The aminopeptidase inhibitor CHR-2863 is an orally bioavailable inhibitor of murine malaria

Malaria remains a significant risk in many areas of the world, with resistance to the current antimalarial pharmacopeia an everincreasing problem. The M1 alanine aminopeptidase (PfM1AAP) and M17 leucine aminopeptidase (PfM17LAP) are believed to play a role in the terminal stages of digestion of host hemoglobin and thereby generate a pool of free amino acids that are essential for parasite growth and development. Here, we show that an orally bioavailable aminopeptidase inhibitor, CHR-2863, is efficacious against murine malaria

Robust open cellular porous polymer monoliths made from cured colloidal gels of latex particles

The coagulation of oppositely charged latexes, prepared from the soap-free emulsion polymerisation of styrene using water as the reaction medium, resulted in the obtainment of colloidal gels that were porous in nature and held together by electrostatic interactions. Chemical crosslinking, involving the introduction of a water-soluble crosslinker, resulted in the obtainment of stronger chemical bonds between particles affording a rigid porous material known as a monolith. It was found that, in a simpler approach, these materials could be prepared using a single latex where the addition of ammonium persulfate both resulted in the formation of the colloidal gel and initiated the crosslinking process. The pore size of the resulting monoliths was predictable as this was observed to directly correlate to the particle diameter, with larger pores achieved using particles of increased size. All gels obtained in this work were highly mouldable and retained their shape, which allowed for a range of formats to be easily prepared without the requirement of a mould

Preparation of highly interconnected hydrophilic polymers from emulsion templates with improved mechanical properties

Highly interconnected hydrophilic polymers were prepared through the polymerisation of (paraffin-oil)-in-water emulsion templates using internal phases below 74 vol%. These were stabilised by Tween 85 and contained acrylamide and N,N/-methylene bisacrylamide, as monomers, in the continuous water phase. The emulsification energy was increased, resulting in increased contact between emulsion droplets, allowing open cellular and highly interconnected structures to be achieved. This was coupled with a reduction in the internal phase volume allowing the obtainment of highly interconnected materials with excellent mechanical properties under compression, producing a Young’s modulus of 490 ± 90 MPa for a material with 36 ± 3% porosity. It was also found that the morphology of these materials could be altered through variations in the internal phase volume, the surfactant level and the emulsification energy. These porous polymers also possessed quite different behaviours in different solvent environments suggesting applications in controlled release or as rigid absorbents

Preparation of inverse polymerized high internal phase emulsions using an amphiphilic macro-RAFT agent as sole stabilizer

Oil-in-water (‘inverse’) High Internal Phase Emulsions (HIPEs) have been prepared using an amphiphilic macro-RAFT agent with toluene as the internal dispersed phase (∼80 vol%) and an aqueous monomer solution as the continuous phase. The water phase consisted of the monomers acrylamide (AM) and N,N′-methylenebisacrylamide (MBAM), an initiator as well as the amphiphilic macro-RAFT agent, that is 2-(butylthiocarbonothioylthio)-2-poly(n-butyl acrylate)-b-poly(acrylic acid), which was used as an anionic polymeric surfactant. The presence of these amphiphilic species allowed the successful preparation of a polyHIPE upon polymerization. The effect of concentration of macro-RAFT agent, pH, initiator, hexadecane as an organic modifier and the polymerization temperature on the morphology of the resulting porous materials was investigated. Varying the lengths of the hydrophilic and hydrophobic blocks of the macro-RAFT agent resulted in polyHIPEs with different porous structures. The presence of RAFT functionality in the polyHIPE was confirmed by elemental analysis, EDX-SEM, Raman and FT-IR spectroscopies. Raman mapping revealed full coverage of the void walls with dithiocarbamate groups

Anti-malaria drug development targeting the M1 alanyl and M17 leucyl aminopeptidases

The M1 alanyl aminopeptidase and M17 leucyl aminopeptidase are critical to the growth and development of malaria parasites inside host erythrocytes. Potent aminopeptidase inhibitors kill malaria parasites in culture and are also active in vivo against murine malaria. Functional recombinant enzyme studies have been used to decipher the three-dimensional structures of both enzymes that together with new and specific inhibitors are facilitating structure-activity- relationship (SAR) and functional studies. Here we review the progress made in our knowledge of these two enzymes which is bringing them closer to being validated anti-malarial drug targets

ESICM LIVES 2016: part two : Milan, Italy. 1-5 October 2016.

Meeting abstrac

Initial invasive or conservative strategy for stable coronary disease

BACKGROUND Among patients with stable coronary disease and moderate or severe ischemia, whether clinical outcomes are better in those who receive an invasive intervention plus medical therapy than in those who receive medical therapy alone is uncertain. METHODS We randomly assigned 5179 patients with moderate or severe ischemia to an initial invasive strategy (angiography and revascularization when feasible) and medical therapy or to an initial conservative strategy of medical therapy alone and angiography if medical therapy failed. The primary outcome was a composite of death from cardiovascular causes, myocardial infarction, or hospitalization for unstable angina, heart failure, or resuscitated cardiac arrest. A key secondary outcome was death from cardiovascular causes or myocardial infarction. RESULTS Over a median of 3.2 years, 318 primary outcome events occurred in the invasive-strategy group and 352 occurred in the conservative-strategy group. At 6 months, the cumulative event rate was 5.3% in the invasive-strategy group and 3.4% in the conservative-strategy group (difference, 1.9 percentage points; 95% confidence interval [CI], 0.8 to 3.0); at 5 years, the cumulative event rate was 16.4% and 18.2%, respectively (difference, 121.8 percentage points; 95% CI, 124.7 to 1.0). Results were similar with respect to the key secondary outcome. The incidence of the primary outcome was sensitive to the definition of myocardial infarction; a secondary analysis yielded more procedural myocardial infarctions of uncertain clinical importance. There were 145 deaths in the invasive-strategy group and 144 deaths in the conservative-strategy group (hazard ratio, 1.05; 95% CI, 0.83 to 1.32). CONCLUSIONS Among patients with stable coronary disease and moderate or severe ischemia, we did not find evidence that an initial invasive strategy, as compared with an initial conservative strategy, reduced the risk of ischemic cardiovascular events or death from any cause over a median of 3.2 years. The trial findings were sensitive to the definition of myocardial infarction that was used

Health-status outcomes with invasive or conservative care in coronary disease

BACKGROUND In the ISCHEMIA trial, an invasive strategy with angiographic assessment and revascularization did not reduce clinical events among patients with stable ischemic heart disease and moderate or severe ischemia. A secondary objective of the trial was to assess angina-related health status among these patients. METHODS We assessed angina-related symptoms, function, and quality of life with the Seattle Angina Questionnaire (SAQ) at randomization, at months 1.5, 3, and 6, and every 6 months thereafter in participants who had been randomly assigned to an invasive treatment strategy (2295 participants) or a conservative strategy (2322). Mixed-effects cumulative probability models within a Bayesian framework were used to estimate differences between the treatment groups. The primary outcome of this health-status analysis was the SAQ summary score (scores range from 0 to 100, with higher scores indicating better health status). All analyses were performed in the overall population and according to baseline angina frequency. RESULTS At baseline, 35% of patients reported having no angina in the previous month. SAQ summary scores increased in both treatment groups, with increases at 3, 12, and 36 months that were 4.1 points (95% credible interval, 3.2 to 5.0), 4.2 points (95% credible interval, 3.3 to 5.1), and 2.9 points (95% credible interval, 2.2 to 3.7) higher with the invasive strategy than with the conservative strategy. Differences were larger among participants who had more frequent angina at baseline (8.5 vs. 0.1 points at 3 months and 5.3 vs. 1.2 points at 36 months among participants with daily or weekly angina as compared with no angina). CONCLUSIONS In the overall trial population with moderate or severe ischemia, which included 35% of participants without angina at baseline, patients randomly assigned to the invasive strategy had greater improvement in angina-related health status than those assigned to the conservative strategy. The modest mean differences favoring the invasive strategy in the overall group reflected minimal differences among asymptomatic patients and larger differences among patients who had had angina at baseline