897 resultados para phase I studies
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Objective: This study evaluated the bioavailability of fluoride after topical application of a dual-fluoride varnish commercially available in Brazil, when compared to Duraphat T. Material and methods: The urinary fluoride output was evaluated in seven 5-year-old children after application of the fluoride varnishes, in two different phases. In the first phase (I), children received topical application of the fluoride varnish Duofluorid XII (2.92% fluorine, calcium fluoride + 2.71% fluorine, sodium fluoride, FGM (TM)). After 1-month interval (phase II), the same amount (0.2 mL) of the fluoride varnish Duraphat (2.26% fluorine, sodium fluoride, Colgate T) was applied. Before each application all the volunteers brushed their teeth with placebo dentifrice for 7 days. Urinary collections were carried out 24 h prior up to 48 h after the applications. Fluoride intake from the diet was also estimated. Fluoride concentration in diet samples and urine was analyzed with the fluoride ion-specific electrode and a miniature calomel reference electrode coupled to a potentiometer. Data were tested by ANOVA and Tukey's post hoc test (p < 0.05). Results: There were significant differences in the urinary fluoride output between phases I and II. The use of Duofluorid XII did not significantly increase the urinary fluoride output, when compared to baseline levels. The application of Duraphat caused a transitory increase in the urinary fluoride output, returning to baseline levels 48 h after its use. Conclusions: The tested varnish formulation, which has been shown to be effective in in vitro studies, also can be considered safe.
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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The crystallization process of lead titanate (PT) prepared using the polymeric precursor method was investigated using X-ray diffractometry, Raman spectroscopy, electron microscopy, and X-ray absorption spectroscopy techniques. The results showed that amorphous PT was formed by an O-Ti-O structure composed of fivefold and sixfold oxygen-coordinated titanium. The local structure of the amorphous PT phase was similar to that of the cubic PT phase, i.e., similar coordination number and similar bond lengths, leading to a topotactic-like transformation during the phase transformation from amorphous to cubic perovskite PT. Because of the low crystallization temperature, every transformation observed during the crystallization process was associated with a short-range rearrangement process.
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In Brazil, the registration of new drugs is carried out only when the regulatory agency (Anvisa, acronym in Portuguese) is fully satisfied with the evidence of their quality, efficacy and safety, presented by a pharmaceutical industry that strive for this registration. With the patent expiration, pharmaceutical companies are attracted to produce biological medicines called biosimilar or biogenerics or simply generics, whose approval may result in reduced treatment costs. But it is necessary that the biosimilar be, at least, equally efective and safe and without contaminants in relation to the original. Recent consensus guidelines aim to establish criteria for efcacy and safety of these medicines. Preclinical studies in vitro and in vivo, the origin of raw materials and clinical studies phase I, II and III are recommended for biosimilar medicine registration in the international market. Low molecular weight heparins are found in this situation. In this review we specifcally addressed this type of medicine, which could serve as a benchmark for other biosimilar medicines.
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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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O fracasso escolar é uma realidade nacional alarmante que torna indispensável o aprimoramento da tecnologia de ensino. O paradigma de equivalência tem contribuído para a compreensão de processos comportamentais relacionados à aquisição de repertórios lingüísticos e de habilidades cognitivas. As investigações acerca da aprendizagem de leitura por meio deste paradigma tem sido relevantes tanto para a identificação das variáveis de controle de respostas corretas e de respostas incorretas na leitura de palavras com função substantiva, quanto para a análise de quais procedimentos são eficazes no sentido de o responder ficar sob controle de propriedades relevantes dos estímulos impressos. Investigou-se, por meio de uma replicação sistemática, o ensino de leitura com compreensão de frases compostas por pronome demonstrativo, substantivo, adjetivo e verbo intransitivo. Participaram cinco alunos com dificuldades em leitura. Os estímulos foram de modalidade auditiva (sílabas, palavras e frases faladas), representada pela letra A; visual (grafia de sílabas, palavras, frases e figuras que representam palavras e frases), representada pela letra B para as figuras e pela letra C para os estímulos impressos e modalidade auditivo-visual. Foi realizado o treino das discriminações condicionais entre palavras/frases faladas e figuras (relações AB) e sílabas/palavras/frases faladas e estímulos impressos (relações ACs, ACp e ACf). Foram programadas conseqüências diferenciais (reforço social) para os acertos e aplicação de procedimentos de correção ou procedimentos especiais para respostas incorretas. Pretendeu-se investigar se após o ensino destas relações pré-requisitos ocorreriam relações equivalentes (palavras impressas e figuras e vice-versa), bem como se os participantes demonstrariam o desempenho de leitura generalizada. Não foram programadas conseqüências diferenciais durante a aplicação dos testes. Ao término de cada sessão, os participantes recebiam brindes variados. Foram programadas quatro fases experimentais. Na Fase I, os estímulos impressos eram palavras com função substantiva. Na Fase II, frases formadas por palavras com funções substantiva e adjetiva. Na Fase III, acrescentou-se o pronome demonstrativo às frases. Na Fase IV, acrescentaram-se verbos intransitivos às frases. Na Fase V, programou-se a retenção do desempenho aprendido durante o experimento. Todos os participantes, com exceção de um, aprenderam o desempenho de linha de base. Nos testes de equivalência e de leitura generalizada, houve maior variabilidade em relação aos estudos anteriores. Todos os participantes apresentaram a leitura com compreensão em pelo menos uma das fases envolvendo frases. Nas Etapas de leitura Generalizada, apenas uma participante obteve 100% de acertos nos testes da Fase II. Os demais participantes apresentaram leitura generalizada parcial ou ausência de leitura recombinativa, sendo necessária a aplicação de procedimento especial para promover escores mais elevados. Considerou-se o paradigma de equivalência promissor para proporcionar o ensino de leitura de frases com compreensão. Propôs-se mudanças no procedimento que tornem o controle experimental mais rígido. Sugeriu-se ainda a investigação da pertinência do paradigma de equivalência para o ensino de leitura de frases, com compreensão, envolvendo classes gramaticais como artigos, advérbios, verbos transitivos diretos e objetos diretos.
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Seed dispersal effectiveness (SDE) is a conceptual framework that aims at quantifying the contribution of seed dispersal vectors to plant fitness. While it is well recognized that diplochorous dispersal systems, characterized by two successive dispersal steps performed by two different vectors (Phase I=primary seed dispersal and Phase II=secondary seed dispersal) which are common in temperate and tropical regions, little attention has been given to distinguishing the relative contribution of one-phase and two-phase dispersal to overall SDE. This conceptual gap probably results from the lack of a clear methodology to include Phase II dispersal into the calculation of SDE and to quantify its relative contribution. We propose a method to evaluate the relative contribution of one-phase and two-phase dispersal to SDE and determine whether two seed dispersers are better than one. To do so, we used the SDE landscape and an extension of the SDE landscape, the Phase II effect landscape, which measures the direction and magnitude of the Phase II dispersal effect on overall SDE. We used simulated and empirical data from a diplochorous dispersal system in the Peruvian Amazon to illustrate this new approach. Our approach provides the relative contribution of one-phase SDE (SDE1) and two-phase SDE (SDE2) to overall SDE and quantifies how much SDE changes with the addition of Phase II dispersal. Considering that the seed dispersal process is context dependent so that Phase II depends on Phase I, we predict the possible range of variation of SDE according to the variation of the probability of Phase II dispersal. In our specific study system composed of two primate species as primary dispersal vectors and different species of dung beetles as secondary dispersal vectors, the relative contribution of SDE1 and SDE2 to overall SDE varied between plant species. We discuss the context dependency of the Phase II dispersal and the potential applications of our approach. This extension to the conceptual framework of SDE enables quantitative evaluation of the effect of Phase II dispersal on plant fitness and can be easily adapted to other biotic and/or abiotic diplochorous dispersal systems.
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Objective—To investigate the infection of calves with Mycobacterium bovis through oral exposure and transmission of M bovis from experimentally infected white-tailed deer to uninfected cattle through indirect contact. Animals—24 11-month-old, white-tailed deer and 28 6-month-old, crossbred calves. Procedure—In the oral exposure experiment, doses of 4.3 X 106 CFUs (high dose) or 5 X 103 CFUs (low dose) of M bovis were each administered orally to 4 calves; as positive controls, 2 calves received M bovis (1.7 X 105 CFUs) via tonsillar instillation. Calves were euthanatized and examined 133 days after exposure. Deer-to-cattle transmission was assessed in 2 phases (involving 9 uninfected calves and 12 deer each); deer were inoculated with 4 X 105 CFUs (phase I) or 7 X 105 CFUs (phase II) of M Bovis. Calves and deer exchanged pens (phase I; 90 days’ duration) or calves received uneaten feed from deer pens (phase II; 140 days’ duration) daily. At completion, animals were euthanatized and tissues were collected for bacteriologic culture and histologic examination. Results—In the low- and high-dose groups, 3 of 4 calves and 1 of 4 calves developed tuberculosis, respectively. In phases I and II, 9 of 9 calves and 4 of 9 calves developed tuberculosis, respectively. Conclusions and Clinical Relevance—Results indicated that experimentally infected deer can transmit M bovis to cattle through sharing of feed. In areas where tuberculosis is endemic in free-ranging white-tailed deer, management practices to prevent access of wildlife to feed intended for livestock should be implemented.
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Solid-state characterization of crystalline drugs is an important pre-formulation step for the development and design of solid dosage forms, such as pellets and tablets. In this study, phase transition and dehydration processes of nevirapine have been studied by differential scanning calorimetry and thermogravimetry differential thermal analysis to overcome the problems of drug formulation, namely poor solubility and poor content uniformity. Phase solubility studies elucidated the mechanism of enhanced nevirapine solubility.
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Abstract Background: Cardiovascular diseases are the major cause of death in the world. Current treatments have not been able to reverse this scenario, creating the need for the development of new therapies. Cell therapies have emerged as an alternative for cardiac diseases of distinct causes in experimental animal studies and more recently in clinical trials. Method/Design: We have designed clinical trials to test for the efficacy of autologous bone marrow derived mononuclear cell therapies in four different cardiopathies: acute and chronic ischemic heart disease, and Chagasic and dilated cardiomyopathy. All trials are multicenter, randomized, double-blind and placebo controlled. In each trial 300 patients will be enrolled and receive optimized therapy for their specific condition. Additionally, half of the patients will receive the autologous bone marrow cells while the other half will receive placebo (saline with 5% autologous serum). For each trial there are specific inclusion and exclusion criteria and the method for cell delivery is intramyocardial for the chronic ischemic heart disease and intracoronary for all others. Primary endpoint for all studies will be the difference in ejection fraction (determined by Simpson's rule) six and twelve months after intervention in relation to the basal ejection fraction. The main hypothesis of this study is that the patients who receive the autologous bone-marrow stem cell implant will have after a 6 month follow-up a mean increase of 5% in absolute left ventricular ejection fraction in comparison with the control group. Discussion: Many phase I clinical trials using cell therapy for cardiac diseases have already been performed. The few randomized studies have yielded conflicting results, rendering necessary larger well controlled trials to test for efficacy of cell therapies in cardiopathies. The trials registration numbers at the NIH registry are the following: Chagasic cardiomyopathy (NCT00349271), dilated cardiomyopathy (NCT00333827), acute myocardial infarction (NCT00350766) and Chronic Ischemic Heart Disease (NCT00362388).
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The effector function of natural killer (NK) cells is regulated by activating and inhibitory receptors, termed killer immunoglobulin-like receptors (KIRs). In haploidentical T-cell depleted transplantation the donor/recipient KIR mismatch significantly impacts on NK-mediated tumor cell killing, particularly in acute myeloid leukaemia (AML). Thirty-four high risk AML patients entered a phase I-II study of adoptive NK-cell based immunotherapy and were screened for the availability of one haploidentical KIR ligand mismatched donor. Thirteen of them resulted as having one suitable donor. NK cells were enriched from steady-state leukaphereses by using a double-step immunomagnetic separation system, consisting in depletion of CD3+ T cells followed by positive selection of CD56+ NK cells. CD56+ cells were enriched from 7,70% (1,26-11,70) to 93,50% (66,41-99,20) (median recovery 53,05% (30,97-72,85), median T-depletion 3,03 log (2,15-4,52) viability >92%) and their citotoxic activity was inalterate. All patients (4 progressions, 1 partial remission and 8 complete remissions) received NK cell infusion which was preceeded by immunosuppressive chemotherapy (fludarabine and cyclophosphamide) and followed by interleukin 2 injections. The median number of reinfused NK cells was 2,74x10(e)6/kg(1,11-5,00) and contamining CD3+ T cells were always less than 1x10(e)5/kg. The procedure was well-tolerated and no significant toxicity, including GvHD, related to NK cell infusion was observed. The donor NK cells were demonstrated in 5/10 patients. Among the 8 patients in complete remission 5 patients are stable after 18, 15, 4, 2 months of follow-up. Three other patients relapsed after 2 and 7 months. The patient in partial remission obtained a complete remission, which lasted for 6 months. The 4 patients with active/progressive disease showed the persistence of disease. This clinical observation may be correlated with in vitro studies, indicating that AML cells are capable to induce NK cell apoptosis in a dose-depend manner. In summery, a two-step enrichment of CD56+ NK cells allows the collection of a suitable number of target cells to be used as adoptive immunotherapy in AML patients. Infusion of NK cells is feasible and safe and adoptively transferred NK cells can be detected after infusion.
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Zielvorgaben der vorliegenden Arbeit war die Identifikation neuer selektiv in Tumoren aktivierter Gene sowie die Entwicklung eines methodischen Prozesses, um die molekularen Effekte der fehlerhaften Aktivierung solcher Gene zu untersuchen. Für die erste Fragestellung haben wir zwei komplementäre Methoden entwickelt. Zum einen haben wir nach neuen Mitglieder der Cancer/Germline (CG) Familie von Genen gesucht, die bereits attraktive Zielstrukturen laufender Phase I/IIa Studien sind. Zu diesem Zweck wurde ein bioinformatischer Data Mining Ansatz generiert. Dieser führte zur erfolgreichen in silico Klonierung neuer CG Gene. Zur Identifikation von in Tumorzellen überexprimierten Genen nutzten wir einen cDNA Mikroarray mit 1152 ausgewählten Genen mit direkter oder indirekter tumorimmunologischer oder tumorbiologischer Relevanz. Die komparative transkriptionelle Untersuchung von humanen Tumor- und Normalgeweben mit diesem Array führte zur Wiederentdeckung bereits bekannter, aber auch zur Aufdeckung bisher nicht beschriebener tumor-assoziierter Transkriptionsveränderungen. Der zweite große Schwerpunkt dieser Arbeit war die Technologieentwicklung eines versatilen Prozesses zur Untersuchung von molekularen Effekten eines aberrant in Zellen exprimierten Gens. Zur Simulation dieser Situation stellten wir in vitro transkribierte RNA dieses Gens her und elektroporierten diese in Zielzellen. Transkriptionsanalysen solcher Transfektanden mit Affymetrix Oligonukleotid Mikroarray deckten auf gesamt-genomischer Ebene ganze Kaskaden konsekutiver, transkriptioneller Alterationen auf.
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Oncolytic virotherapy exploits the ability of viruses to infect and kill cells. It is suitable as treatment for tumors that are not accessible by surgery and/or respond poorly to the current therapeutic approach. HSV is a promising oncolytic agent. It has a large genome size able to accommodate large transgenes and some attenuated oncolytic HSVs (oHSV) are already in clinical trials phase I and II. The aim of this thesis was the generation of HSV-1 retargeted to tumor-specific receptors and detargeted from HSV natural receptors, HVEM and Nectin-1. The retargeting was achieved by inserting a specific single chain antibody (scFv) for the tumor receptor selected inside the HSV glycoprotein gD. In this research three tumor receptors were considered: epidermal growth factor receptor 2 (HER2) overexpressed in 25-30% of breast and ovarian cancers and gliomas, prostate specific membrane antigen (PSMA) expressed in prostate carcinomas and in neovascolature of solid tumors; and epidermal growth factor receptor variant III (EGFRvIII). In vivo studies on HER2 retargeted viruses R-LM113 and R-LM249 have demonstrated their high safety profile. For R-LM249 the antitumor efficacy has been highlighted by target-specific inhibition of the growth of human tumors in models of HER2-positive breast and ovarian cancer in nude mice. In a murine model of HER2-positive glioma in nude mice, R-LM113 was able to significantly increase the survival time of treated mice compared to control. Up to now, PSMA and EGFRvIII viruses (R-LM593 and R-LM613) are only characterized in vitro, confirming the specific retargeting to selected targets. This strategy has proved to be generally applicable to a broad spectrum of receptors for which a single chain antibody is available.
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In Leukemias, recent developments have demonstrated that the Hedgehog pathway plays a key-role in the peculiar ability of self renewal of leukemia stem cells. The aim of this research activity was to investigate, through a first in man, Phase I, open label, clinical trial, the role and the impact, mainly in terms of safety profile, adverse events and pharmacokinetics, of a Sonic Hedgehog inhibitor compound on a population of heavely pretreated patients affected by AML, CML, MF, or MDS, resistant or refractory to standard chemotherapy. Thirty-five patients have been enrolled. The drug was administered orally, in 28 days cycles, without rest periods. The compound showed a good safety profile. The half life was of 17-35 hours, justifying the daily administration. Significant signs of activity, in terms of reduction of bone marrow blast cell amount were seen in most of the patients enrolled. Interestingly, correlative biological studies demonstrated that, comparing the gene expression profyiling signature of separated CD34+ cells before and after one cycle of treatment, the most variably expressed genes were involved in the Hh pathway. Moreover, we observed that many genes involved in MDR (multidrug resistance)were significantly down regulated after treatment. These data might lead to future clinical trials based on combinatory approaches, including, for instance, Hh inhibitors and conventional chemotherapy.