3 research outputs found
Modulação do sistema glutamatérgico por cisplatina em células de glioma humano e astrócitos corticais de ratos
No full textDissertação (mestrado) - Universidade Federal de Santa Catarina, Centro de Ciências Biológicas, Programa de Pós-graduação em Neurociências, Florianópolis, 2013.Gliomas malignos constituem um grupo heterogêneo de tumores, com origem em precursores astrocíticos, abrangendo cerca de 70% de todos os tumores do Sistema Nervoso Central (SNC). Mesmos havendo diversos estudos relacionados e tratamentos, os prognósticos dos pacientes acometidos por esses tumores permanecem ruins. Dentre os tratamentos utilizados o quimioterápico cisplatina (CDDP) é um agente alquilante com atividade antineoplásica. Apesar do amplo espectro de atividade no tratamento de câncer, muitos mecanismos de resistência a essa droga já foram relatados. Gliomas exibem diversos mecanismos de resistência à quimioterapia, além disso, apresentam uma importante alteração no sistema glutamatérgico própria de seu desenvolvimento, que confere resistência, auxiliando na invasibilidade e agressividade tumoral. Assim, objetivo deste estudo foi avaliar o efeito da CDDP sobre o sistema glutamatérgico e mecanismos de resistência em células de glioma humano A172, bem como em culturas primárias de astrócitos corticais de ratos neonatos. CDDP nas concentrações entre 500 e 1000 µM apresenta efeito citotóxico em células de glioma humano. No entanto, astrócitos corticais primários foram mais sensíveis à exposição a CDDP, aprensentando diminuição da viabilidade em menores concentrações (50 e 100 µM). CDDP 100 µM diminuiu a captação de glutamato tanto em células de glioma A172 quanto em astrócitos corticais, entretanto a CDDP 50 µM apresentou esse efeito apenas nas células de glioma A172. CDDP (50 e 100 µM) aumentou a liberação de glutamato tanto na linhagem de glioma humano quanto nos astrócitos corticais. Em se tratando de transportadores de glutamato, foram observados os níveis de expressão do EAAT-2 em células A172 tratadas com CDDP, sendo que as concentrações que alteraram o transporte não modificaram os níveis de expressão desse transportador. A implicação do trocador cistina-glutamato (sistema Xc-) no aumento da liberação de glutamato em gliomas já é bem descrita, entretanto CDDP (50 e 100 µM) não alterou seus níveis de expressão em células de glioma. CDDP não foi modificou os níveis totais de glutationa, entretanto o inibidor do sistema Xc- (sulfassalazina) causou evidente diminuição desses níveis, demonstrando a implicação da atividade do sistema Xc- nas defesas antioxidantes de células de glioma. A inibição do sistema Xc- preveniu o aumento da liberação de glutamato causado pela CDDP. E o tratamento concomitante com CDDP e sulfassalazina não alterou a viabilidade em células de glioma, sugerindo que a resistência à CDDP apresentada por estas células nas concentrações testadas, ocorre por um mecanismo diferente que a produção de glutationa. Esses resultados apontam que a CDDP pode aumentar o potencial invasivo e agressivo de células de glioma humano A172, elevando níveis extracelulares de glutamato através da modulação da atividade de transportadores glutamatérgicos
Antiinflammatory therapy with canakinumab for atherosclerotic disease
No full textBACKGROUND: Experimental and clinical data suggest that reducing inflammation without affecting lipid levels may reduce the risk of cardiovascular disease. Yet, the inflammatory hypothesis of atherothrombosis has remained unproved. METHODS: We conducted a randomized, double-blind trial of canakinumab, a therapeutic monoclonal antibody targeting interleukin-1β, involving 10,061 patients with previous myocardial infarction and a high-sensitivity C-reactive protein level of 2 mg or more per liter. The trial compared three doses of canakinumab (50 mg, 150 mg, and 300 mg, administered subcutaneously every 3 months) with placebo. The primary efficacy end point was nonfatal myocardial infarction, nonfatal stroke, or cardiovascular death. RESULTS: At 48 months, the median reduction from baseline in the high-sensitivity C-reactive protein level was 26 percentage points greater in the group that received the 50-mg dose of canakinumab, 37 percentage points greater in the 150-mg group, and 41 percentage points greater in the 300-mg group than in the placebo group. Canakinumab did not reduce lipid levels from baseline. At a median follow-up of 3.7 years, the incidence rate for the primary end point was 4.50 events per 100 person-years in the placebo group, 4.11 events per 100 person-years in the 50-mg group, 3.86 events per 100 person-years in the 150-mg group, and 3.90 events per 100 person-years in the 300-mg group. The hazard ratios as compared with placebo were as follows: in the 50-mg group, 0.93 (95% confidence interval [CI], 0.80 to 1.07; P=0.30); in the 150-mg group, 0.85 (95% CI, 0.74 to 0.98; P=0.021); and in the 300-mg group, 0.86 (95% CI, 0.75 to 0.99; P=0.031). The 150-mg dose, but not the other doses, met the prespecified multiplicity-adjusted threshold for statistical significance for the primary end point and the secondary end point that additionally included hospitalization for unstable angina that led to urgent revascularization (hazard ratio vs. placebo, 0.83; 95% CI, 0.73 to 0.95; P=0.005). Canakinumab was associated with a higher incidence of fatal infection than was placebo. There was no significant difference in all-cause mortality (hazard ratio for all canakinumab doses vs. placebo, 0.94; 95% CI, 0.83 to 1.06; P=0.31). CONCLUSIONS: Antiinflammatory therapy targeting the interleukin-1β innate immunity pathway with canakinumab at a dose of 150 mg every 3 months led to a significantly lower rate of recurrent cardiovascular events than placebo, independent of lipid-level lowering. Copyright © 2017 Massachusetts Medical Society
Antiinflammatory therapy with canakinumab for atherosclerotic disease
No full textBackground: Experimental and clinical data suggest that reducing inflammation without affecting lipid levels may reduce the risk of cardiovascular disease. Yet, the inflammatory hypothesis of atherothrombosis has remained unproved. Methods: We conducted a randomized, double-blind trial of canakinumab, a therapeutic monoclonal antibody targeting interleukin-1β, involving 10,061 patients with previous myocardial infarction and a high-sensitivity C-reactive protein level of 2 mg or more per liter. The trial compared three doses of canakinumab (50 mg, 150 mg, and 300 mg, administered subcutaneously every 3 months) with placebo. The primary efficacy end point was nonfatal myocardial infarction, nonfatal stroke, or cardiovascular death. RESULTS: At 48 months, the median reduction from baseline in the high-sensitivity C-reactive protein level was 26 percentage points greater in the group that received the 50-mg dose of canakinumab, 37 percentage points greater in the 150-mg group, and 41 percentage points greater in the 300-mg group than in the placebo group. Canakinumab did not reduce lipid levels from baseline. At a median follow-up of 3.7 years, the incidence rate for the primary end point was 4.50 events per 100 person-years in the placebo group, 4.11 events per 100 person-years in the 50-mg group, 3.86 events per 100 person-years in the 150-mg group, and 3.90 events per 100 person-years in the 300-mg group. The hazard ratios as compared with placebo were as follows: in the 50-mg group, 0.93 (95% confidence interval [CI], 0.80 to 1.07; P = 0.30); in the 150-mg group, 0.85 (95% CI, 0.74 to 0.98; P = 0.021); and in the 300-mg group, 0.86 (95% CI, 0.75 to 0.99; P = 0.031). The 150-mg dose, but not the other doses, met the prespecified multiplicity-adjusted threshold for statistical significance for the primary end point and the secondary end point that additionally included hospitalization for unstable angina that led to urgent revascularization (hazard ratio vs. placebo, 0.83; 95% CI, 0.73 to 0.95; P = 0.005). Canakinumab was associated with a higher incidence of fatal infection than was placebo. There was no significant difference in all-cause mortality (hazard ratio for all canakinumab doses vs. placebo, 0.94; 95% CI, 0.83 to 1.06; P = 0.31). Conclusions: Antiinflammatory therapy targeting the interleukin-1β innate immunity pathway with canakinumab at a dose of 150 mg every 3 months led to a significantly lower rate of recurrent cardiovascular events than placebo, independent of lipid-level lowering. (Funded by Novartis; CANTOS ClinicalTrials.gov number, NCT01327846.
