Efficacy and safety of ezetimibe coadministered with pravastatin in patients with primary hypercholesterolemia: a prospective, randomized, double-blind trial.

AIMS: To evaluate the efficacy and safety of ezetimibe 10 mg administered with pravastatin in patients with primary hypercholesterolemia. METHODS AND RESULTS: After dietary stabilization, 2-12 week screening/washout period, and 4-week, single-blind, placebo lead-in period, 538 patients with baseline LDL-C > or =3.8 to < or =6.5 mmol/l and TG < or =4.0 mmol/l were randomized to one of eight possible treatments administered daily for 12 weeks: ezetimibe 10mg; pravastatin 10, 20, or 40 mg; ezetimibe 10 mg plus pravastatin 10, 20, or 40 mg; or placebo. The primary efficacy endpoint was percent reduction in LDL-C from baseline to study endpoint for ezetimibe 10 mg plus pravastatin (pooled doses) compared to pravastatin alone (pooled doses) and ezetimibe alone. The combined use of ezetimibe and pravastatin resulted in significant incremental reductions in LDL-C and TG compared to pooled pravastatin alone (p<0.01). Coadministration therapy reduced LDL-C by 34-41%, TG by 21-23%, and increased HDL-C by 7.8-8.4%, depending on the dose of pravastatin. The combined regimen was well tolerated, with a safety profile similar to pravastatin alone and placebo. CONCLUSIONS: When coadministered with pravastatin, ezetimibe provided significant incremental reductions in LDL-C and TG and was well tolerated with a safety profile similar to pravastatin alone.     

Development of immunofiltration assay by light addressable potentiometric sensor with genetically biotinylated recombinant antibody for rapid identification of Venezuelan equine encephalitis virus

A genetically biotinylated single chain fragment variable antibody (scFv) against Venezuelan equine encephalitis virus (VEE) was applied in a system consisting of an immunofiltration enzyme assay (IFA) with a light addressable potentiometric sensor (LAPS) for the rapid identification of VEE. The IFA involved formation of an immunocomplex sandwich consisting of VEE, biotinylated antibody, fluoresceinated antibody and streptavidin, capture of the sandwich by filtration on biotinylated membrane, and labeling of the sandwich by anti-fluorescein urease conjugate. The concentration ratio of biotinylated to fluoresceinated antibodies was investigated and optimized. By the IFA/LAPS assay, the limit of detection (LOD) of VEE was approximately 30 ng/ml, similar to that achieved when chemically biotinylated monoclonal antibody (mAb) was applied. Total assay variance of the IFA/LAPS assay for both intra- and inter-assay precision was less than 20%. Assay accuracy was measured by comparing VEE concentrations estimated by IFA/LAPS standard curve to those obtained by conventional protein assay. VEE concentrations were found to differ by no more than 10%. The IFA/LAPS assay sensitivity was approximately equal to that of a conventional enzyme-linked immunosorbent assay (ELISA) utilizing polystyrene plates and a chromogenic substrate; however, less time and effort were required for performance of the IFA/LAPS assay. More importantly, use of genetically biotinylated scFv in the IFA/LAPS assay obviates the need for chemical biotinylation of antibody with resultant possible impairment of the antigen-binding site. Furthermore, the potential for batch-to-batch variability resulting from inequality in the number of biotin molecules labeled per antibody molecule is eliminated.     

Association of HLA antigens with differential responsiveness toMycobacterium w vaccine in multibacillary leprosy patients

Leprosy patients undergoing phase II trials in two hospitals of New Delhi, India, were HLA typed to see the association of HLA with differential responsiveness toMycobacterium w vaccine. The vaccine comprises an atypical, nonpathogenic mycobacterium,Mycobacterium w, which has cross-reactive antigens withM. leprae. Multibacillary patients who are lepromin negative are vaccinated at an interval of 3 months. Considerable improvement is evident in the patients in terms of a decline in bacterial indices and histopathological and immunological upgrading. But all the patients do not respond to the vaccine in the same manner; some are slow responders, while others are good responders. HLA-A28 and DQw3 (DQw8+9) were found to be associated with slow responsiveness, while DQw1 and DQw7 were found to be associated with a more rapid responsiveness to theM. w vaccine. However, these associations were not significant afterP correction for the number of antigens tested for each locus except for HLA-DQw3 (DQw8 and DQw9) and DQw7. DQw7, a new defined split of HLA-DQw3, seems to be associated with the responsiveness toM. w vaccine.     

Diagnosis of aortic occlusive diseases using impedance plethysmography

Impedance plethysmographic observations have been correlated with aortographic observations in 57 patients suspected of aortic occlusive diseases. Aortic occlusions have been characterised by marked decrease in blood flow index and significant increase in differential pulse arrival time at thigh level bilaterally. Atherosclerotic affection of the aorta has been featured by a bilateral decrease in the value of blood flow index as well as differential pulse arrival time at thigh level. Leriche's syndrome, however, has been found to decrease the blood flow index moderately at thigh in both the legs without any significant change in differential pulse arrival time. Aortography in all the patients has confirmed the diagnosis made by impedance plethysmography.     

Interaction of human plasma fibronectin with cariogenic and non-cariogenic oral streptococci

The interaction of purified human plasma fibronectin (Fn) with bacteria was studied with a variety of oral streptococci. Each of the strains of Streptococcus mutans, Streptococcus salivarius, Streptococcus sanguis, and Streptococcus mitis tested was aggregated by Fn to various degrees, depending on the concentration of Fn added to the test mixtures. Binding assays performed with radiolabeled Fn and various strains of streptococci demonstrated various capabilities to bind Fn, and the amount of Fn bound by each strain was paralleled by its Fn-induced aggregation, with S. mutans 6715 giving the highest values in both assays. Because of the avid binding of Fn by certain strains of potentially cariogenic streptococci, we investigated the possibility that Fn may be present in human saliva and may be adsorbed from saliva onto artificial tooth pellicles. Immunoreactive Fn was detected in paraffin-stimulated whole saliva by enzyme-linked immunosorbent assays of saliva adsorbed onto gelatin-coated cuvettes and by immunoelectroblots (Western blots) of salivary components separated on sodium dodecyl sulfate-polyacrylamide slab gels. Furthermore, immunoreactive Fn was found to be present in artificial tooth pellicles formed by incubating hydroxyapatite beads with whole human saliva. These results demonstrate that certain strains of oral streptococci bind to and are aggregated by Fn. The presence of Fn in artificial tooth pellicles suggests that this macromolecule may play a role in the attachment of potentially cariogenic and other oral streptococci to dental tissues.     

Production of interleukin-1 and tumor necrosis factor by bone marrow-derived macrophages: effect of cisplatin and lipopolysaccharide

Mature macrophages derived in vitro from bone marrow progenitors under the influence of either L929 CM (a source of M-CSF) or GM-CSF have been shown to differ morphologically and functionally. Treatment of these bone marrow-derived macrophages with cisplatin or LPS resulted in the expression of enhanced tumoricidal activity and the production of significant amounts of extracellular and membrane-associated IL-1 and TNF. rGM-CSF-derived bone marrow macrophages produced higher amounts of TNF and IL-1 activity than L929CM-derived macrophages. Untreated bone marrow-derived macrophages showed little IL-1 and TNF activity. Bone marrow macrophages cultured with medium alone also did not respond to cisplatin or LPS for the production of IL-1 and TNF. Neutralization studies with anti-IL-1 and anti-TNF antibodies inhibited the IL-1 and TNF activity of bone marrow-derived macrophages. These results suggest that cisplatin or LPS treatment of murine bone marrow-derived macrophages results in increased expression of both released and membrane-associated IL-1 and TNF.     

Ascorbic acid metabolism in rats and guinea pigs after the administration of ethanol

Ascorbic acid metabolism was studied in guinea pigs and rats after the administration of ethanol and a high dose of ascorbic acid (AA). Male guinea pigs were maintained for 30 days as follows: (1) controls (1 mg AA/100 g body wt.); (2) ethanol (1 mg AA/100 g body wt. + 900 mg ethanol/100 g body wt); (3) ascorbic acid (25 mg AA/100 g body wt.); (4) ascorbic acid + ethanol (25 mg AA/100 g body wt. + 900 mg ethanol/100 g body wt.). Rats were also grouped into four groups as in the case of guinea pigs, but the dose of AA was 200 mg/100 g body weight. Rats adjusted to ethanol intoxication by enhancing the biosynthesis of ascorbate as evidenced by elevated activity of L-gulono lactone oxidase (GLO). Hence ascorbate levels were not lowered in rats after administration of alcohol. However, alcohol administration lowered tissue levels of ascorbate in guinea pigs. But the supplementation of ascorbate along with alcohol raised the tissue level of this vitamin. Guinea pigs responded to the ascorbate deficiency during alcohol administration by lowering the degradation of ascorbate, as seen by the lower activity of the degrading enzyme gulono lactone hydrolase. It is concluded that on the administration of alcohol, guinea pigs are dependent upon additional exogenous supplies of ascorbic acid, whereas rats are not.     

cis-Acting packaging motifs of porcine adenovirus type 3

The cis-acting packaging domain is required for selective encapsidation of adenovirus DNA into preformed empty capsids late in the viral life cycle. Earlier, it was demonstrated that the cis-acting packaging domain of porcine adenovirus type (PAdV)-3 is located between nucleotide position (nt) 212 and 531 at the left end genome which contains six AT/GC rich motifs. Removal of packaging domain from left end to the right end of the genome produced a viable mutant virus suggesting that the identified cis-acting packaging domain represents the DNA sequences required for selective packaging of PAdV-3 DNA, whose position and orientation appear to be flexible. Here, by constructing and analyzing a panel of virus mutants carrying deletions or linker scanning mutations in AT/GC rich sequences, we examined the significance of the continuous A/T or G/C sequences individually in the viral packaging process. In contrast to consensus bipartite structure (5'-TTTGN8CG-3') described for most of packaging motifs of human adenovirus type 5 (HAdV-5), the packaging motifs I, II, III, and IV of PAdV-3 displayed a tripartite structure in which the continuous A/T nucleotides were flanked by G/C-rich sequences. Mutations in both continuous A/T nucleotides and its flanking GC-rich sequences reduced the packaging efficiency of mutants to varying degrees. In addition, although the continuous A/T sequences were present in all of the packaging motifs, their significance in the packaging process appears to vary within each packaging motif.