Nanotechnology-based drug delivery systems for the treatment of Alzheimer's disease

Alzheimer's disease is a neurological disorder that results in cognitive and behavioral impairment. Conventional treatment strategies, such as acetylcholinesterase inhibitor drugs, often fail due to their poor solubility, lower bioavailability, and ineffective ability to cross the blood-brain barrier. Nanotechnological treatment methods, which involve the design, characterization, production, and application of nanoscale drug delivery systems, have been employed to optimize therapeutics. These nanotechnologies include polymeric nanoparticles, solid lipid nanoparticles, nanostructured lipid carriers, microemulsion, nanoemulsion, and liquid crystals. Each of these are promising tools for the delivery of therapeutic devices to the brain via various routes of administration, particularly the intranasal route. The objective of this study is to present a systematic review of nanotechnology-based drug delivery systems for the treatment of Alzheimer's disease.

Incorporação de nanoemulsões de óleos essenciais de melaleuca, copaíba e limão em filmes de alginato de sódio para utilização como curativo

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Efeitos da luz visível associada à ftalocianina de cloro-alumínio na inativação da Borrelia anserina

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Efeitos da luz visível associada à ftalocianina de cloro-alumínio na inativação da Borrelia anserina

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Periocular basal cell carcinoma: cost of topical immunotherapy versus estimated cost of surgical treatment

Purpose: The objective of this study was to compare the estimated cost of clinical and surgical treatment for basl cell carcinoma of the eyelid. Methods: This was a pilot study of 12 patients with basal cell carcinoma receiving treatment with 5% imiquimod cream at the ocular plastic surgery center, medical school University of Sao Paulo (HC-FMUSP, Brazil). The cost of clinical treatment was estimated based on the time of treatment and amount of medication consumed by patients in the home setting. The cost of surgical treatment was estimated by ophthalmologists with experience in reconstructive plastic surgery based on analysis of images of the same patients. Surgeons responded to a questionnaire with four questions about surgical technique, surgical materials required, estimated duration of surgery and type of anesthesia. Results: Immunotherapy lasted from 8 to 12 weeks. All patients reported each cold-stored sachet with 5% imiquimod cream lasted 3 days. According to the institution, a box with 12 sachets costs BRL 480.00. Patients required 1.58-3.11 boxes for complete treatment, corresponding to a total cost of BRL 758.40-1,492.80. Based on image analysis, surgeons evaluated surgery would require 1-3 hours. The estimated cost of surgery room and staff was BRL 263.00, to which the cost of supplies was added. Thus, the total cost of surgical treatment was BRL 272.61-864.82. On the average, immunotherapy was 57,64% more costly than surgical treatment. Conclusions: Malignant eyelid tumors are a common finding in clinical ophthalmology. Surgery is still the treatment of choice at our institution, but immunotherapy with 5% imiquimod cream may be indicated for patients with multiple lesions or high surgical risk and for patients declining surgery for reasons of fear or esthetic concerns. The ability to estimate costs related to the treatment of malignant eyelid tumors is an important aid in the financial planning of health care institutions. Further studies should evaluate the possibility of institutions equating the cost of immunotherapy and surgical treatment by acquiring similar but less expensive medications.

Babassu Nanoemulsions Have Physical and Chemical Stability

Babassu is considered one of the greatest native resources in the world and its oil is used in body and hair formulations. The aim of this study was to evaluate the short-term stability in oil-in-water (O/W) nanoemulsions containing babassu oil prepared by emulsification phase inversion submitted to the centrifugation, thermal stress, and heating/cooling cycle tests. The formulations showed no change compared to the droplet size, polydispersity index, pH, and electrical conductivity values after thermal stress and heating/cooling cycle tests. Based on these results, the nanoemulsions obtained can be considered as promising disperse systems for pharmaceutical and cosmetic applications.

Lipid Transfer to HDL is Higher in Marathon Runners than in Sedentary Subjects, but is Acutely Inhibited During the Run

Although exercise increases HDL-cholesterol, exercise-induced changes in HDL metabolism have been little explored. Lipid transfer to HDL is essential for HDL's role in reverse cholesterol transport. We investigated the effects of acute exhaustive exercise on lipid transfer to HDL. We compared plasma lipid, apolipoprotein and cytokine levels and in vitro transfer of four lipids from a radioactively labeled lipid donor nanoemulsion to HDL in sedentary individuals (n = 28) and in marathon runners (n = 14) at baseline, immediately after and 72 h after a marathon. While HDL-cholesterol concentrations and apo A1 levels were higher in marathon runners, LDL-cholesterol, apo B and triacylglycerol levels were similar in both groups. Transfers of non-esterified cholesterol [6.8 (5.7-7.2) vs. 5.2 (4.5-6), p = 0.001], phospholipids [21.7 (20.4-22.2) vs. 8.2 (7.7-8.9), p = 0.0001] and triacylglycerol [3.7 (3.1-4) vs. 1.3 (0.8-1.7), p = 0.0001] were higher in marathon runners, but esterified-cholesterol transfer was similar. Immediately after the marathon, LDL- and HDL-cholesterol concentrations and apo A1 levels were unchanged, but apo B and triacylglycerol levels increased. Lipid transfer of non-esterified cholesterol [6.8 (5.7-7.2) vs. 5.8 (4.9-6.6), p = 0.0001], phospholipids [21.7 (20.4-22.2) vs. 19.1 (18.6-19.3), p = 0.0001], esterified-cholesterol [3.2 (2.2-3.8) vs. 2.3 (2-2.9), p = 0.02] and triacylglycerol [3.7 (3.1-4) vs. 2.6 (2.1-2.8), p = 0.0001] to HDL were all reduced immediately after the marathon but returned to baseline 72 h later. Running a marathon increased IL-6 and TNF-alpha levels, but after 72 h these values returned to baseline. Lipid transfer, except esterified-cholesterol transfer, was higher in marathon runners than in sedentary individuals, but the marathon itself acutely inhibited lipid transfer. In light of these novel observations, further study is required to clarify how these metabolic changes can influence HDL composition and anti-atherogenic function.

Lipid transfers to HDL are predictors of precocious clinical coronary heart disease

Background: High-density-lipoprotein (HDL) has several antiatherogenic properties and, although the concentration of HDL-cholesterol negatively correlates with incidence of coronary artery disease (CAD), this is not sufficient to evaluate the overall HDL protective role. The aim was to investigate whether precocious CAD patients show abnormalities in lipid transfers to HDL, a fundamental step in HDL metabolism and function. Methods: Thirty normocholesterolemic CAD patients aged <50 y and 30 controls paired for sex, age and B.M.I. were studied. Fasting blood samples were collected for the in vitro lipid transfer assay and plasma lipid determination. A donor nanoemulsion labeled with radioactive free-cholesterol. cholesteryl esters, phospholipids and triglycerides was incubated with whole plasma and after chemical precipitation of non-HDL fractions, supernatant was counted for radioactivity in HDL. Results: LDL and HDL-cholesterol and triglycerides were equal in both groups. Transfers of free-cholesterol (3.8 +/- 1.2%vs 7.0 +/- 33%,p<0.0001) and triglycerides (3.7 +/- 1.7%vs 4.9 +/- 1.9%, p = 0.0125) were diminished in CAD patients whereas cholesteryl ester transfer increased (6.5 +/- 1.9%vs 4.8 +/- 1.8%, p = 0.0008); phospholipid transfer was equal (17.8 +/- 3.5% vs19.5 +/- 3.9%). Conclusion: Alterations in the transfer of lipids to HDL may constitute a new marker for precocious CAD and relation of this metabolic alteration with HDL antiatherogenic function should be investigated in future studies. (C) 2011 Published by Elsevier B.V.

Removal from the plasma of the free and esterified forms of cholesterol and transfer of lipids to HDL in type 2 diabetes mellitus patients

Background: The aim was to investigate new markers for type 2 diabetes (T2DM) dyslipidemia related with LDL and HDL metabolism. Removal from plasma of free and esterified cholesterol transported in LDL and the transfer of lipids to HDL are important aspects of the lipoprotein intravascular metabolism. The plasma kinetics (fractional clearance rate, FCR) and transfers of lipids to HDL were explored in T2DM patients and controls, using as tool a nanoemulsion that mimics LDL lipid structure (LDE). Results: C-14- cholesteryl ester FCR of the nanoemulsion was greater in T2DM than in controls (0.07 +/- 0.02 vs. 0.05 +/- 0.01 h(-1), p = 0.02) indicating that LDE was removed faster, but FCR H-3- cholesterol was equal in both groups. Esterification rates of LDE free-cholesterol were equal. Cholesteryl ester and triglyceride transfer from LDE to HDL was greater in T2DM (4.2 +/- 0.8 vs. 3.5 +/- 0.7%, p = 0.03 and 6.8 +/- 1.6% vs. 5.0 +/- 1.1, p = 0.03, respectively). Phospholipid and free cholesterol transfers were not different. Conclusions: The kinetics of free and esterified cholesterol tended to be independent in T2DM patients and the lipid transfers to HDL were also disturbed. These novel findings may be related with pathophysiological mechanisms of diabetic macrovascular disease.

Lipoprotein metabolism in patients with type 1 diabetes under intensive insulin treatment

Background Type 1 diabetes (T1DM) is frequently accompanied by dyslipidemia related with insulin-dependent steps of the intravascular lipoprotein metabolism. T1DM dyslipidemia may predispose to precocious cardiovascular disease and the lipid status in T1DM under intensive insulin treatment has not been sufficiently explored. The aim was to investigate the plasma lipids and the metabolism of LDL and HDL in insulin-treated T1DM patients with high glycemic levels. Methods Sixteen male patients with T1DM (26 ± 7 yrs) with glycated hemoglobin >7%, and 15 control subjects (28 ± 6 yrs) were injected with a lipid nanoemulsion (LDE) resembling LDL and labeled with 14C-cholesteryl ester and 3H-free-cholesterol for determination of fractional clearance rates (FCR, in h-1) and cholesterol esterification kinetics. Transfer of labeled lipids from LDE to HDL was assayed in vitro. Results LDL-cholesterol (83 ± 15 vs 100 ± 29 mg/dl, p=0.08) tended to be lower in T1DM than in controls; HDL-cholesterol and triglycerides were equal. LDE marker 14C-cholesteryl ester was removed faster from plasma in T1DM patients than in controls (FCR=0.059 ± 0.022 vs 0.039 ± 0.022h-1, p=0.019), which may account for their lower LDL-cholesterol levels. Cholesterol esterification kinetics and transfer of non-esterified and esterified cholesterol, phospholipids and triglycerides from LDE to HDL were also equal. Conclusion T1DM patients under intensive insulin treatment but with poor glycemic control had lower LDL-cholesterol with higher LDE plasma clearance, indicating that LDL plasma removal was even more efficient than in controls. Furthermore, HDL-cholesterol and triglycerides, cholesterol esterification and transfer of lipids to HDL, an important step in reverse cholesterol transport, were all normal. Coexistence of high glycemia levels with normal intravascular lipid metabolism may be related to differences in exogenous insulin bioavailabity and different insulin mechanisms of action on glucose and lipids. Those findings may have important implications for prevention of macrovascular disease by intensive insulin treatment.

Formation and stability of oil-in-water nanoemulsions containing rice bran oil: in vitro and in vivo assessments

Abstract Background Nanoemulsions have practical application in a multitude of commercial areas, such as the chemical, pharmaceutical and cosmetic industries. Cosmetic industries use rice bran oil in sunscreen formulations, anti ageing products and in treatments for skin diseases. The aim of this study was to create rice bran oil nanoemulsions using low energy emulsification methods and to evaluate their physical stability, irritation potential and moisturising activity on volunteers with normal and diseased skin types. Results The nanoemulsion developed by this phase diagram method was composed of 10% rice bran oil, 10% surfactants sorbitan oleate/PEG-30 castor oil, 0.05% antioxidant and 0.50% preservatives formulated in distilled water. The nanoemulsion was stable over the time course of this study. In vitro assays showed that this formulation has a low irritation potential, and when applied to human skin during in vivo studies, the nanoemulsion improved the skin's moisture and maintained normal skin pH values. Conclusion The results of irritation potential studies and in vivo assessments indicate that this nanoemulsion has potential to be a useful tool to treat skin diseases, such as atopic dermatitis and psoriasis.

Effect of neoadjuvant chemotherapy on low-density lipoprotein (LDL) receptor and LDL receptor-related protein 1 (LRP-1) receptor in locally advanced breast cancer

Low-density lipoprotein (LDL) receptors are overexpressed in most neoplastic cell lines and provide a mechanism for the internalization and concentration of drug-laden nanoemulsions that bind to these receptors. The aim of the present study was to determine whether the administration of standard chemotherapeutic schemes can alter the expression of LDL and LDL receptor-related protein 1 (LRP-1) receptors in breast carcinoma. Fragments of tumoral and normal breast tissue from 16 consecutive volunteer women with breast cancer in stage II or III were obtained from biopsies before the beginning of neoadjuvant chemotherapy and after chemotherapy, from fragments excised during mastectomy. Tissues were analyzed by immunohistochemistry for both receptors. Because complete response to treatment was achieved in 4 patients, only the tumors from 12 were analyzed. Before chemotherapy, there was overexpression of LDL receptor in the tumoral tissue compared to normal breast tissue in 8 of these patients. LRP-1 receptor overexpression was observed in tumors of 4 patients. After chemotherapy, expression of both receptors decreased in the tumors of 6 patients, increased in 4 and was unchanged in 2. Nonetheless, even when chemotherapy reduced receptors expression, the expression was still above normal. The fact that chemotherapy does not impair LDL receptors expression supports the use of drug carrier systems that target neoplastic cells by the LDL receptor endocytic pathway in patients on conventional chemotherapy.

Rocca delle Caminate a Meldola (FC): dal restauro al recupero funzionale

La Rocca delle Caminate nella coscienza e nell’immaginario Ben volentieri mi sono occupato dell’ambizioso progetto di restauro e recupero funzionale della Rocca delle Caminate, perché se è vero che il complesso ha rivestito un’importanza rilevante sotto il profilo storico e politico di questa parte di Romagna, è pur vero che vive nei miei ricordi fin dall’epoca dell’infanzia, ed è venuto acquistando nel tempo un preciso valore nella mia coscienza e nel mio immaginario. Questa rocca, questa fortificazione, questa torre che si staglia all’orizzonte dominando con austerità le amene vallate, l’ho sempre veduta e ha sempre sollevato in me suggestioni e interrogativi che però non mi ero mai preoccupato di chiarire: ero, per così dire, rimasto fedele alla mia emotività e mi erano bastati i racconti di nonna che andava spesso rammentando di quando, durante il ventennio fascista, insieme alle sorelle percorreva a piedi i sentieri che dalla vicina Dogheria conducevano alle Caminate, in occasione di una tal festa o di una tal funzione religiosa. Le sue parole e i suoi racconti continuano a donarmi un po’ del profumo dell’epoca, e fa specie notare come ancora oggi – in un tempo che fa dello sfavillio delle luci sfoggio di opulenza e miraggio di benessere – vengano puntualmente traditi dall’ammirazione per un faro che all’epoca ruotava emanando luce verde, bianca e rossa: quella del tricolore italiano. La Rocca delle Caminate – dicevo – è sempre stata una veduta familiare e fin troppo consuetudinaria, nei cui riguardi ero quasi giunto a una sorta d’indolenza intellettuale. Eppure, alla vigilia di decidere l’oggetto di questa tesi, ho volto lo sguardo ancora verso la “torre che domina a meraviglia il circostante paese”, ma in questa circostanza trovandomi cambiato: non più solo emozionato dal racconto nella memoria degli anziani, bensì spinto a una sfida anche per onorare il loro attaccamento verso questa fortificazione. È un popolo, quello che ho trovato, che mi ha stupito alquanto per la capacità di ricordare. Voglio dire ricordo, non trasognata visione; sottolineo fulgida testimonianza, non di rado animata dalla fierezza di chi sente fortemente il radicamento a una terra e rivendica il diritto di poter un giorno rivedere la ‘propria’ Rocca come l’ha veduta un tempo, poterla finalmente visitare e toccare, al di là di ogni colore politico, al di là di ogni vicenda passata, bella o brutta che sia. Poterla, in concreto, vivere. Così, un giorno ho varcato il limite dell’ingresso della Rocca e ho iniziato a camminare lungo il viale che conduce al castello; mi sono immerso nel parco e ho goduto della frescura dei pini, dei frassini e dei cipressi che fanno da contorno alla fortificazione. Certamente, ho avvertito un po’ di soggezione giunto ai piedi dell’arce, e mi è sorto spontaneo pormi alcune domande: quanti fanti e cavalieri saranno giunti a questa sommità in armi? Quanti ne saranno morti travolti nella furia della battaglia? Quanti uomini avranno provveduto alla sicurezza di questi bastioni oggi privati per sempre delle originarie mura difensive? Quanti castellani avranno presieduto alla difesa del castro? Ma più che a ogni altra cosa, il mio pensiero è andato a un protagonista della storia recente, a Benito Mussolini, che fra la fine degli anni venti e l’inizio degli anni trenta aveva eletto questo luogo a dimora estiva. Camminando lungo i corridoi della residenza e visitando le ampie stanze, nel rimbombo dei miei passi è stato pressoché impossibile non pensare a quest’uomo che si riconosceva in un duce e che qui ha passato le sue giornate, qui ha indetto feste, qui ha tenuto incontri politici e ha preso importanti decisioni. Come dimenticare quel mezzobusto, quella testa, quella postura impettita? Come dimenticare quello sguardo sempre un po’ accigliato e quei proclami che coglievano il plauso delle masse prima ancora di essere compiutamente formulati? In questo clima, fra castellani, capitani, cavalieri e duces di ogni epoca, sono entrato in punta di piedi, procedendo ai rilevamenti e ai calcoli per la realizzazione di questo progetto. È vero, non è stato facile muoversi nel silenzio che avvolge questo posto magico senza romperne l’incanto, e se a volte, maldestramente, ho fatto più rumore del solito, me ne rammarico. Sono sicuro che questi illustri signori sapranno scusarmene.

Untersuchung des immunogenen Potentials von Dense Bodies des Humanen Cytomegalovirus (HCMV) als Grundlage für die Entwicklung einer neuartigen HCMV-Vakzine

ZusammenfassungDas Humane Cytomegalovirus (HCMV) ist ein Erreger von erheblicher klinischer Bedeutung. Eine HCMV-Vakzine ist bislang nicht verfügbar. Immunität ist nur durch eine Kombination effizienter humoraler und zellulärer Effektormechanismen zu vermitteln. Inhalt der Arbeit war es zu untersuchen, ob defekte virale Partikel, sog. Dense Bodies (DB) eine derartige Immunantwort gegen HCMV induzieren können. Die Immunisierung mit DB induzierte im Mausmodell die Bildung HCMV-neutralisierender Antikörper, die über ein Jahr hinweg im Serum der Tiere nachweisbar blieben. Die Spiegel an neutralisierenden Antikörpern waren mit Titern vergleichbar, die nach einer durchlaufenen, natürlichen HCMV-Infektion in menschlichen Seren gemessen wurden. Obwohl DB ein Totantigen darstellen und keine de novo-Synthese von viralen Proteinen vermitteln, stimulierten sie zudem eine deutliche HCMV-spezifische, zytotoxische T-Zell-Antwort (CTL-Antwort). Die Analyse der T-Helferzell-Antwort ergab, dass die Applikation von DB eine Th1-artige Immunantwort auslöste, die die Kontrolle einer Virusinfektion unterstützt. DB des HCMV sind folglich geeignet, sowohl humorale als auch zelluläre Immuneffektormechanismen effizient zu induzieren. Sie erwiesen sich als ein wirksames Antigentransportsystem, das als vielversprechende Grundlage für die Entwicklung einer rekombinanten HCMV-Vakzine dienen kann. Um die Immunogenität der DB für die Anwendung am Menschen weiter zu optimieren, müssen sie um zusätzliche Epitope ergänzt werden. Derartige rekombinante DB können nur durch Konstruktion mutanter HCMV-Genome generiert werden. Daher wurden im Rahmen dieser Arbeit zwei Genombereiche des HCMV dahingehend charakterisiert, ob sie zur Insertion von Fremdsequenzen geeignet sind. Der Leserahmen UL32, der für das Phosphoprotein pp150 kodiert, erwies sich als essentiell. Mit der IE4-Region hingegen konnte ein 5 kB langes Genomfragment identifiziert werden, das aus dem Genom deletiert und gegen zusätzliche antigene Determinanten ausgetauscht werden kann. Zusammenfassend eröffnen die vorgestellten Ergebnisse neue Möglichkeiten zur Entwicklung eines wirksamen Impfstoffes gegen HCMV.

Studien zur Immunregulation am Beispiel der Kollagen-Typ-II-induzierten Arthritis

Die Immunisierung von Mäusen bestimmter Stämme (z.B. DBA/1) mit Kollagen-Typ-II (CII) führt zu Gelenkentzündungen, die in ihrem Verlauf der Rheumatoiden Arthritis beim Menschen ähnlich sind. Viele Untersuchungen deuten darauf hin, daß vor allem TH1-Zellen entscheidend an der Entstehung einer CIA beteiligt sind. In diesem Zusammenhang ist IL-12, das an der Induktion der TH1-Zellantwort beteiligt ist, von herausragender Bedeutung. Zur Klärung der Funktion von IL-12 wurde ein IL-12-Antagonist, (IL-12(p40)2), der aus einem Homodimer der IL-12p40-Kette besteht, in vivo eingesetzt. DBA/1-Mäuse, die transgen für die T-Zellrezeptor ß-Kette eines CII-spezifischen, arthritogenen T-Zellklons sind und infolge dessen eine CIA mit 100%-iger Inzidenz, frühem Auftreten und einem schweren chronischen Verlauf entwickeln, wurden mit IL-12(p40)2 behandelt. Die Behandlung von TCR-ßtg-Mäusen mit IL-12(p40)2 verzögerte die Entwicklung einer CIA und führte zu deutlich abgeschwächten Krankheitssymptomen, konnte aber nicht die Induktion einer CIA verhindern. Darüber hinaus produzierten die Milzzellen der IL-12(p40)2-behandelten Gruppe nach einer Stimulation mit CII geringere Menge an IFN-g, verglichen mit Kontrollgruppe. Somit resultiert aus einer in vivo Neutralisation von IL-12 eine supprimierte Entwicklung von CII-spezifischen TH1-Zellen. Diese Ergebnisse lassen darauf schließen, daß endogen gebildetes IL-12 bei der Induktion einer CIA eine wichtige Rolle spielt, indem es die Differenzierung von TH1-Zellen fördert und die Produktion von IFN-g steigert. Hinsichtlich der Funktion von IFN-g bei der CIA gibt es allerdings widersprüchliche Befunde. Zur Klärung der Funktion von IFN-g wurden die TCR-ßtg-Mäuse mit Mäusen gekreuzt, die defizient für die Produktion von IFN-g (IFN-g KO) sind. Es zeigte sich, daß keine der verwendeten F2 (IFN-g KO, TCR-ßtg)-Mäuse nach Immunisierung Symptome einer CIA entwickelten. Somit scheint IFN-g essentiell für die Entstehung einer CIA zu sein. Unerwarteterweise führte aber auch die Behandlung mit IL-12 von F2 (IFN-g KO,TCR-ßtg)-Mäusen in 50% der Tiere zur Entwicklung einer CIA. Da solche Mäuse kein IFN-g bilden können, kann IL-12 auch unabhängig von IFN-g die Induktion einer CIA vermitteln. IL-12 scheint somit eine zweifache Bedeutung bei der Entstehung einer CIA zuzukommen, zum einen als direkter Induktor, wie am Beispiel der F2 (IFN-g KO, TCR-ßtg)-Mäuse nachgewiesen wurde, und zum anderen als starker Promoter der IFN-g-Bildung in normalen Mäusen.