Hereditary peripheral neuropathies of childhood: an overview for clinicians

This review focuses on the “pure” hereditary peripheral neuropathies where peripheral nerve disease is the main manifestation and does not address neurodegenerative disorders associated with but not dominated by peripheral neuropathy. Aetiologies of childhood-onset peripheral neuropathies differ from those of adult-onset, with more inherited conditions, especially autosomal recessive. Charcot–Marie-Tooth disease is the commonest neuromuscular disorder. The genetic labels of CMT (Charcot–Marie-Tooth) disease types 1–4 are the preferred sub-type terms. Clinical presentations and molecular genetic heterogeneity of hereditary peripheral neuropathies are diverse. For most patients worldwide, diagnostic studies are limited to clinical assessment. Such markers which could be used to identify specific sub-types include presentation in early childhood, scoliosis, marked sensory involvement, respiratory compromise, upper limb involvement, visual or hearing impairment, pyramidal signs and mental retardation. These key markers may assist targeted genetic testing and aid in diagnosing children where DNA testing is not possible.     

IFN-α对人皮肤淋巴瘤细胞系Hut78的影响

目的研究IFN-α对人皮肤T细胞淋巴瘤(CTCL)细胞的增殖抑制和凋亡诱导作用,探讨IFN-α治疗CTCL的机制。方法分别用3000,5000,10000,20000U/mL的IFN-α作用Hut78细胞24,48,72h后,利用MTS法检测Hut78细胞的生存率;并用流式细胞术检测不同浓度IFN-α作用细胞24h后,Hut78细胞的凋亡情况。运用Real-time PCR检测不同时间点IFN-α作用后,BCL11B mRNA的表达情况,Western blot检测不同时间点IFN-α作用后BCL11B蛋白的表达情况,免疫荧光检测IFN-α不同时间点作用后,BCL11B蛋白在Hut78细胞表达程度和分布情况。结果 IFN-α能明显抑制Hut78细胞的增殖,且这种作用呈剂量依赖性和时间依赖性。其抑制效应在48h达到峰值。IFN-α还能显著诱导Hut78细胞的凋亡,其作用亦呈浓度依赖性。10000U/mL IFN-α作用细胞3,6,9,12h后,BCL11B mR-NA表达均显著降低,其中在6h时间点BCL11B的mRNA表达下降到最低点,10000U/mL IFN-α作用细胞6,12,24h后BCL11B的蛋白也明显降低,在12h时间点,BCL11B的蛋白表达量下降至最低。结论 IFN-α通过抑制细胞增殖和促进细胞凋亡对CTCL起到治疗作用,并可通过降低BCL11B的表达,促进细胞凋亡,并提高CTCL细胞对常规化疗的敏感性。     

Mice lacking rhes show altered morphine analgesia, tolerance, and dependence

Nitric oxide (NO) is an important messenger in the central nervous system to mediate male copulatory behavior. EGb 761, a standardized extract of Gingko biloba, has been reported to facilitate male copulation in rats. The present study is to determine the effects of neuronal nitric oxide synthase (nNOS) in the medial preoptic area (MPOA) on copulation in male rats following EGb 761 treatment. Adult male rats were treated with 50mg/kg of EGb 761 or distilled water by oral gavage for 14 consecutive days. The animals were sacrificed approximately 14h after the last behavioral test and MPOA brain tissues were collected for nNOS immunohistochemistry. EGb 761 treatment for 14 days significantly increased the intromission frequency compared to the vehicle-treated controls on day 14. An increase in ejaculation frequency was also seen in the EGb 761-treated group compared to the vehicle-treated controls on day 14 and to the same group on day 0. However, EGb 761 treatment did not influence the number of nNOS-immunoreactive cells in the MPOA. These results suggest that enhanced male copulatory performance in sexually experienced rats administered EGb 761 may not be related to central nNOS activity in the MPOA.     

Investigative drugs for the treatment of cutaneous T-cell lymphomas (CTCL): an update

Introduction: Cutaneous T-cell lymphoma (CTCL) is a heterogeneous group of skin-homing T-cell neoplasms, which represent approximately 75% of all primary cutaneous lymphomas. Mycosis fungoides and Sézary syndrome are the most common CTCL. Early stage disease follows a protracted course, carries a 5-year disease specific survival of 97% and can be treated with skin-directed therapies. Widespread, advanced disease has a 5-year OS of less than 25% and necessitates systemic treatment. Allogeneic stem cell transplantation is a potentially curative treatment option for advanced CTCL, however, transplant-related morbidity and mortality must be considered and a risk-benefit assessment performed on individual basis.

Areas covered: Herein, we provide a review of investigative drugs in early-stage trials for the treatment of cutaneous CTCL, including topically applied immunomodulators such as replicating herpes virus or toll-like receptor 7/8 agonist resiquimod and systemic therapies with monoclonal antibodies, such as anti-CD47, recombinant cytotoxic interleukin 2 fusion protein anti-KIR3DL2 antibody and anti-miR-155 antibody.

Expert Opinion: Among the reviewed drugs, resiquimod shows promising clinical efficacy with good tolerability in early CTCL. In refractory or relapsed disease, intratumoral anti-CD47-, anti-CCR4- and anti-KIR3DL2-antibodies show high response rates, however, latter two also show considerable toxicity. Larger trials are needed to better evaluate the discussed therapies.     

Trivalent and quadrivalent MF59(®)-adjuvanted influenza vaccine in young children: a dose- and schedule-finding study

Young children are at increased risk for influenza infections and related complications. The protection offered to children by conventional trivalent inactivated influenza vaccines (TIV) is suboptimal, due to poor immunogenicity and a higher exposure to infection and complications in this age group, particularly from influenza B strains. In this dose-ranging, factorial design trial, we report the safety and immunogenicity of different combinations of adjuvanted (ATIV) and non-adjuvanted trivalent (TIV) and quadrivalent (QIV) influenza vaccines in 480 healthy children 6 to <36 months of age.The results show that the second B strain added to TIV was immunogenic and did not affect immunogenicity of the other strains. The addition of the MF59^® adjuvant promoted robust immune responses with notable elevations in antibodies observed even after one dose. A dose-response relationship was observed between the antibody response and MF59 adjuvant. No patterns in safety and tolerability emerged with different adjuvant and antigen doses nor with the addition of a second B strain. MF59-adjuvanted QIV offers potential advantages to young children.     

Immunogenicity and protective efficacy in dogs of an MF59™-adjuvanted vaccine against recombinant canine/porcine coronavirus

Recently, canine coronavirus (CCoV) strains with putative recombinant origin with porcine transmissible gastroenteritis virus (TGEV) were shown to be widespread in Europe. In this study, a killed vaccine against TGEV-like CCoV strains, included in the new subtype CCoV-IIb, was developed through inactivation with betapropiolactone and emulsification with MF59™ adjuvant. Safety, immunogenicity and efficacy of the developed vaccine were evaluated in vivo. Five 10-week-old beagle pups were administered (three weeks apart) two vaccine doses, whereas two animals served as unvaccinated controls. The vaccine was shown to be safe as no local neither systemic reactions were observed after first and second dose administration. Serum antibodies against CCoV were detected in vaccinates starting from study day 14 (by enzyme-linked immunosorbent assay) or 28 (by virus neutralisation test). Subsequent challenge with virulent CCoV-IIb resulted in the development of mild gastroenteric disease in control pups, whereas vaccinates did not display clinical signs. Faecal shedding of the challenge virus occurred in both treatment groups, but vaccinated dogs were found to shed very low viral titres in comparison to controls. The developed vaccine may help control the CCoV-IIb-induced disease (and active virus circulation) in environments, such as kennels and shelters, where the pathogenic potential of this virus is greater as a consequence of predisposing factors and concurrent infections.     

Trigonella foenum graecum seed extract protects kidney function and morphology in diabetic rats via its antioxidant activity

Oxidative stress is involved in the development and progression of diabetic nephropathy (DN). Because Trigonella foenum graecum has been reported to have antidiabetic and antioxidative effects, we hypothesized that T foenum graecum seed aqueous extract (TE) restores the kidney function of diabetic rats via its antioxidant activity. Rats were fed diets enriched with sucrose (50%, wt/wt), lard (30%, wt/wt), and cholesterol (2.5%, wt/wt) for 8 weeks to induce insulin resistance. After a DN model was induced by streptozotocin, the rats were administered a low (440 mg/kg), medium (870 mg/kg), or high (1740 mg/kg) dose of TE by oral intragastric intubation for 6 weeks. In TE-treated DN rats, blood glucose, kidney/body weight ratio, serum creatinine, blood urea nitrogen, 24-hour content of urinary protein, and creatinine clearance were significantly decreased compared with nontreated DN rats. Diabetic rats showed decreased activities of superoxide dismutase and catalase, increased concentrations of malondialdehyde in the serum and kidney, and increased levels of 8-hydroxy-2′-deoxyguanosine in urine and renal cortex DNA. Treatment with TE restored the altered parameters in a dose-dependent manner. Furthermore, all of the ultramorphologic abnormalities in the kidney of diabetic rats, including the uneven thickening of the glomerular base membrane, were markedly ameliorated by TE treatment. We conclude that TE confers protection against functional and morphologic injuries in the kidneys of diabetic rats by increasing activities of antioxidants and inhibiting accumulation of oxidized DNA in the kidney, suggesting a potential drug for the prevention and therapy of DN.     

日本药用原辅料MF登记制度对我国的启示

目的:为我国药用原辅料备案管理制度的实施提供参考。方法:研究日本药用原辅料MF登记制度(主文件制度),比较分析我国《药用原辅材料备案管理规定》(征求意见稿)的有关情况并提出建议。结果与结论:日本药用原辅料MF登记制度继承了欧美DMF制度的基本管理方式,但某些具体管理措施的设计更加科学,如登记证明采用MF注册证书、变更分类及批准方式等,而且采取了有效的过渡管理即在5年时间内完成全面推行。我国的药用原辅料备案管理制度在制定过程中可以在考虑本国实际情况(如我国引入的制度基础、实施目的等与日本有所不同)的基础上,充分借鉴其合理的制度设计和有效的过渡管理措施。