective visual analogue scales and cold pressor test. Plasma drug concentrations were measured from 0 to 48 h, behavioural and analgesic effects from 0 to 12 h. Results: Following St John's wort administration the oxycodone AUC decreased 50% (p < 0.001). Oxycodone elimination half‐life shortened from a mean ± SD 3.8 ± 0.7 to 3.0 ± 0.4 h (p < 0.001). The self‐reported drug effect of oxycodone as measured by AUEC_0–12 decreased significantly (p = 0.004). Differences between St John's wort and placebo phases in cold pain threshold and intensity AUEC_0–12 were not observed. Conclusions: St John's wort greatly reduced the plasma concentrations of oral oxycodone. The self‐reported drug effect of oxycodone decreased significantly. This interaction may potentially be of some clinical significance when treating patients with chronic pain.     

Panoramic ultrasonography is a valid method to measure changes in skeletal muscle cross-sectional area

The purpose of this study was to examine the reliability and validity of the “panoramic” brightness mode ultrasonography (US) method to detect training-induced changes in muscle cross-sectional area (CSA) by comparison with results obtained using magnetic resonance imaging (MRI). Out of 27 young male volunteers, 20 subjects were assigned to training group and seven to non-training control group. Muscle CSAs of vastus lateralis were analyzed by MRI and US before and after 21 weeks of either heavy resistance training or control period. Measured by both the US and MRI, the resistance training induced significant increases (~13–14%, P < 0.001) in muscle CSA, whereas no changes were observed in control group. A high repeatability was found between the two consequent US measurements (intraclass correlation coefficient, ICC of 0.997) with standard error of measurement (SEM) of 0.38 cm² and smallest detectable difference of 1.1 cm². Validity of the US method against MRI in assessing CSA of VL produced ICC of 0.905 and SEM of 0.87 cm² with high limits of agreement analyzed by Bland and Altman method. However, the MRI produced systematically (10 ± 4%, P < 0.01) larger CSA values than the US method. The US showed high agreement against MRI in detecting changes in muscle CSA (ICC of 0.929, SEM of 0.94 cm²). The results of this study showed that the panoramic US method provides repeatable measures of a muscle CSA although MRI produced larger absolute CSA values. Moreover, this US method detects training-induced changes in muscle CSA with a comparable degree of precision to MRI.     

Potential mechanism for Calvados-related oesophageal cancer

The old Normandian habit of consumption of hot Calvados is associated with an increased risk of oesophageal cancer compared to other alcoholic beverages. The role of alcohol consumption in the risk of oesophageal cancer is well established. The first metabolite of alcohol, acetaldehyde is a potential local carcinogen in humans. Accordingly, different acetaldehyde concentrations in different beverages could account for some of the variations in cancer risk with regard to the type of alcoholic beverage. Eighteen samples of farm-made Calvados were collected in Normandy. Samples of commercially available beverages were purchased, including factory-made Calvados, other spirits, wines, beer and cider. The samples were analysed gas-chromatically for acetaldehyde and ethanol concentrations. All results are expressed as mean ± SD. The mean acetaldehyde concentration of all Calvados samples (1781 ± 861 μM, n = 25) differed highly significantly (p < 0.001) from that of all wine samples (275 ± 236 μM), from all other spirits samples (1251 ± 1155 μM, p < 0.05), and from all beer and cider samples (233 ± 281 μM, p < 0.001). Farm-made Calvados and farm-made cognac had the highest mean acetaldehyde concentration of the measured beverages. The high concentration of acetaldehyde combined with possible effects of the high temperature at which Calvados is consumed could account for the increased risk of Calvados-related oesophageal cancer.     

Scintigraphy in prediction of the salivary gland function after gland-sparing intensity modulated radiation therapy for head and neck cancer

BACKGROUND AND PURPOSE: To evaluate salivary gland scintigraphy in prediction of salivary flow following radiation therapy. PATIENTS AND METHODS: Twenty patients diagnosed with head and neck cancer were treated with intensity modulated radiation therapy with an intention to spare the salivary gland function. The total quantitative saliva secretion was measured prior to and 6 and 12 months after therapy, and the function of the major salivary glands was monitored using Tc-99m-pertechnetate scintigraphy. Two models were designed for prediction of the post-treatment salivary flow: an average model, based on the average proportions of saliva produced by each of the four major glands in healthy subjects, and an individual model, based on saliva produced by each gland as measured by scintigraphy prior to therapy. These models were compared with volume-based (Lyman) normal tissue complication probability models using two published sets of model parameters. RESULTS: The D(50) for the parotid and the submandibular gland function assessed at 6 and 12 months after radiotherapy was approximately 39Gy. The scintigraphy-based individual model predicted well the measured post-treatment saliva flow rates. The correlation coefficient between the predicted stimulated and the measured saliva flow rate was 0.77 (p<0.0001) at 6 months and 0.55 (p=0.034) at 12 months after completion of radiotherapy. The relative changes in unstimulated and stimulated salivary flow rates showed similar dependency on the cumulative radiation dose. CONCLUSIONS: Salivary gland function assessed by scintigraphy prior to radiotherapy is useful in prediction of the residual salivary flow after radiotherapy.     

Comparison of retinoic acid and phorbol myristate acetate as inducers of monocytic differentiation

Several human myeloid leukemia cell lines growing in vitro can be induced to differentiate to more mature monocyteJ. macrophage-like cells by treatment with protein kinase C-activating phorbol esters, such as PMA. In addition to PMA, cells of the THP-I myeloid leukemia cell line acquire macro-phage-like characteristics after treatment with all-trans retinoic acid (RA). To analyze the signal transduction mechanisms induced by RA, we first compared the effects of PMA and RA on the expression of genes which are known to be regulated during monocytic differentiation. Both RA and PMA effectively down-regulated c-myc expression, while c-myb expression decreased only after PMA treatment. Expression of the β2-integrin genes. CDIIa and CDIIb, was clearly increased after both of these treatments. Their effects on the src-family tyrosine kinase genes were different: hck expression was similarly induced by these agents but lyn expression was stronger and more rapid after RA treatment. RA also enhanced lyn mRNA production rapidly in HL-60, indicating that the activation of lyn gene expression is common in monocytic and granulocytic maturation of myeloid leukemia cells. To examine whether the AP-1 enhancer activity is involved in RA-induced monocytic differentiation, THP-1 cells were transiently transfected with a chloramphenicol acetyi transferase (CAT)-reporter gene containing S copies of the AP-1 binding sites. In contrast to PMA, RA did not induce any CAT activity in these cells, thus suggesting that the RA-induced changes in the expression of those genes described above were not dependent on the AP-1 enhancer activity. © Wiley-Liss, Inc.     

Lactulose reduces intracolonic acetaldehyde concentration and ethanol elimination rate in rats

BACKGROUND: Normal colonic bacteria possessing alcohol dehydrogenase activity can oxidize ethanol to acetaldehyde. Acetaldehyde recently has been shown to be a local carcinogen in humans. The aim of the study was to examine the effect of lactulose feeding on fecal and cecal pH, intracolonic acetaldehyde concentration, and total ethanol elimination rate in rats. METHODS: Sixty Wistar rats were divided into four groups. Groups 2 and 4 received lactulose daily (11 g/kg body weight for 14 days). On days 7 and 14, groups 1 and 2 received ethanol (1.5 g/kg body weight) intraperitoneally, whereas groups 3 and 4 received saline. RESULTS: Fecal and cecal pH values decreased significantly after lactulose treatment compared with the controls. Lactulose feeding reduced the total ethanol elimination rate by 13.8% (257 +/- 0.008 mg/kg/hr vs. 298 +/- 0.003 mg/kg/hr, p < 0.001) and the intracecal acetaldehyde concentration by 66.2% after ethanol (49 +/- 29 microM vs. 145 +/- 47 microM, p = 0.03) compared with the controls. CONCLUSION: Lactulose feeding to rats significantly reduces ethanol elimination rate and intraluminal acetaldehyde concentration in the colon after ethanol administration. This prebiotic thus could be used as an effective agent to block the microbial production of carcinogenic acetaldehyde in the large intestine.     

Interleukin 1 alpha gene polymorphism as a susceptibility factor in Alzheimer's disease and its influence on the extent of histopathological hallmark lesions of Alzheimer's disease

We investigated the association of the interleukin 1alpha (IL1A) (-889) C/T polymorphism with Alzheimer's disease (AD) and with the extent of AD histopathological lesions, the senile/neuritic plaques (SPs/NPs) and neurofibrillary tangles. We evaluated 98 neuropathologically confirmed AD patients and 240 controls as well as 146 clinically diagnosed AD patients and 278 controls but found no association of the IL1A C/T polymorphism with AD even after adjustment for the apolipoprotein E (APOE) genotype, gender or age. The extents of AD histopathological lesions were not influenced by the IL1A genotype except after exclusion of the APOE epsilon4 allele, when a trend towards more SPs/NPs was observed in AD patients with the IL1A C/C compared to patients with the T/T genotype. These results do not confirm previous studies which have indicated that the IL1A C/T polymorphism is a susceptibility factor for AD. However, the IL1A C/C genotype might be associated with the progression of SPs/NPs in AD patients, but the effect is weak and obscured by the APOE epsilon4 allele.