Melittin disruption of raft and non-raft-forming biomimetic membranes: A study by quartz crystal microbalance with dissipation monitoring

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Melittin disruption of raft and non-raft-forming biomimetic membranes: A study by quartz crystal microbalance with dissipation monitoring

In this work we examine the role of lateral phase separation in cholesterol-containing biomimetic membranes on the disrupting action of melittin using a label-free surface-sensitive technique, quartz crystal microbalance with dissipation monitoring (QCM-D). Melittin disruption mechanisms depend strongly on the geometry of the lipid layer; however, despite the interplay between layer geometry/thickness and melittin activity, results indicate that the presence of lipid heterogeneity and lateral phase separation greatly influences the disrupting efficiency of melittin. In homogeneous non-raft forming membranes with high cholesterol content, melittin spontaneous activity is strongly delayed compared to heterogeneous raft-forming systems with the same amount of cholesterol. These results confirm the importance of lateral phase separation as a determinant factor in peptide activity. The information provided can be used for the design of more efficient antimicrobial peptides and the possibility of using a label-free approach for tailored-membranes and interactions with other types of peptides, such as amyloid peptides.info:eu-repo/semantics/publishe

Safety and efficacy of fluoxetine on functional outcome after acute stroke (AFFINITY): a randomised, double-blind, placebo-controlled trial

Background: Trials of fluoxetine for recovery after stroke report conflicting results. The Assessment oF FluoxetINe In sTroke recoverY (AFFINITY) trial aimed to show if daily oral fluoxetine for 6 months after stroke improves functional outcome in an ethnically diverse population. Methods: AFFINITY was a randomised, parallel-group, double-blind, placebo-controlled trial done in 43 hospital stroke units in Australia (n=29), New Zealand (four), and Vietnam (ten). Eligible patients were adults (aged ≥18 years) with a clinical diagnosis of acute stroke in the previous 2–15 days, brain imaging consistent with ischaemic or haemorrhagic stroke, and a persisting neurological deficit that produced a modified Rankin Scale (mRS) score of 1 or more. Patients were randomly assigned 1:1 via a web-based system using a minimisation algorithm to once daily, oral fluoxetine 20 mg capsules or matching placebo for 6 months. Patients, carers, investigators, and outcome assessors were masked to the treatment allocation. The primary outcome was functional status, measured by the mRS, at 6 months. The primary analysis was an ordinal logistic regression of the mRS at 6 months, adjusted for minimisation variables. Primary and safety analyses were done according to the patient's treatment allocation. The trial is registered with the Australian New Zealand Clinical Trials Registry, ACTRN12611000774921. Findings: Between Jan 11, 2013, and June 30, 2019, 1280 patients were recruited in Australia (n=532), New Zealand (n=42), and Vietnam (n=706), of whom 642 were randomly assigned to fluoxetine and 638 were randomly assigned to placebo. Mean duration of trial treatment was 167 days (SD 48·1). At 6 months, mRS data were available in 624 (97%) patients in the fluoxetine group and 632 (99%) in the placebo group. The distribution of mRS categories was similar in the fluoxetine and placebo groups (adjusted common odds ratio 0·94, 95% CI 0·76–1·15; p=0·53). Compared with patients in the placebo group, patients in the fluoxetine group had more falls (20 [3%] vs seven [1%]; p=0·018), bone fractures (19 [3%] vs six [1%]; p=0·014), and epileptic seizures (ten [2%] vs two [<1%]; p=0·038) at 6 months. Interpretation: Oral fluoxetine 20 mg daily for 6 months after acute stroke did not improve functional outcome and increased the risk of falls, bone fractures, and epileptic seizures. These results do not support the use of fluoxetine to improve functional outcome after stroke. Funding: National Health and Medical Research Council of Australia