A comparative study on the anti-inflammatory effects of single oral doses of naproxen and its hydrogen sulfide (H2S)-releasing derivative ATB-346 in rats with carrageenan-induced synovitis

BACKGROUND: Non-steroidal antiinflammatory drugs (NSAIDs) are the most commonly prescribed agents for arthritic patients, although gastric effects limit their long-term use. Considering the reported gastric safety of hydrogen sulfide (H2S)-releasing NSAIDs, in addition to the anti-inflammatory effects of H2S administration to rats with synovitis, we decided to evaluate the effects of the H2S-releasing naproxen derivative ATB-346 in this animal model. METHODS: Male Wistar rats were anesthetized with inhalatory halothane and pre-treated with equimolar oral doses of either naproxen (0.3, 1, 3 or 10 mg/kg) or ATB-346 (0.48, 1.6, 4.8, or 16 mg/kg) 30 min before the i.art. injection of 7.5 mg of carrageenan (CGN) into the right knee joint cavity. Joint swelling and pain score were assessed after 1, 3 and 5 h, and tactile allodynia after 2 and 4 h. After the last measurement, the joint cavity lavages were performed for counting of the recruited leukocytes. The drugs (at the highest doses) were also tested for their gastric effects by evaluating macroscopical damage score and neutrophil recruitment (measured as myeloperoxidase - MPO activity) in the stomachs 5 h after administration of the drugs. In addition, the serum naproxen pharmacokinetic profiles of both compounds, administered at the highest equimolar doses, were obtained during the first 6 h after dosing. RESULTS: At the two highest tested doses, both naproxen and ATB-346 reduced edema and pain score (measured 3 and 5 h after CGN; P < 0.001). Tactile allodynia was similarly inhibited by ~45% 4 h after CGN by both naproxen (at 1, 3 and 10 mg/kg) and ATB-346 (at 1.6 and 4.8 mg/kg; P < 0.001), as well as leukocyte infiltration. Naproxen (but not ATB-346) induced significant gastric damage and, despite the increased gastric MPO activity by ~130% in the naproxen-, but not in the ATB-346-treated rats, this effect was of no statistical significance. CONCLUSION: The presence of a H2S-releasing moiety in the ATB-346 structure does not impair the antiinflammatory activity of the parent compound in rats with CGN-induced synovitis. In addition, released H2S may account for the absence of deleterious gastric effects, thus making of ATB-346 a potentially useful therapeutic alternative to traditional naproxen for treatment of patients with arthritis.

Bioremediation of PAHs - Limitations and soultions

Introduction 1.1 Occurrence of polycyclic aromatic hydrocarbons (PAH) in the environment Worldwide industrial and agricultural developments have released a large number of natural and synthetic hazardous compounds into the environment due to careless waste disposal, illegal waste dumping and accidental spills. As a result, there are numerous sites in the world that require cleanup of soils and groundwater. Polycyclic aromatic hydrocarbons (PAHs) are one of the major groups of these contaminants (Da Silva et al., 2003). PAHs constitute a diverse class of organic compounds consisting of two or more aromatic rings with various structural configurations (Prabhu and Phale, 2003). Being a derivative of benzene, PAHs are thermodynamically stable. In addition, these chemicals tend to adhere to particle surfaces, such as soils, because of their low water solubility and strong hydrophobicity, and this results in greater persistence under natural conditions. This persistence coupled with their potential carcinogenicity makes PAHs problematic environmental contaminants (Cerniglia, 1992; Sutherland, 1992). PAHs are widely found in high concentrations at many industrial sites, particularly those associated with petroleum, gas production and wood preserving industries (Wilson and Jones, 1993). 1.2 Remediation technologies Conventional techniques used for the remediation of soil polluted with organic contaminants include excavation of the contaminated soil and disposal to a landfill or capping - containment - of the contaminated areas of a site. These methods have some drawbacks. The first method simply moves the contamination elsewhere and may create significant risks in the excavation, handling and transport of hazardous material. Additionally, it is very difficult and increasingly expensive to find new landfill sites for the final disposal of the material. The cap and containment method is only an interim solution since the contamination remains on site, requiring monitoring and maintenance of the isolation barriers long into the future, with all the associated costs and potential liability. A better approach than these traditional methods is to completely destroy the pollutants, if possible, or transform them into harmless substances. Some technologies that have been used are high-temperature incineration and various types of chemical decomposition (for example, base-catalyzed dechlorination, UV oxidation). However, these methods have significant disadvantages, principally their technological complexity, high cost , and the lack of public acceptance. Bioremediation, on the contrast, is a promising option for the complete removal and destruction of contaminants. 1.3 Bioremediation of PAH contaminated soil & groundwater Bioremediation is the use of living organisms, primarily microorganisms, to degrade or detoxify hazardous wastes into harmless substances such as carbon dioxide, water and cell biomass Most PAHs are biodegradable unter natural conditions (Da Silva et al., 2003; Meysami and Baheri, 2003) and bioremediation for cleanup of PAH wastes has been extensively studied at both laboratory and commercial levels- It has been implemented at a number of contaminated sites, including the cleanup of the Exxon Valdez oil spill in Prince William Sound, Alaska in 1989, the Mega Borg spill off the Texas coast in 1990 and the Burgan Oil Field, Kuwait in 1994 (Purwaningsih, 2002). Different strategies for PAH bioremediation, such as in situ , ex situ or on site bioremediation were developed in recent years. In situ bioremediation is a technique that is applied to soil and groundwater at the site without removing the contaminated soil or groundwater, based on the provision of optimum conditions for microbiological contaminant breakdown.. Ex situ bioremediation of PAHs, on the other hand, is a technique applied to soil and groundwater which has been removed from the site via excavation (soil) or pumping (water). Hazardous contaminants are converted in controlled bioreactors into harmless compounds in an efficient manner. 1.4 Bioavailability of PAH in the subsurface Frequently, PAH contamination in the environment is occurs as contaminants that are sorbed onto soilparticles rather than in phase (NAPL, non aqueous phase liquids). It is known that the biodegradation rate of most PAHs sorbed onto soil is far lower than rates measured in solution cultures of microorganisms with pure solid pollutants (Alexander and Scow, 1989; Hamaker, 1972). It is generally believed that only that fraction of PAHs dissolved in the solution can be metabolized by microorganisms in soil. The amount of contaminant that can be readily taken up and degraded by microorganisms is defined as bioavailability (Bosma et al., 1997; Maier, 2000). Two phenomena have been suggested to cause the low bioavailability of PAHs in soil (Danielsson, 2000). The first one is strong adsorption of the contaminants to the soil constituents which then leads to very slow release rates of contaminants to the aqueous phase. Sorption is often well correlated with soil organic matter content (Means, 1980) and significantly reduces biodegradation (Manilal and Alexander, 1991). The second phenomenon is slow mass transfer of pollutants, such as pore diffusion in the soil aggregates or diffusion in the organic matter in the soil. The complex set of these physical, chemical and biological processes is schematically illustrated in Figure 1. As shown in Figure 1, biodegradation processes are taking place in the soil solution while diffusion processes occur in the narrow pores in and between soil aggregates (Danielsson, 2000). Seemingly contradictory studies can be found in the literature that indicate the rate and final extent of metabolism may be either lower or higher for sorbed PAHs by soil than those for pure PAHs (Van Loosdrecht et al., 1990). These contrasting results demonstrate that the bioavailability of organic contaminants sorbed onto soil is far from being well understood. Besides bioavailability, there are several other factors influencing the rate and extent of biodegradation of PAHs in soil including microbial population characteristics, physical and chemical properties of PAHs and environmental factors (temperature, moisture, pH, degree of contamination). Figure 1: Schematic diagram showing possible rate-limiting processes during bioremediation of hydrophobic organic contaminants in a contaminated soil-water system (not to scale) (Danielsson, 2000). 1.5 Increasing the bioavailability of PAH in soil Attempts to improve the biodegradation of PAHs in soil by increasing their bioavailability include the use of surfactants , solvents or solubility enhancers.. However, introduction of synthetic surfactant may result in the addition of one more pollutant. (Wang and Brusseau, 1993).A study conducted by Mulder et al. showed that the introduction of hydropropyl-ß-cyclodextrin (HPCD), a well-known PAH solubility enhancer, significantly increased the solubilization of PAHs although it did not improve the biodegradation rate of PAHs (Mulder et al., 1998), indicating that further research is required in order to develop a feasible and efficient remediation method. Enhancing the extent of PAHs mass transfer from the soil phase to the liquid might prove an efficient and environmentally low-risk alternative way of addressing the problem of slow PAH biodegradation in soil.

Photovernetzbare flüssigkristalline Polymere unterschiedlicher Kettentopologien

„Photovernetzbare flüssigkristalline Polymere unterschiedlicher Kettentopologien“, Patrick Beyer, Mainz 2007 Zusammenfassung In der vorliegenden Arbeit wurde die Synthese und Charakterisierung flüssigkristalliner Elastomere unterschiedlicher Polymertopologien vorgestellt. Dabei wurden Systeme synthetisiert, bei denen die mesogenen Einheiten entweder als Seitengruppen an ein Polymerrückgrat angebunden (Seitenkettenelastomere) oder direkt in die Polymerkette integriert (Hauptkettenelastomere) sind (siehe Abbildung). Bezüglich der Seitenkettensysteme konnten erstmals photovernetzbare smektische Seitenkettenpolymere, in denen aufgrund der Anknüpfung eines photoisomerisierbaren Azobenzols eine Photo- modulation der ferroelektrischen Eigenschaften möglich ist, dargestellt werden. Homöotrop orientierte freistehende Filme dieser Materialien konnten durch Spincoaten dargestellt und unter Ausnutzung des Dichroismus der Azobenzole durch geeignete Wahl der Bestrahlungsgeometrie photovernetzt werden. Aufbauend auf diesen Untersuchungen wurde anhand eines nicht vernetzbaren Modellsystems im Detail der Einfluss der trans-cis Isomerisierung des Azobenzols auf die ferroelektrischen Parameter untersucht. Durch zeitaufgelöste Messungen der Absorption der Azobenzole, der spontanen Polarisation und des Direktorneigungswinkels und Auswertung der kinetischen Prozesse konnte eine lineare Abhängigkeit der ferroelektrischen Eigenschaften vom Grad der Isomerisierungsreaktion festgestellt werden. Durch Vergleich dieser in der flüssigkristallinen Phase erhaltenen Ergebnisse mit der Kinetik der thermischen Reisomerisierung in Lösung (Toluol) konnte ferner eine deutliche Reduzierung der Relaxationszeiten in der anisotropen flüssigkristallinen Umgebung festgestellt und auf eine Absenkung der Aktivierungsenergie zurückgeführt werden. Makroskopische Formänderungen der Seitenkettenelastomere am Phasenübergang von der flüssigkristallinen in die isotrope Phase konnten jedoch nicht festgestellt werden. Aus diesem Grund wurden neue Synthesestrategien für die Darstellung von Hauptkettenelastomeren entwickelt, die sich aufgrund der direkten Kopplung von flüssigkristallinem Ordnungsgrad und Polymerkettenkonformation besser für die Herstellung thermischer Aktuatoren eignen. Auf Basis flüssigkristalliner Polymalonate konnten dabei lateral funktionalisierte smektische Hauptkettenpolymere synthetisiert werden, welche erstmals die Darstellung von LC-Hauptkettenelastomeren durch Photovernetzung in der flüssigkristallinen Phase erlauben. Durch laterale Bromierung konnte in diesen Systemen die Kristallisationstendenz der verwendeten Biphenyleinheiten unterdrückt werden. Bezüglich der Photovernetzung konnten zwei neue Synthesemethoden entwickelt werden, bei denen der Vernetzungsschritt entweder durch radikalische Polymerisation lateral angebundener Acrylatgruppen oder durch photoaktive Benzophenongruppen erfolgte. Basierend auf den Benzophenon funktionalisierten Systemen konnte ein neuartiges Verfahren zur Darstellung makroskopisch orientierter Hauptkettenelastomere durch Photovernetzung entwickelt werden. Die Elastomerproben, deren Ordnungsgrad durch Röntgenuntersuchungen ermittelt werden konnte, zeigen am Phasenübergang von der flüssigkristallinen in die isotrope Phase eine reversible Formänderung von 40%. Im Gegensatz zu anderen bekannten smektischen Systemen konnten die in dieser Arbeit vorgestellten Elastomere ohne Zerstörung der Phase bis zu 60% entlang der smektischen Schichtnormalen gestreckt werden, was im Kontext einer geringen Korrelation der smektischen Schichten in Hauptkettenelastomeren diskutiert wurde.

Biologisch aktive Sekundärmetabolite aus Pflanzen und Pilzen : Phenanthro-Alkaloide ; phytotoxische Dioxolanone

Als Phenanthro-Alkaloide wird eine kleine Gruppe von pentacyclischen, auf dem Phenanthren-Strukturmotiv basierenden Indolizidinen sowie Chinolizidinen bezeichnet. Von Letztgenannten sind bisher fünf, von den homologen Phenanthroindolizidinen mehr als sechzig natürliche Vertreter gefunden worden. Das wohl bekannteste Alkaloid in dieser Gruppe ist das Indolizidin-Alkaloid Tylophorin, das beispielsweise aus Tylophora indica (Apocynaceae, "Hundsgiftgewächse") gewonnen werden kann. Tylophorin und verwandte Derivate besitzen potente biologische und physiologische Wirkungen. So entfalten sie sowohl antiinflammatorische als auch antineoplastische Effekte (wirksam auch bei MDR-Tumorzelllinien, MDR = "multi drug resistant").rnrnDas Ziel der vorliegenden Arbeit war es, neue Methoden zur Herstellung von Phenanthro-Alkaloiden und deren Derivaten zu entwickeln. Ausgehend von (S)-Prolin konnten sowohl (S)-(+)-Tylophorin (>99% ee) als auch ein bisher noch nicht beschriebenes Derivat, das sich durch eine deutlich geringere Lichtempfindlichkeit im Vergleich zu Tylophorin aus¬zeichnet, in 33%-iger Gesamtausbeute über neun lineare Stufen, hergestellt werden. Die Synthese von (R)-(-)-Tylophorin gelang in analoger Weise aus (R)-Prolin in 21%-iger Ausbeute (93% ee). Der Einsatz von Schutzgruppen war nicht notwendig.rnDer Schlüsselschritt ist in beiden Fällen eine Cyclisierung an eine C=N-Doppelbindung über freie Radikale, die bei der Synthese des neuen Derivats hochstereoselektiv zur Bildung des (13aS,14S) Diastereomers führt. Die Synthese von 7-Methoxycryptopleurin gelang durch eine ähnliche Synthesestrategie. rnrnZur Herstellung von Cryptopleurin ist zunächst ein neuer Syntheseweg für 9-(Hydroxymethyl)-2,3,6-trimethoxyphenanthren entwickelt worden. Dieser führt über den Aufbau eines Biphenylsystems durch palladiumkatalysierte Kreuzkupplung, eine anschließende COREY-FUCHS-Transformation und als Schlüsselschritt über eine Gold-NHC-Komplex katalysierte 6-endo-dig-Cyclisierung zum entsprechenden Phenanthren. Diese Ringschlussreaktion verläuft in gewünschter Weise regioselektiv unter Bildung des 2,3,6-trimethoxysubstituierten Phenanthrens. Die Bil¬dung des regioisomeren 2,3,8-Trimethoxyphenanthrens wird nicht beobachtet. Der Alkohol wird dann in fünf linearen Stufen (34%) in das Xanthogenat überführt, aus dem sich durch eine zweistufige Reaktionssequenz, bestehend aus einer Radikal¬cyclisierung nach ZARD und einer Reduktion mit LiAlH4 das extrem lichtempfindliche und hochtoxische Alkaloid (R)-(-)-Cryptopleurin gewinnen ließ (50%).rnNachdem beide Enantiomere und das Racemat von Tylophorin synthetisiert worden waren und zum Vergleich bereit standen, wurde Tylophorin aus Tylophora indica extrahiert. rnDie Motivation rührte unter anderem daher, dass in der bisherigen Literatur Unstimmigkeiten über das in der Natur vorkommende Enantiomer des Tylophorins herrschten. Vor Beginn dieser Arbeit ging man davon aus, dass in T. indica nur (R)-(-)-Tylophorin vorkommt und für die Diskrepanzen zwischen den berichteten Drehwerten von, aus Pflanzenmaterial isolierten und des synthetisierten Naturstoffs, dessen Zersetzung vor oder während der Messung verantwortlich ist. Dieser Effekt kann zwar auch beobachtet werden, jedoch trägt er nur in geringem Maße zur Erniederigung des Drehwertes bei. Schließlich sind Proben von synthetisiertem Tylophorin in gleichem Maße von der schnell eintretenden Oxidation des Alkaloids betroffen. Aus dem Rohextrakt ist Tylophorin durch RP-HPLC isoliert worden. Anschließend wurde die Probe mittels chiraler HPLC/MS analysiert. Durch den Vergleich mit den bereit stehenden synthetischen Proben von (R)- und (S)-Tylophorin konnte in dieser Arbeit erstmals experimentell belegt werden, dass es sich bei (−)-Tylophorin aus T. indica um ein scalemisches Gemisch im Verhältnis von 56:44 (R:S) handelt.rnrnDas Ziel dieses Teilprojektes war die Entwicklung einer Synthese für den bisher noch nicht synthetisch hergestellten phytotoxischen Sekundärmetabolit (+)-Phenguignardiasäure. Isoliert wurde diese Verbindung aus Guignardia bidwellii, dem Erreger der Schwarzfäule der Weinrebe. Die absolute Konfiguration des quartären Stereozentrums war zu Beginn dieser Arbeit nicht bekannt. Ausgehend von (R)-Phenylmilchsäure und 3-Phenylprop-2-in-1-ol gelang die Synthese beider Enantiomere des Dioxolanons in acht linearen Stufen. Sie liefert den experimentellen Beweis (ECD, Polarimetrie) für die (S)-Konfiguration von natürlicher (+)-Phenguignardiasäure.rnrn

Alternative derivative expansion in Functional RG and application

We give a brief review of the Functional Renormalization method in quantum field theory, which is intrinsically non perturbative, in terms of both the Polchinski equation for the Wilsonian action and the Wetterich equation for the generator of the proper verteces. For the latter case we show a simple application for a theory with one real scalar field within the LPA and LPA' approximations. For the first case, instead, we give a covariant "Hamiltonian" version of the Polchinski equation which consists in doing a Legendre transform of the flow for the corresponding effective Lagrangian replacing arbitrary high order derivative of fields with momenta fields. This approach is suitable for studying new truncations in the derivative expansion. We apply this formulation for a theory with one real scalar field and, as a novel result, derive the flow equations for a theory with N real scalar fields with the O(N) internal symmetry. Within this new approach we analyze numerically the scaling solutions for N=1 in d=3 (critical Ising model), at the leading order in the derivative expansion with an infinite number of couplings, encoded in two functions V(phi) and Z(phi), obtaining an estimate for the quantum anomalous dimension with a 10% accuracy (confronting with Monte Carlo results).

NCX-1000, a nitric oxide-releasing derivative of UDCA, does not decrease portal pressure in patients with cirrhosis: results of a randomized, double-blind, dose-escalating study

NCX-1000 (2(acetyloxy) benzoic acid-3(nitrooxymethyl)phenyl ester) is an nitric oxide (NO)-releasing derivative of ursodeoxycholic acid (UDCA), which showed selective vasodilatory effect on intrahepatic circulation in animal models of cirrhosis. This study was aimed at testing the efficacy and tolerability of this compound in patients with cirrhosis and portal hypertension.

Clinical Outcomes Following Treatment of Non-contained Intrabony Defects with Enamel Matrix Derivative (EMD) or Guided Tissue Regeneration (GTR). A 12-month Randomized Controlled Clinical trial

The purpose of this study is to compare the healing of deep, non-contained intrabony defects (i.e., with a ?80% 1-wall component and a residual 2- to 3-wall component in the most apical part) treated with either an enamel matrix derivative (EMD) or guided tissue regeneration (GTR) after 12 months.

Healing of two and three wall intrabony periodontal defects following treatment with an enamel matrix derivative combined with autogenous bone

BACKGROUND: There are still limited data on the outcomes of regenerative periodontal surgery using a combination of an enamel matrix protein derivative (EMD) and autogenous bone (AB). AIM: To evaluate the healing of deep intrabony defects treated with either a combination EMD+AB or EMD alone. MATERIALS AND METHODS: Forty patients with advanced chronic periodontitis, with one deep intrabony defect, were randomly treated with either EMD+AB (test) or EMD (control). Clinical assessments were performed at baseline and at 1 year after treatment. The primary outcome variable was relative attachment level (RAL). RESULTS: Healing was uneventful in all patients. The test sites showed a reduction in the mean probing pocket depth (PPD) of 5.6 +/- 0.9 mm (p<0.001), a gain in the mean RAL of 4.2 +/- 1.1 mm (p<0.001) and a gain in the mean probing bone level (PBL) of 3.9 +/- 1.0 mm (p<0.001). The control group displayed a mean PPD reduction of 4.6 +/- 0.4 mm (p<0.001), a mean RAL gain of 3.4 +/- 0.8 mm (p<0.001) and a mean PBL gain of 2.8 +/- 0.8 mm (p<0.001). RAL gains of > or =4 mm were measured in 90% of the test defects and in 55% of the controls. PBL gains of > or =4 mm were obtained in 85% of the test defects and in 25% of the control ones. The test treatment resulted in statistically higher PPD reductions, RAL gains and PBL gains compared with the control (p<0.01). CONCLUSIONS: Within their limits, the present results indicate that: (i) at 1 year after surgery, both therapies resulted in statistically significant clinical improvements compared with baseline and (ii) although the combination of EMD+AB resulted in statistically significant higher soft and hard tissue improvements compared with treatment with EMD, the clinical relevance of this finding is unclear.

The quassinoid derivative NBT-272 targets both the AKT and ERK signaling pathways in embryonal tumors

The quassinoid analogue NBT-272 has been reported to inhibit MYC, thus warranting a further effort 7to better understand its preclinical properties in models of embryonal tumors (ET), a family of childhood malignancies sharing relevant biological and genetic features such as deregulated expression of MYC oncogenes. In our study, NBT-272 displayed a strong antiproliferative activity in vitro that resulted from the combination of diverse biological effects, ranging from G(1)/S arrest of the cell cycle to apoptosis and autophagy. The compound prevented the full activation of both eukaryotic translation initiation factor 4E (eIF4E) and its binding protein 4EBP-1, regulating cap-dependent protein translation. Interestingly, all responses induced by NBT-272 in ET could be attributed to interference with 2 main proproliferative signaling pathways, that is, the AKT and the MEK/extracellular signal-regulated kinase pathways. These findings also suggested that the depleting effect of NBT-272 on MYC protein expression occurred via indirect mechanisms, rather than selective inhibition. Finally, the ability of NBT-272 to arrest tumor growth in a xenograft model of neuroblastoma plays a role in the strong antitumor activity of this compound, both in vitro and in vivo, with its potential to target cell-survival pathways that are relevant for the development and progression of ET.

Effect of enamel matrix derivative and parathyroid hormone on bone formation in standardized osseous defects: an experimental study in minipigs

Previous experimental studies have indicated that locally administered enamel matrix derivative (EMD) and parathyroid hormone (PTH) may have a stimulatory effect on bone formation. However, it is not clear if the positive effect of EMD is related to its effect on the periodontium as a whole or directly on the bone-forming cells. In addition, it is not known if the presentation of PTH by adding the amino acid sequence Arg-Gly-Asp (RGD) is essential for its osteopromotive effect. Local delivery of a bioactive substance at the right time and in the right concentration often constitutes a major challenge. Polyethylene glycol-based hydrogel (PEG) is a degradable vehicle developed for delivery of bioactive proteins. To enhance the mechanical stability of the PEG-bioactive substance complex, an osteoconductive bone substitute material is often needed.

Mechanisms of osteoclastogenesis inhibition by a novel class of biphenyl-type cannabinoid CB(2) receptor inverse agonists

The cannabinoid CB(2) receptor is known to modulate osteoclast function by poorly understood mechanisms. Here, we report that the natural biphenyl neolignan 4'-O-methylhonokiol (MH) is a CB(2) receptor-selective antiosteoclastogenic lead structure (K(i) < 50 nM). Intriguingly, MH triggers a simultaneous G(i) inverse agonist response and a strong CB(2) receptor-dependent increase in intracellular calcium. The most active inverse agonists from a library of MH derivatives inhibited osteoclastogenesis in RANK ligand-stimulated RAW264.7 cells and primary human macrophages. Moreover, these ligands potently inhibited the osteoclastogenic action of endocannabinoids. Our data show that CB(2) receptor-mediated cAMP formation, but not intracellular calcium, is crucially involved in the regulation of osteoclastogenesis, primarily by inhibiting macrophage chemotaxis and TNF-α expression. MH is an easily accessible CB(2) receptor-selective scaffold that exhibits a novel type of functional heterogeneity.

Four-year results following treatment of intrabony periodontal defects with an enamel matrix derivative alone or combined with a biphasic calcium phosphate

The aim of this study was to evaluate the 4-year clinical outcomes following regenerative surgery in intrabony defects with either EMD + BCP or EMD. Twenty-four patients with advanced chronic periodontitis, displaying one-, two-, or three-walled intrabony defect with a probing depth of at least 6 mm, were randomly treated with either EMD + BCP (test) or EMD alone (control). The following clinical parameters were evaluated at baseline, at 1 year and at 4 years after regenerative surgery: plaque index, gingival index, bleeding on probing, probing depth, gingival recession, and clinical attachment level (CAL). The primary outcome variable was CAL. No differences in any of the investigated parameters were observed at baseline between the two groups. The test group demonstrated a mean CAL change from from 10.8 ± 1.6 mm to 7.4 ± 1.6 mm (p < 0.001) and to 7.6 ± 1.7 mm (p < 0.001) at 1 and 4 years, respectively. In the control group, mean CAL changed from 10.4 ± 1.3 at baseline to 6.9 ± 1.0 mm (p < 0.001) at 1 year and 7.2 ± 1.2 mm (p < 0.001) at 4 years. At 4 years, two defects in the test group and three defects in the control group have lost 1 mm of the CAL gained at 1 year. Compared to baseline, at 4 years, a CAL gain of ≥3 mm was measured in 67% of the defects (i.e., in 8 out of 12) in the test group and in 75% of the defects (i.e., in 9 out of 12) in the control group. There were no statistically significant differences in any of the investigated parameters at 1 and at 4 years between the two groups. Within their limits, the present results indicate that: (a) the clinical improvements obtained with both treatments can be maintained over a period of 4 years, and (b) in two- and three-walled intrabony defects, the addition of BCP did not additionally improve the outcomes obtained with EMD alone. In two- and three-walled intrabony defects, the combination of EMD + BCP did not show any advantage over the use of EMD alone.