Imprinted contact lenses for sustained release of polymyxin B and related antimicrobial peptides

The aim of this work was to develop drug-soft contact lens combination products suitable for controlled release of antimicrobial peptides on the ocular surface. Incorporation of functional monomers and the application of molecular imprinting techniques were explored to endow 2-hydroxyethyl methacrylate (HEMA) hydrogels with the ability to load and to sustain the release of polymyxin B and vancomycin. Various HEMA–drug–functional monomer–cross–linker molar ratios were evaluated to prepare polymyxin B imprinted and non-imprinted hydrogels. Acrylic acid-functionalized and imprinted hydrogels loaded greater amounts of polymyxin B and led to more sustained release profiles, in comparison with non-functionalized and non-imprinted networks. Polymyxin B-loaded hydrogels showed good biocompatibility in hen’s egg test-chorioallantoic membrane tests. Functionalized hydrogels also loaded vancomycin and sustained its release, but the imprinting effect was only exhibited with polymyxin B, as demonstrated in rebinding tests. Microbiological assays carried out with Pseudomonas aeruginosa allowed identification of the most suitable hydrogel composition for efficient bacteria eradication; some hydrogels being able to stand several continued challenges against this important bacterial pathogen

Design of the Prevention of Adult Caries Study (PACS): A randomized clinical trial assessing the effect of a chlorhexidine dental coating for the prevention of adult caries

<p>Abstract</p> <p>Background</p> <p>Dental caries is one of the primary causes of tooth loss among adults. It is estimated to affect a majority of Americans aged 55 and older, with a disproportionately higher burden in disadvantaged populations. Although a number of treatments are currently in use for caries prevention in adults, evidence for their efficacy and effectiveness is limited.</p> <p>Methods/Design</p> <p>The Prevention of Adult Caries Study (PACS) is a multicenter, placebo-controlled, double-blind, randomized clinical trial of the efficacy of a chlorhexidine (10% w/v) dental coating in preventing adult caries. Participants (n = 983) were recruited from four different dental delivery systems serving four diverse communities, including one American Indian population, and were randomized to receive either chlorhexidine or a placebo treatment. The primary outcome is the net caries increment (including non-cavitated lesions) from baseline to 13 months of follow-up. A cost-effectiveness analysis also will be considered.</p> <p>Discussion</p> <p>This new dental treatment, if efficacious and approved for use by the Food and Drug Administration (FDA), would become a new in-office, anti-microbial agent for the prevention of adult caries in the United States.</p> <p>Trial Registration Number</p> <p>NCT00357877</p

Design of the Prevention of Adult Caries Study (PACS): a randomized clinical trial assessing the effect of a chlorhexidine dental coating for the prevention of adult caries

Abstract Background Dental caries is one of the primary causes of tooth loss among adults. It is estimated to affect a majority of Americans aged 55 and older, with a disproportionately higher burden in disadvantaged populations. Although a number of treatments are currently in use for caries prevention in adults, evidence for their efficacy and effectiveness is limited. Methods/Design The Prevention of Adult Caries Study (PACS) is a multicenter, placebo-controlled, double-blind, randomized clinical trial of the efficacy of a chlorhexidine (10% w/v) dental coating in preventing adult caries. Participants (n = 983) were recruited from four different dental delivery systems serving four diverse communities, including one American Indian population, and were randomized to receive either chlorhexidine or a placebo treatment. The primary outcome is the net caries increment (including non-cavitated lesions) from baseline to 13 months of follow-up. A cost-effectiveness analysis also will be considered. Discussion This new dental treatment, if efficacious and approved for use by the Food and Drug Administration (FDA), would become a new in-office, anti-microbial agent for the prevention of adult caries in the United States. Trial Registration Number NCT0035787

An inverse-breathing encapsulation system for cell delivery

Cell encapsulation represents a promising therapeutic strategy for many hormone-deficient diseases such as type 1 diabetes (T1D). However, adequate oxygenation of the encapsulated cells remains a challenge, especially in the poorly oxygenated subcutaneous site. Here, we present an encapsulation system that generates oxygen (O2) for the cells from their own waste product, carbon dioxide (CO2), in a self-regulated (i.e., "inverse breathing") way. We leveraged a gas-solid (CO2-lithium peroxide) reaction that was completely separated from the aqueous cellular environment by a gas permeable membrane. O2 measurements and imaging validated CO2-responsive O2 release, which improved cell survival in hypoxic conditions. Simulation-guided optimization yielded a device that restored normoglycemia of immunocompetent diabetic mice for over 3 months. Furthermore, functional islets were observed in scaled-up device implants in minipigs retrieved after 2 months. This inverse breathing device provides a potential system to support long-term cell function in the clinically attractive subcutaneous site

Insulin Degradation by Acinar Cell Proteases Creates a Dysfunctional Environment for Human Islets Before/After Transplantation: Benefits of α-1 Antitrypsin Treatment

BACKGROUND: Pancreatic acinar cells are commonly co-transplanted along with islets during auto-and allo-transplantations. The aims of this study were to identify how acinar cell proteases cause human islet cell loss before and after transplantation of impure islet preparations and to prevent islet loss and function with supplementation of alpha-1 antitrypsin (A1AT). METHODS: Acinar cell protease activity, insulin levels, and percent islet loss were measured after culture of pure and impure clinical islet preparations. The effect of proteases on ultra-structure of islets and beta cell insulin granules were examined by transmission electron microscopy (TEM). The number of insulin granules and insulin-labeled immune-gold particles were counted. The in vivo effect of proteases on islet function was studied by transplanting acinar cells adjacent to islet grafts in diabetic mice. The effects of A1AT culture supplementation on protease activity, insulin levels, and islet function were assessed in pure and impure islets. RESULTS: Islet loss after culture was significantly higher in impure relative to pure preparations (30 vs. 14%, p<0.04). Lower islet purity was associated with increased protease activity and decreased insulin levels in culture supernatants. Reduced beta cell insulin granules and insulin degradation by proteases were confirmed by TEM. Transplantation results showed delayed islet graft function when acinar cells were transplanted adjacent to the islets under the kidney capsule. Supplementation of A1AT to impure islet cultures maintained islet mass, restored insulin levels, and preserved islet functional integrity. CONCLUSIONS: Culture of impure islets in the presence of A1AT prevents insulin degradation and improves islet recovery