Selective 5HT3 antagonists and sensory processing: a systematic review

Ondansetron is a selective serotonin (5HT3) receptor antagonist that is under evaluation as an adjunctive treatment for schizophrenia, and a novel treatment for hallucinations in Parkinson’s disease. Ondansetron reverses sensory gating deficits and improves visuoperceptual processing in animal models of psychosis, but it is unclear to what extent preclinical findings have been replicated in humans. We systematically reviewed human studies that evaluated the effects of ondansetron and other 5HT3 receptor antagonists on sensory gating deficits or sensory processing. Of 11 eligible studies, eight included patients with schizophrenia who were chronically stable on antipsychotic medication; five measured sensory gating using the P50 suppression response to a repeated auditory stimulus; others included tests of visuoperceptual function. Three studies in healthy participants included tests of visuoperceptual and sensorimotor function. A consistent and robust finding (five studies) was that ondansetron and tropisetron (5HT3 antagonist and α7-nicotinic receptor partial agonist) improved sensory gating in patients with schizophrenia. Tropisetron also improved sustained visual attention in non-smoking patients. There was inconsistent evidence of the effects of 5HT3 antagonists on other measures of sensory processing, but interpretation was limited by the small number of studies, methodological heterogeneity and the potential confounding effects of concomitant medication in patients. Despite these limitations, we found strong evidence that selective 5HT3 antagonists (with or without direct α7-nicotinic partial agonist effects) improved sensory gating. Future studies should investigate how this relates to potential improvement in neurocognitive symptoms in antipsychotic naive patients with prodromal or milder symptoms, in order to understand the clinical implications.Subject terms: Perception, Predictive markers     

Improvement in health‐related quality of life after renal sympathetic denervation in real‐world hypertensive patients: 12‐month outcomes in the Global SYMPLICITY Registry

Renal denervation has been shown to reduce blood pressure in patients with uncontrolled hypertension, but less is known about its impact on quality of life. This analysis evaluated 12‐month blood pressure and quality of life outcomes in 934 patients from the Global SYMPLICITY Registry who completed the EuroQoL five‐dimensions three‐level questionnaire (EQ‐5D‐3L). At baseline, 32% of patients reported anxiety/depression and 48% reported pain/discomfort. At 12 months (n=496), office and 24‐hour ambulatory systolic blood pressure were reduced by 13.9±26.6 and 7.7±19.3 mm Hg, respectively, and 8% (P<.001) more patients reported no problems in anxiety/depression. Furthermore, numerically more patients reported no problems in pain/discomfort (4%, P=.08). Perceived health‐related quality of life (visual analog scale) improved from baseline to 12 months (68±18 vs 73±17, P<.001), and the improvement was largest among patients with severe anxiety/depression at baseline (50±24 vs 64±22, P=.005 [n=32]). In this analysis, renal denervation was associated with a significant improvement in health‐related quality of life, particularly anxiety/depression.     

Lymphokines and immunoregulatory molecules in subacute sclerosing panencephalitis

Frozen brain specimens from six patients with subacute sclerosing panencephalitis (SSPE) were analyzed immunohistochemically for the presence of leukocyte subpopulations and specific cytokines. In brain regions demonstrating perivascular cell infiltration and gliosis, CD4 and CD8 positive cells were identified within the brain parenchyma. Cytokine analysis revealed cells staining positively for tumor necrosis factor-alpha and interferon-gamma. These results were similar to those observed in multiple sclerosis (MS) and progressive rubella panencephalitis tissue and were different from other predominantly noninflammatory neurologic diseases and normal controls. Although SSPE and MS differ significantly in their etiology and histopathology, the similarities in leukocyte and cytokine staining patterns suggest a common mechanism of disease progression.     

Eine eigenartige,lokalisierte Hautveränderung,hervorgerufen durch intraperitoneale Einspritzung eines Polypeptides

Ohne ZusammenfassungMit 4 Textabbildungen.     

Einzelreferate und Buchbesprechungen

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Einzelreferate und Buchbesprechungen

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