Structural Basis of Outstanding Multivalent Effects in Jack Bean α-Mannosidase Inhibition

Multivalent design of glycosidase inhibitors is a promising strategy for the treatment of diseases involving enzymatic hydrolysis of glycosidic bonds in carbohydrates. An essential prerequisite for successful applications is the atomic‐level understanding of how outstanding binding enhancement occurs with multivalent inhibitors. Herein we report the first high‐resolution crystal structures of the Jack bean α‐mannosidase (JBα‐man) in apo and inhibited states. The three‐dimensional structure of JBα‐man in complex with the multimeric cyclopeptoid‐based inhibitor displaying the largest binding enhancements reported so far provides decisive insight into the molecular mechanisms underlying multivalent effects in glycosidase inhibition.Instituto de Física de Líquidos y Sistemas Biológico

Complication of facial cellulitis: muscle hematoma after surgical treatment of complicated pericoronitis

Observation: A 24-year-old man was referred to the dental emergency department for the management of a left submandibular cellulitis. The origin was a mandibular third molar. Drainage of the cellulitis and avulsion of the tooth were performed under general anesthesia. The follow-up was marked by a secondary infection of peri-zygomatic hematoma requiring a second drainage procedure. Discussion: The origin of the hematoma was a tear of the insertions of the mandibular elevators secondary to the trismus. The patient underwent two back-to-back general anesthesia procedures with tight trismus making induction and intubation difficult. Conclusion: A two-stage treatment with initial drainage and delayed avulsion after improvement of trismus is discussed

Duration of treatment with bisphosphonates at the time of osteonecrosis of the jaw onset in patients with rheumatoid arthritis. Review.

International audienceIntroductionRheumatoid arthritis (RA) is a frequent and co-morbid condition. One of the main complications is induced osteoporosis. Treatments related to this complication significantly modify oral and implant management. Affected patients represent a population at intermediate risk of osteonecrosis of the jaw (ONJ). The objective was to search the literature for durations of treatment with bisphosphonates at the time of ONJ occurrence in patients with RA in order to obtain an average duration.Materials And MethodsA bibliographic search in the PUBMED/MEDLINE database was carried out using the following equation “(osteonecrosis) AND jaw) AND rheumatoid arthritis” with no time limitation. The primary study endpoint was the duration of treatment with bisphosphonates (BP) at the time of ONJ onset in patients with RA.Results12 articles accounting for 50 patients were included. Patients had had a median of 46.8 months of treatment with BP before ONJ occurred. Mean, minimum and maximum treatment times were 48.68, 6 and 120 months, respectively. The standard deviation was 27.77 months.DiscussionThe median treatment duration in our cohort of patients with RA was less than that reported for osteoporosis. We therefore recommend that practitioners take additional precautions regarding oral surgery or implant procedures, particularly in patients with RA who have been treated with BP for more than 4 years