Immunolocalization of AQP5 in resting and stimulated normal labial glands and in Sjogren's syndrome.

OBJECTIVE: In our current work in vivo examination of AQP5 distribution in labial salivary glands following stimulation of secretion has been done in normal individuals and in Sjogren's syndrome patients. SUBJECTS AND METHODS: For this study, we selected 5 patients with primary Sjogren's syndrome (mean age 62,4 + 10,6 SD years) diagnosed in accordance with the European Cooperative Community classification criteria. There were 5 patients (mean age 27 + 2,5 SD years) in the control group. The subcellular distribution of AQP5 in human labial gland biopsies was determined with light and immunoelectron microscopy before and 30 min after administration of oral pilocarpine. RESULTS: In unstimulated control and Sjogren's labial glands AQP5 is about 90% localized in the apical plasma membrane, with only rarely associated gold particles with intracellular membrane structures. We have found no evidence of pilocarpine-induced changes in localization of AQP5 in either healthy individuals or Sjogren's patients. CONCLUSIONS: Our studies indicate that neither Sjogren's syndrome itself, nor muscarinic cholinergic stimulation in vivo caused any significant changes in the distribution of AQP5 in the labial salivary gland cells. This article is protected by copyright. All rights reserved

Prioritising drugs for single patient (n-of-1) trials in palliative care

Many of the drugs prescribed commonly to palliative care patients have potentially significant side-effects and are of unproven benefit. The acquisition of evidence to support the prescribing of these drugs has been very slow. Single patient trials (SPTs) (also known as n-of-1 trials) offer a potential means of obtaining the evidence necessary to support or refute the use of several of the drugs and interventions whose use is currently based on physician experience or anecdote alone. A list of SPTs considered “most urgent”, for commonly employed treatments and for the most common and most troublesome symptoms in palliative care is presented. These are drugs for which the gap between evidence and practice is greatest, where the evidence of efficacy is most lacking, where significant side effects potentially lead to the greatest morbidity, or where cost is a major patient burden. Although not all the drugs used in palliative care are suitable, SPTs provide a potential alternative method of gathering evidence in palliative care